Patterns of Telehealth Use During Pregnancy and Postpartum Among Commercially Insured Women

This study assesses telehealth use during pregnancy and postpartum among commercially insured women with live birth from 2019 to 2021. It also assesses differences in telehealth use by rural/urban status and describes the most frequently utilized services.

We used the Merative MarketScan Commercial database for women aged 15-49 who had a live birth delivery between 2019 and 2021, with continuous insurance enrollment for 10 months predelivery and 12 months postdelivery. We described patient characteristics stratified by telehealth user (TU) versus non-telehealth user (NTU) for all cohorts based on year of delivery. The major diagnostic categories (MDCs) were used to assess service types of telehealth use.

The total telehealth visits during predelivery and postpartum periods were 60,655 in 2019; 204,935 in 2020; and 276,425 in 2021. An increasing proportion of telehealth visits occurred in the predelivery period (2.8% in 2019, 24.2% in 2020, and 46.1% in 2021). Across all cohorts, a higher proportion of TUs had diabetes (9.9%-12.8% versus 6.2%-7.3%), hypertension (6.0-6.6% versus 3.7%-4.4%), and depression (6.4%-7.6% versus 1.3-2.3%) compared with NTUs. Lower proportion of TUs lived in rural areas compared with NTUs (6.6%-7.3% versus 11.2%-13.0%). The MDC for mental health services was present for greater than 50% of telehealth visits during postpartum.

Increased telehealth visits for mental health services among pregnant and postpartum women suggest more accessible care or heightened mental health needs. Further research may determine if increased telehealth use improves maternal and birth outcomes.