HHS Study Shows 63-Fold Increase in Medicare Telehealth Utilization During the Pandemic

A report from the U.S. Department of Health and Human Services (HHS) has found that considerable increases in the use of telehealth helped maintain some healthcare access during the COVID- 19 pandemic, with specialists such as behavioral health providers seeing the highest telehealth utilization. The report, which was produced by researchers in HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) and analyzes Medicare fee-for-service (FFS) data in 2019 and 2020, also shows that telehealth services were accessed more in urban areas than rural communities, and Black Medicare beneficiaries were less likely than white beneficiaries to utilize telehealth. “During the COVID-19 pandemic, various telehealth flexibilities enabled patient access to their providers,” said HHS Acting Assistant Secretary for Planning and Evaluation Rebecca Haffajee. “Prepandemic telehealth visits for Medicare beneficiaries went from hundreds of thousands to tens of millions, with many utilizing telehealth for the first time.”

The ASPE report found the share of Medicare visits conducted through telehealth in 2020 increased 63-fold, from approximately 840,000 in 2019 to 52.7 million. States with the highest use of telehealth in 2020 included Massachusetts, Vermont, Rhode Island, New Hampshire and Connecticut. States with the lowest use of telehealth in 2020 included Tennessee, Nebraska, Kansas, North Dakota and Wyoming. The report also found insightful trends on the kinds of services Medicare beneficiaries sought through telehealth. While overall healthcare visits for Medicare beneficiaries declined in 2020 compared to 2019, telehealth was particularly helpful in offsetting potential foregone behavioral healthcare. In 2020, telehealth visits comprised a third of total visits to behavioral health specialists, compared to 8 percent of visits to primary care providers and 3 percent of visits to other specialists. These findings prominently show an increased interest in seeking behavioral healthcare through telehealth.

To help protect access to care, the Centers for Medicare and Medicaid (CMS) recently announced that for the first time outside of the COVID-19 public health emergency (PHE), Medicare will pay for mental health visits furnished by rural health clinics and federally qualified health centers via interactive video-based telehealth, including audio-only telephone calls. Additionally, CMS is permanently eliminating geographic barriers and allowing patients in their homes to access telehealth services for diagnosis, evaluation and treatment of mental health disorders, including via audio-only communications technology. These provisions were included in the Consolidated Appropriations Act of 2021.

Other Medicare services added to the telehealth services list temporarily during the PHE will remain in place through Dec. 31, 2023, while CMS continues to evaluate whether these services should be permanently added to the Medicare telehealth services list. And to provide more transparency and visibility into telemedicine usage, CMS is also releasing a new snapshot showing the number of people with Medicare who utilized telemedicine services between March 1, 2020, and Feb. 28, 2021. The snapshot includes Medicare FFS claims data, Medicare Advantage encounter data and Medicare enrollment information.