Telehealth critical for Medicare beneficiaries in pandemic's first year

Photo: Kilito Chan/Getty Images

Telehealth was a critical lifeline for people in the early days of the COVID-19 pandemic, though this was especially true for Medicare beneficiaries, with more than 28 million beneficiaries using virtual health services during the first year of the public-health emergency, according to a report from the Department of Health and Human Services' Office of the Inspector General.

With more than two in five Medicare recipients using the technology, beneficiaries used 88 times more telehealth services during the first year of the pandemic than they used in the prior year.

Telehealth use peaked in April 2020 and remained high through early 2021; overall, beneficiaries used telehealth to receive 12% of their services during that first year. They employed telehealth most commonly for office visits, which accounted for just under half of all telehealth services used in 2020.

However, beneficiaries' use of telehealth for behavioral health services stands out. Beneficiaries used telehealth for a larger share of their behavioral health services, compared with their use of telehealth for other services. Specifically, beneficiaries used telehealth for 43% of behavioral health services, whereas they used telehealth for 13% of office visits.

WHAT'S THE IMPACT?

The pandemic created significant challenges for how Medicare beneficiaries accessed healthcare. In response, HHS and the Centers for Medicare and Medicaid Services took a number of actions to temporarily expand access to telehealth for Medicare beneficiaries. 

CMS allowed beneficiaries to use telehealth for a wide range of services; it also allowed beneficiaries to use telehealth in different locations, including in urban areas and from the beneficiary's home.

One of HHS' main conclusions, aside from telehealth's ability to provide critical services, is that the technology has long-term potential to increase access for Medicare beneficiaries specifically – especially for services such as mental-health treatment, which showed high utilization in 2020 and beyond.

These findings are important for CMS, Congress and other stakeholders to take into account as they consider making changes to telehealth in Medicare, according to HHS. For example, CMS could use the findings to inform changes to the services that are allowed via telehealth on a permanent basis.

THE LARGER TREND

Telehealth still enjoys widespread popularity among patients, even though its appeal has dimmed somewhat. A December 2021 Rock Health survey found that in 2020, 53% of respondents were more satisfied with live video virtual care than in-person interactions. This satisfaction decreased somewhat in 2021, however, with just 43% of respondents reporting the same.

Rock Health hypothesizes that as the pandemic evolved, consumers began to view telehealth as an alternative to in-person care rather than a necessary replacement. Some of the satisfaction patients felt toward the beginning of the pandemic may have been rooted in gratitude at having any care options at all.

Another possible explanation for the decline among patients is changing usage. In 2020, 33% of telehealth users primarily employed the technology for medical emergencies. Fast forward to 2021, and 32% of users harnessed telehealth for minor illnesses, 20% for medical emergencies and 18% for chronic conditions. This is perhaps a better reflection of the technology's current strengths as a care model well-suited for low-acuity issues.

Some providers, such as Avera Health in South Dakota, have used telehealth technology to implement a remote patient-monitoring program that allows for care inside the home. Dr. Andy Burchett, Avera's chief medical information officer and chair of family medicine, spoke in depth about the program at the HIMSS22 annual conference in Orlando, Florida, last week.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com