Telehealth Use Spikes During the Pandemic, but a Digital Divide Remains
BHI co-authored a recently published study in JAMA Network Open that found almost 24% of privately insured working-age individuals used telehealth for outpatient care in the early phase of the pandemic compared to just 0.3% during the same time in 2019.
However, persons living in areas with limited social resources were significantly less likely to use telehealth, suggesting barriers to digitally-enabled care in disadvantaged communities.
The cohort study for more than 36 million U.S. individuals set out to document patterns of ambulatory care before and during the initial stage of the pandemic and to assess the factors associated with telehealth adoption.
The study found that:
In-person ambulatory patient visits decreased by 37% from March to June 2020 compared with the same period in 2019. Telehealth filled half of the gap so that the overall COVID-19-era patient and practitioner visit rate was 18% lower than that of 2019.
Behavioral health encounters were far more likely than medical contacts to take place virtually.
The impact of COVID-19 and telehealth on health plan finances
Health plans’ financial impacts from the beginning of the pandemic were complicated, the study found:
Blue Company enrollees’ medical care costs decreased by 15% between 2019 and 2020. And yet, during 2020, members with one or more COVID-19-related service encounters incurred more than three times the medical costs.
Members with one or more telehealth visits in 2020 had considerably higher costs than persons having only in-person ambulatory contacts.
All of this suggests that regulators who determine telehealth policies and reimbursement must think carefully about barriers and facilitators to telehealth usage. Fixing the digital divide across social and geographic lines won’t be easy. And as the study notes, we need a better understanding of costs, utilization, and outcome differences among those using and not using telehealth services. BHI welcomes the opportunity to play a pivotal role in this future research.
