In response to the COVID-19 pandemic, the Medicare program provided temporary waivers increasing telehealth flexibility for the duration of the public health emergency (PHE). There are numerous issues for policy makers to address as they consider permanent expansion of these Medicare waivers when the pandemic ends. The goal of this report is to provide information for these policy considerations by analyzing trends in Medicare fee-for-service (FFS) beneficiary use of telehealth compared to in-person visits in 2019 before the COVID-19 pandemic and in 2020 during the pandemic
Telehealth Visit Trends
From FierceHealthcare —
The study, released Friday (PDF) by the Department of Health and Human Services (HHS), comes as advocates are pressing to make key flexibilities the federal government enabled at the start of the pandemic to be permanent. Even as telehealth use increased, there was still a decrease in Part B visits to doctors’ offices.
“Our findings show net decline in healthcare utilization in 2020—despite large increase in telehealth—underscore the need to carefully consider the extension of Medicare telehealth flexibilities after the pandemic ends and evaluate the impacts of telehealth on patient access, healthcare quality and health outcomes,” the report said.
- The number of Medicare fee-for-service (FFS) beneficiary telehealth visits increased 63-fold in 2020, from approximately 840,000 in 2019 to nearly 52.7 million in 2020.
- Despite the increase in telehealth visits during the pandemic, total utilization of all Medicare FFS Part B clinician visits declined about 11% in 2020 compared to levels in 2019.
- Most beneficiaries (92%) received telehealth visits from their homes, which was not permissible in Medicare prior to the pandemic.
- Prior to the pandemic, telehealth made up less than 1% of visits across all visit specialties but increased substantially in 2020. Telehealth increased to 8% of primary care visits, while specialty care had smallest shift towards telehealth (3% of specialist visits).
- Visits to behavioral health specialists showed the largest increase in telehealth in 2020. Telehealth comprised a third of total visits to behavioral health specialists. While data limitations preclude clear identification of audio-only telehealth services, up to 70% of these telehealth visits during 2020 were potentially reimbursable for audio-only services.
- Black and rural beneficiaries had lower use of telehealth compared with White and urban beneficiaries, respectively. Telehealth use varied by state, with higher use in the Northeast and West, and lower in the Midwest and South.