Medicare Patients in Metro Areas More Likely to Report Telehealth Use

Medicare beneficiaries living in metropolitan areas were more likely to report that they used telehealth services, a new study revealed.

Published in the Journal of Evaluation in Clinical Practice, the study examined telehealth use among Medicare beneficiaries during the COVID-19 pandemic.

As the pandemic spurred telehealth use in the U.S., there were concerns that seniors would be left behind, with one 2020 study showing that 13 million older adults may have trouble accessing telemedicine services.

But seniors adapted. The new study shows 38.3 percent of Medicare beneficiaries reported that they used either video or voice calls with their physicians, and only 7.6 percent reported that they were unable to get care because of COVID-19.

For the study, researchers assessed the responses of 9,686 beneficiaries to the CMS Medicare Current Beneficiary Survey Fall 2020 COVID-19 Supplement.

More than half (58.3 percent) of beneficiaries reported that their primary care physicians have offered telehealth appointments since July 2020.

The temporary payment parity between telehealth and in-person care enacted by the Centers for Medicare and Medicaid Services and private insurers during the pandemic likely drove this trend.  

"We were surprised that our research found that so many primary care physicians offered telehealth services and how a change in Medicare reimbursement policy may have accelerated the use of telehealth services," said the study's lead author Hanadi Y. Hamadi, PhD, of the University of North Florida, in a news release.

But this increase in access did not extend to specialty care, according to the survey, with only 28.1 percent of beneficiaries reporting that their specialists have offered telehealth since July last year.

Further, the study revealed differences in telehealth access and usage among Medicare beneficiaries based on age, sex, location, and internet access.

Compared to people who were older 75 years, younger Medicare beneficiaries were more likely to have a telehealth appointment with their primary care physician, to report higher rates of specialist telehealth visits and to use video or voice calls with their physicians.

With regard to sex-based differences, men were more likely than women to report that their specialist offered telehealth. But men were less likely to say that their primary care physician offered telehealth appointments or use video or voice calls with their physicians.

In addition, beneficiaries who lived in non-metro areas were less likely to report that their primary care provider offered telehealth appointments and use video or voice calls as compared to their metro-based counterparts.

Also, Medicare beneficiaries with internet access were more likely to report that their specialist and primary care physician offered telehealth visits and that they used the services.

"While more research is needed, this may indicate that infrastructure policies should be considered that encourage the further investment and expansion of affordable and accessible internet services to areas that have either limited, unreliable, or no internet access," researchers wrote.

The study findings can offer guidance to policymakers as they decide how to support and encourage telehealth use, especially among seniors, after the flexibilities instituted amid the pandemic end.

The study shows that "Medicare beneficiaries were provided with an important and emerging access point to the healthcare system as in-person visits were being discouraged or were unavailable due to the risks of the COVID-19 virus," researchers concluded. "As a result, policymakers should consider developing policies that further encourage the growth of telehealth services, for example, specialty care, to better prepare patients for future and unexpected barriers to in-person healthcare."