Telehealth Use Among Medical Groups Peaked in First Half of 2020

Telehealth utilization peaked in the first half of 2020 and decreased as the year came to a close, with providers predicting that virtual care use would continue to decline in upcoming years, according to the 2021 Medical Group Telehealth Survey.

AMGA Consulting conducted the survey and gathered responses from 56 medical groups representing more than 38,000 healthcare providers.

The majority of the participants (86 percent) were part of multispecialty groups with primary care, while the remaining were either multispecialty without primary care, primary care, or single-specialty groups.

At the beginning of the COVID-19 pandemic, health systems and clinics restricted in-person care, which unsurprisingly led to the increased adoption of virtual care services.

Telehealth utilization among medical groups saw the most significant increase between the first and second quarter of 2020, the survey found. Primary care specialty groups had the biggest incline, with telehealth accounting for 1.9 percent of all visits in Q1 and 33.3 percent of all visits in Q2. 

Medical and surgical specialty groups also hit their telehealth use peak in Q2, with a respective 26.7 percent and 12.6 percent of all visits being conducted virtually.  

“The explosive growth of telehealth in 2020 was not surprising. It was an extraordinary reaction to an extraordinary situation,” Fred Horton, president of AMGA Consulting, said in a press release. “As we study the long-term effects this uptick in utilization had on quality, I believe we’ll find that telehealth adds a new dimension to healthcare delivery.”

However, telehealth utilization declined in the third quarter and continued to recede in the fourth quarter. By the end of the year, virtual care accounted for 11.2 percent of all primary care visits, 13 percent of medical specialty visits, and only 3.3 percent of surgical specialty visits, according to the survey.

What’s more, 55 percent of all medical groups said that they projected telehealth utilization to decrease in 2021 and the upcoming years, as compared to 2020. One in four groups said they expect virtual care use to stay the same and 20 percent projected an increase in telehealth utilization. These predictions remained similar among the different specialty groups.

“Respondents’ expressed intent to lessen telehealth utilization in the future indicates a more rational approach to managing care by the respective setting, both in-person and telehealth,” Horton said. “This will result in a more optimal matching of care need and modality as compared to the de facto reassignment of care to the telehealth setting that occurred during the lockdown phase of the pandemic.”

During 2020, medical groups had a median of 241 and an average of 335 telehealth visits per provider and most of the visits lasted for around 22 minutes. Chronic care and mental healthcare were the most common virtual services, accounting for 30 percent and 28 percent of all telehealth appointments, respectively.

Somewhat surprisingly, telehealth utilization was highest among patients who were 65 years and older, and utilization rates declined in younger patients.

In terms of modality, video visits proved to be more popular than audio-only visits, the survey participants reported. Among all medical groups, video visits accounted for 80 percent of all appointments, whereas 19.8 percent were conducted via telephone.

Half of the patients who used telehealth during 2020 had commercial insurance, while 31 percent received coverage under Medicare, and 13 percent were on Medicaid. For the visits involving commercially insured patients, 82 percent of providers said that they were reimbursed equally for telehealth and in-person visits. The remaining 18 percent reported that they received less reimbursement for telehealth appointments.

The survey results suggest that although telehealth use skyrocketed during the COVID-19 pandemic, virtual care may see the most success with patients who prefer the modality over in-person care or whose health concerns can be easily addressed virtually.