Telehealth Use Among Medicare Beneficiaries Drops to 15% in Q2 2022

Telehealth utilization among Medicare beneficiaries has dropped from pandemic highs, but usage still varies by race, sex, and location, new CMS data shows.

In the second quarter of 2022, about 15 percent of Medicare beneficiaries used telehealth, down from 48 percent in Q2 2020, according to a new data analysis from the Centers for Medicare and Medicaid Services (CMS).

CMS recently released its Medicare Telehealth Trends Report, which includes information from Medicare Fee-for-Service (FFS) Part B claims and Medicare enrollment data. The data is from Jan. 1, 2020, to June 30, 2022.

Before the COVID-19 pandemic, Medicare reimbursed for telehealth services under limited circumstances. But following the start of the public health emergency, CMS enacted regulatory flexibilities for telehealth reimbursement, including lifting geographic area restrictions, which enabled Medicare patients to participate in virtual visits from their homes.

Telehealth utilization among Medicare beneficiaries has fluctuated since 2020. In Q1 2020, only 7 percent of beneficiaries used a telehealth service. This figure skyrocketed to 47 percent in Q2 2020 but dropped to 28 percent in Q4 2020.

Through most of 2021, telehealth usage among this population hovered at 16 to 18 percent. It increased slightly to 19 percent in Q1 2022 and then declined to 15 percent in Q2 2022.

Telehealth usage has also varied by race, sex, and location of residence.

Asian/Pacific Islander Medicare beneficiaries used telehealth the most in Q2 2022, with 17 percent engaging in virtual care in this quarter. Hispanic beneficiaries followed, with usage rates of 16 percent. Meanwhile, Black, White, and American Indian/Alaska Native beneficiaries had usage rates of 13 percent each. These figures represent a significant drop from Q2 2020, when usage rates for all these groups ranged from 44 to 49 percent.

Like in Q2 2020, women used telehealth more than men in Q2 2022. In the latter period, 14 percent of female Medicare beneficiaries used telehealth versus 12 percent of male beneficiaries. Similarly, in Q2 2020, 46 percent of female patients, compared with 43 percent of male patients, participated in a telehealth visit.

With regard to location, only 9 percent of rural Medicare beneficiaries used telehealth in Q2 2022, down from 35 percent in Q2 2020. Comparatively, 14 percent of urban Medicare beneficiaries used telehealth in Q2 2022, a significant decrease from 47 percent in Q2 2020.

"These differences may be driven by a number of factors, including access to broadband internet, varying state-level policies on the delivery of telehealth across state lines and the timing and degree to which the pandemic affected geographic areas differently," the report states.

The new data adds to growing research on telehealth use among Medicare patients.

A study published in September found that many Medicare beneficiaries benefitted from the elimination of restrictions on out-of-state telehealth services during the COVID-19 pandemic, especially those with cancer and rural residents.

The study examined out-of-state telehealth data from January to June 2021. Researchers found that 8.3 million Medicare beneficiaries participated in a telehealth visit in that period, and of these, 422,547 (5 percent) had one or more out-of-state telehealth visits.

Rural residents were more likely to receive telehealth from an out-of-state location. Also, 9.8 percent of out-of-state telehealth visits were for cancer care, the highest among all specialties.

These data points are essential for lawmakers as they consider which temporary telehealth flexibilities should be made permanent. Though telehealth waivers for Medicare beneficiaries are likely to be extended for two years, their fate post-2024 remains unclear.