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On 15th October early hours , USA CMS Administrator Seem Verma announced on twitter ”

In an effort to provide greater transparency to our state partners & the public, @CMSGov is releasing, for the first time, a preliminary #Medicaid & CHIP data snapshot on #telehealth utilization during the #COVID19 Public Health Emergency ”

Lets provide you the detail analysis and snapshot provided by her here in this post

Services Delivered via Telehealth Among Medicaid & CHIP Beneficiaries During COVID-19

Preliminary Medicaid & CHIP Data Snapshot Services through June 30, 2020

Contents

Medicaid & CHIP Overview

Services Delivered via Telehealth in Medicaid & CHIP

What You Should Know When Using the Data

Services Delivered via Telehealth, Results

Age and Telehealth

State Variation in Telehealth

Appendix A: State Variation in Other Services Claims Lag

Medicaid & CHIP Content Overview

Medicaid and CHIP Population: As of June 2020, over 91.8 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities, were enrolled across each state’s Medicaid or the Children’s Health Insurance Program for at least one day in the year. About 42% of beneficiaries were children, which translates to nearly 40 million beneficiaries. Approximately 55% of beneficiaries were female, 45% were male, and 9% were over the age of 65. 13% of the population is dually-eligible for Medicare and Medicaid. 34% of the population is white, 22% of the population is of unknown race, 21% is Hispanic, 17% is black, 4% is Asian, and less than 1 percent is American Indian and Alaska Native, Hawaiian/Pacific Islander, or multiracial.

Medicaid and CHIP Data Processing: Medicaid and CHIP providers, managed care agencies, and Pharmacy Benefit Managers submit administrative claims data to state Medicaid and CHIP agencies for processing. Those agencies subsequently submit the data to CMS on a monthly basis via T-MSIS. These submissions have considerable variation in terms of completeness and quality. CMS processes states’ submissions and transforms them into the T-MSIS Analytic Files (TAF), which form the basis of this analysis. Given this process, there may be a significant “claims lag” between when a service occurs and when it is represented in TAF. Therefore, users should interpret the results with caution.

Data Quality Concerns: The results include services through the end of June 2020. They are based on August T- MSIS submissions with services through the end of July. Recent dates of service have very little time for claims runout and we expect large changes in the results after each monthly update. Because data for July are mostly incomplete, results are only presented through June.

Services Delivered via Telehealth in Medicaid & CHIP

Type of service delivered via telehealth Description Evaluation and management services Routine office visits provided via video Virtual check-ins Remote evaluations of recorded video or images submitted by an established patient followed by a brief (5-10 minute) check-in with a physician or other provider via telephone or other telecommunications device to decide whether an office visit or other service is needed Asynchronous electronic communication Communication with an established patient through a patient portal or other online method, resulting in a digital evaluation and management service Remote patient monitoring Use of digital technologies to collect and transmit health data from individuals to health care providers Critical care or interprofessional consults Consultative services provided through digital technologies Other telehealth visits Any other services provided via telehealth     To identify services delivered via telehealth, we used a combination of Current Procedural Terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes, place of service codes, and procedure code modifiers.

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What You Should Know When Using The Data

Claims Lag: Use caution when interpreting the data. We collect Medicaid and CHIP data for programmatic purposes, but not for public health surveillance. There will always be a delay, or “claims lag”, between when a service occurs and when the claim or encounter for that service is reflected in our database. The length of the lag depends on the submitting state, claim type, and the delivery system. It is possible that there is a longer claims lag due to the pandemic. For Medicaid and CHIP data, no claims are submitted to CMS in the same month the service was delivered.

Other Services Claims: This telehealth analysis relies on claims from the Other Services file. This file contains outpatient facility claims and professional claims. Claims for services in the Other Services file include but are not limited to: physician services, outpatient hospital services, dental services, other physician services (e.g., chiropractors, podiatrists, psychologists, optometrists, etc.), clinic services, laboratory services, X-ray services, sterilizations, home health services, personal support services, and managed care capitation payments. Historically, 90% of both FFS and encounter Other Services claims are submitted within 6 months. There is significant variation across states in terms of claims submissions. Some states submit 90% of all other services claims within only 3 months, while other states take nearly a year.

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Preliminary data suggest that services delivered via telehealth increased from February through April 2020

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Preliminary data suggest that services delivered via telehealth were highest among working age adults, followed by children and older adults

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Preliminary data suggest that, among children, services delivered via telehealth per 1,000 beneficiary months from March through June 2020 varied across states

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Preliminary data suggest that, among adults age 19 to 64, services delivered via telehealth per 1,000 beneficiary months from March through June 2020 varied across states

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Preliminary data suggest that services delivered via telehealth (paid by Medicaid) per 1,000 beneficiary months from March through June 2020 was lowest among beneficiaries age 65+ across most states

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Appendix A: State Variation in Other Services Claims Lag

Claims Lag: Use caution when interpreting the data. We collect Medicaid and CHIP data for programmatic purposes, but not for public health surveillance. There will always be a delay, or “claims lag”, between when a service occurs and when the claim or encounter for that service is reflected in our database. The length of the lag depends on the submitting state, claim type, and the delivery system. It is possible that there is a longer claims lag due to the pandemic. For Medicaid and CHIP data, no claims are submitted to CMS in the same month the service was delivered.

Percent of Medicaid & CHIP Other Services claims received by months after service was delivered (based on March 2018 service date) Months after service 1 2 3 4 5 6 Fastest claims submission, Other Services Claims % Colorado 58.0 86.9 91.6 95.1 96.1 97.2 Nebraska 49.7 83.4 90.9 93.5 94.8 96.4 South Dakota 40.3 84.6 92.8 95.8 97.0 98.4 Arkansas 39.1 80.8 87.8 90.4 93.2 96.1 Longest claims submission, Other Services Claims % Hawaii 5.0 43.8 76.6 85.7 88.3 89.7 Illinois 4.9 33.2 48.7 60.3 63.3 74.2 Missouri 2.9 46.4 79.7 86.0 88.2 90.0 Puerto Rico 1.1 48.2 87.7 95.2 98.5 99.2    

This telehealth analysis relies on claims from the Other Services file. Historically, 90% of both FFS and encounter Other Services claims are submitted within 6 months. There is significant variation across states in terms of claims submissions. Some states submit 90% of all Other Services claims within only 3 months, while other states take nearly a year.

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Source of above information – https://www.medicaid.gov/resources-for-states/downloads/medicaid-chip-beneficiaries-COVID-19-snapshot-data-through-20200630.pdf

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