In the beginning of the COVID-19 pandemic, the U.S. federal government implemented temporary Medicare policy changes as part of the public health emergency. Coverage for telehealth was expanded resulting in a large increase in telehealth utilization. As the amount of COVID-19 cases continue to diminish, federal and state policy makers are considering permanent telehealth policy options. A recent study conducted by researchers at the University of Michigan may be used as evidence for the continued extensive use of telehealth in healthcare provision.
Telehealth has often been criticized for encouraging excessive use which will result in unnecessary appointments and expenses. However, according to the new study, this is not applicable to the Medicare market. The study consisted of analyzing data from part B claims of Medicare fee-for-service beneficiaries. From January 1, 2019, through December 31, 2021, beneficiaries who received outpatient evaluation and management (E&M) services were tracked down.The researchers then determined the monthly percentage of outpatient E&M services delivered both in-person and via telehealth.
The study found that in April 2020, monthly telehealth services peaked, consisting of roughly half of all monthly E&M services. By the second half of 2021,telehealth consisted of just under 10% of monthly E&M services. The study also found that in 2021, roughly 33% of individuals under Medicare coverage used at least one telehealth service. There were limited differences between telehealth users and non-users concerning age, gender, and race. However, the study found that individuals from rural areas utilized telehealth services less often than individuals from non-rural areas.
Perhaps most importantly, the study found that the total number of outpatient E&M services was roughly 255.2 million in 2020 and 260.7 million in 2021. These totals are substantially lower than 2019’s total of 289 million. These findings suggest that the amount of outpatient E&M services used by Medicare recipients has not increased as a result of the temporary COVID-19 telehealth flexibilities. The researchers hope that the results of the study should clarify some criticisms concerning the impact of large-scale use of telehealth in healthcare provision.
However, Chad Elimoottil, the lead author of the study, has contended that telehealth has only been used as a substitute for in-person care rather than an expansion of care. While the study has dismissed allegations that telehealth will be abused for excessive care, more work is required to establish telehealth as an expansion of health care. The lower volume of use in rural areas may be a result of poor signal and broadband coverage. These issues need to be addressed to ensure equal accessibility to telehealth.