- Fee-for-service Medicare beneficiaries adopted telehealth for primary care at unprecedented rates as COVID-19 spread in the U.S., according to a new HHS report.
- The report, released Tuesday by HHS' Assistant Secretary for Planning and Evaluation, analyzed claims data from January through early June and found FFS Medicare beneficiaries' use of in-person primary care fell sharply mid-March, while telehealth visits steadily ticked up to make up the deficit. Almost half — 43.5% — of all Medicare primary care visits were being conducted through telehealth in April. That's up from just 0.1% in February.
- Both rural and urban areas saw an increase in use, though it was more marked in urban counties. Providers in rural counties saw a smaller increase in virtual care visits as a proportion of all primary care visits in March and April, and a decrease in May. By comparison, providers in urban counties saw greater virtual care use in March and April and a smaller dip in May.
The Trump administration relaxed regulatory barriers to telehealth use beginning in March as the pandemic shuttered businesses, including doctor's offices, and hospitals preserved resources to care for COVID-19 patients. Use of primary care flatlined as a result, and telehealth rose as an important modality for patients to retain access to the healthcare system, while allowing providers to recoup lost revenue.
Medicare beneficiaries especially had been closed off from virtual care, as it was only allowable in the federal program under strict locations and circumstances. Now, 6 months into the national emergency declaration allowing Medicare to reimburse more broadly for telehealth, 135 telehealth services are covered by FFS Medicare for its almost 40 million beneficiaries and the U.S. has witnessed a meteroric rise in virtual care use.
However, as COVID-19 cases dipped due to stringent stay-at-home orders and social distancing in mid-April through May, FFS Medicare beneficiaries' use of virtual care also declined slightly, but appears to have leveled off by the beginning of June, the report found.
Telehealth has long been touted as a way to bring healthcare to the masses, especially those in rural areas without a provider close geographically. But Massachusetts, Rhode Island, Connecticut and New York saw the strongest growth in telehealth primary care visits after the emergency declaration, the report found.
More rural states Iowa, South Dakota and Oklahoma saw a one-third jump in primary care telehealth visits in April. The state with the lowest telehealth adoption, Nebraska, saw virtual care grow to account for up to 22% of all primary care visits.
The report comes as Congress debates a fifth round of COVID-19 relief legislation, and telehealth providers clamor to have the relaxed regulations, the majority of which are temporary, codified into law. It's likely some but not all of the regulatory changes will remain post-pandemic, and experts believe Congress will permit HHS to continue paying for telehealth more generously in its federal payer programs.