DURHAM N.C. – Blue Cross Blue Shield of North Carolina (Blue Cross NC) today shared key findings from a two-year review of the company’s telehealth claims data and details of its new telehealth policy taking effect in 2023. In March 2020, Blue Cross NC was one of the first insurers in the nation to quickly respond to the pandemic by expanding coverage to pay doctors and facilities the same as in-person visits for all video and audio-only visits. Findings in the study show an overwhelming demand for behavioral health and primary care services through telehealth.
“The pandemic has radically changed how members prefer to access care,” said Dr. Stephen Friedhoff, senior vice president of Health Care Services at Blue Cross NC. “The substantial increase of telehealth usage during the pandemic has provided two years of member data that is more informative than the entire 20 years prior when our company first began covering telehealth. Blue Cross NC is responding to ensure our policies reflect these findings by expanding telehealth options so members can access easy, affordable care no matter where they live.”
Delivering on its commitment to implement a telehealth strategy extending beyond the pandemic, Blue Cross NC will update its telehealth policy, effective Jan. 1, 2023, to significantly expand its list of covered telehealth services, compared to services covered prior to the pandemic.
The new telehealth policy will cover telehealth services for behavioral health, primary care and outpatient visits, which accounted for more than 97% of telehealth claims received during the last two years. In consultation with health care providers, some services were identified as less effective or inappropriate to conduct virtually and will not be covered when provided via telehealth, for example, surgery, anesthesia, laboratory testing and radiology.
The new policy will apply to all Blue Cross NC fully insured and administrative services only (ASO) plans, including the State Health Plan. However, it does not apply to Blue Cross NC members receiving care from out-of-state providers. Members who do not have a commercial plan can find more information about their telehealth coverage below.
- Medicare Advantage members should review their evidence of coverage.
- Healthy BlueSM members have certain telehealth visits covered at parity under Medicaid benefits determined by the state
- Federal Employee Program members can find details in their Service Benefit Plan Brochure.
“This post-pandemic policy reaffirms our commitment to telehealth and serves as the foundation we will build on in the future as we continue to study patterns in telehealth usage,” said Friedhoff.
Based on claims received during the pandemic for all commercial plans offered and administered by Blue Cross NC, including the State Health Plan, findings include:
- In 2020 alone, Blue Cross NC experienced a 7,500% increase in telehealth claims
- In 2020, total member telehealth visits for behavioral health and primary care exceeded 2.7 million, accounting for more than 92% of all telehealth visits
- In 2021, 59 medical services accounted for 99% of all paid telehealth claims
- Out of all claims in 2020 (both in-person and virtual), telehealth visits accounted for:
- 47% of behavioral health visits
- 10% of family medicine visits
- 9% of primary care visits
- 7% of pediatric visits
- 4% of OB/GYN visits
- 2% of specialist visits
“While we still have much to learn about how telehealth impacts health outcomes, these findings have helped and will continue to inform our future telehealth offerings to make care more accessible and affordable for our members,” said Friedhoff.
Members should talk with their doctor or call the number on the back of their Blue Cross NC member ID card to learn more about accessing telehealth benefits.
About Blue Cross and Blue Shield of North Carolina
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to making health care better, simpler and more affordable. We have been driving better health in North Carolina since 1933, working to tackle our communities’ greatest health challenges. Blue Cross NC serves its customers and communities of more than 4.2 million members, including approximately 1.1 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at www.bluecrossnc.com. All other marks are the property of their respective owners.
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