Which physicians are most likely to provide telehealth?
Physician characteristics such as sex and specialty are associated with the likelihood of physicians providing care services via telehealth, per new research.
Female physicians, psychiatrists and physicians practicing in metropolitan areas are more likely to offer telehealth services than their counterparts, new research reveals.
Published in Health Affairs, the study assessed telehealth delivery across different types of physicians and practice characteristics in 2022. According to the study authors from Weill Cornell Medicine, the findings could help inform policy decision-making.
During the COVID-19 pandemic, Congress introduced several waivers to expand access to virtual care. These include waivers that eliminated geographic restrictions on originating sites for telehealth services, allowed federally qualified health centers and rural health centers to provide telehealth services and lifted the initial in-person exam requirements for those receiving telemental healthcare. These waivers have been extended through the end of 2024, though telehealth stakeholders are pressing Congress to make them permanent or extend them further.
For the study, the researchers examined 2022 claims data for a national sample of Medicare fee-for-service beneficiaries. They used the data to understand the association between physicians' demographic characteristics and their probability of providing telehealth. These characteristics included the physician's specialty, as well as the location and size of their practice.
The study authors found that the probability of telehealth delivery varied by physician age and sex. Female physicians deliver relatively more services via telehealth than their male counterparts across age groups and most specialties. In fact, the study shows that female physicians aged 66 and older provided nearly twice the share of their visits by telehealth compared with younger male physicians aged 20 to 39.
Further, telehealth delivery varied significantly across physician specialties. Psychiatrists were highly likely to provide telehealth services, with telehealth claims making up 46.3% of their visits, compared to primary care physicians. Telehealth claims accounted for only 7.4% of primary care visits.
Study shows that female physicians aged 66 and older provided nearly twice the share of their visits by telehealth compared with younger male physicians aged 20 to 39.
Among medical specialties, telehealth delivery rates varied from 0.6% in dermatology to 13.1% in neurology, and among surgical specialties, telehealth delivery rates ranged from 0.7% in ophthalmology to 6.8% in neurosurgery.
Not only that, but telehealth delivery also varied by the location of the physician's practice. Researchers found higher telehealth rates concentrated in the Northeast and West U.S. regions and metropolitan areas. Physicians practicing in metropolitan areas delivered a higher share of visits via telehealth (8.3%) than those in rural areas (5.3%).
These trends were consistent across specialties. For example, primary care physicians in metropolitan areas provided 8.3% of visits via telehealth, whereas those in rural areas provided 3.8%. Similarly, psychiatrists in metropolitan areas provided 49.1% of visits via telehealth versus 44.2% of visits among those in rural areas.
Additionally, researchers found that physicians in large practices with 50 or more physicians were more likely to provide telehealth than those in practices with one to five physicians.
"Determining how physician and practice characteristics influence telehealth uptake is important for understanding how telehealth may affect health care access and patient outcomes," the researchers concluded. "These trends require ongoing attention as policy makers consider the future of telehealth policy in the U.S."
Though the future of telehealth is still uncertain, Congress appears to be considering a two-year extension of pandemic-era telehealth flexibilities. In May 2024, the House Energy and Commerce Subcommittee on Health passed a bill that extends various pandemic-era telehealth flexibilities for two years and the Acute Hospital Care at Home (AHCAH) waiver for five years. The House Ways and Means Committee advanced a similar bill in the same month.
Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.
