The Health Care Cost Institute (HCCI) has released six policy briefs assessing the impact of a range of national and state policies on healthcare costs and utilization, and the findings seem to span the entire range of the healthcare spectrum. There is one finding, though, that seems to stand out among the others: The entire reimbursement for telehealth services is nearly 40 percent lower than nontelehealth care.

According to the report, telehealth claims submitted by primary care providers have increased from 1,246 claims in 2009 to 2,558 in 2013, yet they continued to be reimbursed at lower rates. Only seven states have passed laws that mandate reimbursement parity between telehealth and nontelehealth care, so the two services equaling each other in regard to reimbursement in the near future seems unlikely.

Though the other findings are not nearly as shocking as the telehealth news, they are insightful to helping paint a fuller picture of healthcare. Specifically, findings include:

  • Provider consolidation drives up spending on cancer treatment. An analysis by the University of Chicago found the consolidation of outpatient practices drove significant increases in cancer treatment spending in large part because of the additional facility fees that hospital outpatient departments and their affiliated clinics are able to charge insurers. Consolidation also appears to increase the use of more expensive medicines and other outpatient care components.
  • Unrestricted access to physical therapy reduces opioid use and lowers costs. Seeing a physical therapist as the first point of care for lower back pain reduces potentially costly services later on, including emergency department visits and use of prescription opioids, according to the University of Washington and colleagues.
  • Nurse practitioners push down the price of primary care. The University of California San Francisco and colleagues examined the effects of independent scope-of-practice laws in states from 2008 through 2012, which allow nurse practitioners to treat patients without a supervising physician. They found that prices for primary care services fell by 1 percent to 4 percent. However, overall spending on healthcare increased.
  • Designing insurance benefits to incentivize patients to choose low-priced providers for colonoscopies can lead to savings of 8.5 percent per procedure. The University of California Berkeley estimate that if just three health insurers — Aetna, Humana and UnitedHealthcare — adopted a reference-based payments program for colonoscopies, U.S. medical spending would decrease by approximately $95 million per year. These estimates were modeled on the healthcare savings of the California Public Employees' Retirement System (CalPERS).
  • Mental health law has limited effect on access to mental health services. The University of Colorado School of Medicine and colleagues found that the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) has had little to no effect on access and use of mental health services for patients with depression, bipolar or schizophrenia.

The briefs were developed by independent researchers using HCCI's repository of commercial claims data for more than 50 million insured Americans, one of the largest private health insurance claims databases of its kind.

"Currently, we have limited information on the effects of reforms happening at the state and national levels," said HCCI senior researcher Amanda Frost in a statement. "We believe that this data-driven research will build a knowledge base about the changing healthcare landscape, and serve as a resource for policymakers and consumers alike."

HCCI holds de-identified Health Insurance Portability and Accountability Act (HIPAA) compliant claims data from three of the nation's largest health insurance providers. The data represent the healthcare activity of more than 25 percent of the nation's privately insured population.

The briefs were developed through HCCI's State Health Policy Grant Program, which was funded by a $1.5 million grant from the Laura and John Arnold Foundation, and carried out in partnership with the National Academy for State Health Policy.

The full report can be accessed here.