Telehealth Use High Among Older LA Medicaid Beneficiaries in 2020

A new study published in JMIR found that Medicaid beneficiaries between the ages of 50 and 64 had higher telehealth claims during the COVID-19 pandemic compared to those aged 18 to 34. 

Although the COVID-19 pandemic led to increased use of telehealth, a lack of clarity surrounding how age and level of digital literacy affect its use remained. Due to this, researchers aimed to gather insight into how the pandemic impacted the use of telehealth modalities among Medicaid beneficiaries in Louisiana.

Researchers used interrupted time series models on Louisiana Medicaid claims that reviewed total, in-person, and telehealth visit claims per 1,000 beneficiaries to determine trends. They focused on the period of January 2018 to December 2020 and separated age into four categories: 0 to 17, 18 to 34, 35 to 49, and 50 to 64 years.

Following data analysis, researchers found similar telehealth use trends across all age groups over time. These trends included an increase in use in April 2020, followed by gradual downward trends, increases in July 2020, and flat trends until December 2020.

In April 2020, the 50 to 64 age group experienced an increase of 184.09 telehealth claims per 1,000 Medicaid beneficiaries. In July 2020, claims for this age group fell by 120.81 per 1,000 Medicaid beneficiaries. Among the 18 to 34 age group, telehealth claims increased by 84.47 per 1,000 beneficiaries in April 2020 and 57 per 1,000 beneficiaries in July 2020.

Overall, from baseline to December 2020, telehealth claims per 1,000 Medicaid beneficiaries rose by 123.65 among those aged 50 to 64 and 59.07 among those aged 18 to 34.

Researchers noted that this data shows that older patients in Louisiana had higher telehealth claim rates during the COVID-19 pandemic. Also, given that telehealth use remained high in December 2020, researchers also concluded that telehealth would likely serve as a channel for maintaining integral access to care.

Further, this data could serve as a tool for policymakers to determine telehealth laws and the policies that would most assist Medicaid beneficiaries.

Prior studies have also indicated satisfaction with telehealth among older populations.

A study published in the Journal of the American Geriatrics Society in October 2022 found that although many patients older than 65 preferred in-person care, many were also satisfied with telehealth and wanted it to remain a care delivery option.

Researchers reached this conclusion after gathering questionnaire responses from 208 patients over 65, all of whom had participated in a phone-only or video visit since March 2020. Overall, the median patient satisfaction score was six on a seven-point scale. However, 39.5 percent of the study population still thought telehealth was inferior to in-person care.

Despite these findings, prior research efforts have also indicated that physicians have a negative perception of telehealth for senior care.

A December 2022 survey from West Health and members of the Collaborative for Telehealth and Aging found that over half of clinicians thought telehealth was not a good care delivery option for older patients. A common belief among physicians was that physical or cognitive challenges that older adults often experience would serve as barriers to experiencing telehealth benefits.