Telehealth barriers in maternal fetal medicine providers by patient insurance status

Abstract

Telehealth has the potential to improve access to care and decrease health disparities. The use of telehealth has increased following the Covid-19 pandemic. However, little is known on the variations in telehealth utilization by Maternal Fetal Medicine (MFM) providers and its relationship to patient insurance status. We aimed to assess differences in maternal fetal medicine physician telehealth usage by percentage of Medicaid-covered patients. We conducted a web-based, anonymous survey of Society for Maternal-Fetal Medicine membership in December 2020, amid the Covid-19 pandemic. Users of telehealth were defined by reported use of live video teleconferencing before or after the start of the Covid-19 pandemic. Comparisons by percentage of Medicaid-covered patients were performed using Fisher’s exact test and a p-value of < 0.05 was considered significant. Out of the total completed surveys, 328 (88%) were users of telehealth. Respondents practiced in the South (31%), West (28%), Northeast (21%), and Midwest (20%). Of the total respondents, 52% reported practicing in a university hospital setting. There was no difference in telehealth user status by the percentage of patients covered by Medicaid. There were no differences in provider-reported barriers to telehealth usage by percentage of publicly insured patients in their practice. 40% of respondents cited reimbursement / insurance coverage as a barrier to telehealth, though this was not different in practices with majority Medicaid patient populations (p =1.00). Half of the respondents across payer mix reported patient access to internet or data plans as a barrier to telehealth implementation. A majority of MFM providers offer telehealth services, with providers facing similar barriers, independent of patient insurance status. These results suggest an opportunity to improve overall uptake of telehealth for providers across a diverse payer mix.View Large Image Figure ViewerDownload Hi-res image Download (PPT)