A recent report issued by the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has found that Medicare recipients who reside in urban areas were more likely to use telehealth compared to recipients who reside in rural areas during the first year of the pandemic.
The OIG conducted the study to assess how the COVID-19 pandemic telehealth expansion affected Medicare recipients’ access to care. The data collected by the researchers highlighted who benefited most by the unprecedented expansion to help government agencies to make decisions about whether some of the temporary changes to healthcare should become permanent. The analysis was focused on Medicare recipients who received care via telehealth between March 1, 2020, to February 28, 2021. The data was obtained from Medicare fee-for-service claims data, Medicare Advantage encounter data, and data from the Medicare Enrollments Database. Massachusetts, Delaware, and California had the greatest percentages of telehealth users. The states with the lowest proportion of usage, however, were mostly rural, such North Dakota, Wyoming, Montana, and Nebraska. In 2020, 53% of Medicare and Medicaid recipients who were also dually eligible for telehealth services used telehealth, compared to 40% of those who were solely on Medicare.
The study revealed that Medicare recipients from urban areas were more likely to use telehealth than those from rural areas in the first year of the pandemic. The study also found that dually eligible recipients, Hispanic recipients, younger recipients, and female recipients were also more likely than others to use telehealth. Furthermore, approximately a 20 percent of recipients utilized audio-only telehealth services, with the great majority choosing to use audio-only services exclusively. Both dual eligible and Hispanic recipients as well as older beneficiaries were more likely to use these audio-only programs.
For the OIG, it is crucial for United States legislatures and other stakeholders to address concerns regarding issues such as access, quality of care, cost, health equity, and program integrity before considering telehealth as a permanent method of healthcare treatment. In addressing these concerns, the risks will be kept to a minimum and the advantages of telehealth will be realized. The data from the report demonstrates to stakeholders how the pandemic expansion of telehealth services improved access to care, especially for communities who are typically underserved. Using the data, the OIG recommends stakeholders to take the necessary actions to enable a smooth transition from the current pandemic-related flexibility to thoughtful long-term policies for the use of telehealth for beneficiaries in urban areas and from the beneficiary’s home, momentarily broaden the use of audio only telehealth services and assess their effect, require a modifier to recognize all audio-only telehealth services offered in Medicare, and utilize telehealth to promote health care equity.