Medicare reimbursed telehealth exercise physiology services were underutilised through the coronavirus (COVID-19) pandemic: an ecological study

Abstract

Objectives: To describe the quantity and cost of in-person and telehealth exercise physiology (EP) reimbursed under the Medicare Benefits Schedule (MBS) in Australia before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This study uses publicly available MBS data to describe EP services (in-person and telehealth) reimbursed by Medicare between January 2020 and December 2021. Data were extracted at state and national levels. Results: Despite a reduction in quantity and cost in quartile (Q) 2 2020 (41% reduction), MBS-reimbursed EP services have remained relatively constant at a national level through the 2-year observation period. Service claims averaged 88 555 per quarter in 2020 and 95 015 in 2021. The proportion of telehealth consultations relative to total quarterly claims for EP was <1% in Q1 2020, 6.0% in Q2 2020, 2.4% in Q3 2020 and 1.7% in Q4 2020. This dropped to an average of 1.4% across 2021 (Q1-Q4). States undergoing lockdown periods reported decreased service rates relative to February 2020 (i.e. pre-lockdown). EP services were associated with a Medicare expenditure of AUD17.9M in 2020 (telehealth = 2.4% of total) and AUD19.7M (telehealth = 1.5% of total) in 2021. Conclusions: Quantity and cost of MBS-reimbursed EP services remained relatively constant throughout the height of service disruption due to COVID-19 (2020/21). Telehealth uptake during this time has been minimal for EP.