By James Coleman
Contributing writer
All problems these days seem to have a digital solution because of modern technology, with healthcare and doctors’ visits being no exception. Thanks to technological advances and the onset of the pandemic in 2020, which forced the medical industry to adapt, telehealth use grew rapidly and became more accessible, as people could not go to doctors’ offices for in-person visits in reliable safety. Now that the lockdown has been lifted for over a year, and in-person service is available again, where does telehealth stand?
The care that people receive using telehealth is like that of an in-person visit, as they can get test results, prescriptions, follow up on physical therapy or surgery, and even receive mental health treatment. Doctors can monitor symptoms remotely. Telehealth services generally cost less than in-person visits as well.
To look at the future of telehealth and the likelihood of continued investment in the space, it’s important to look at the recent past. Telehealth saw a rapid spike during the Covid-19 pandemic in 2020, increasing 63-fold, according to a study from the U.S Department of Health and Human Services. Medicare visits done through telehealth rose from “approximately 840,000 in 2019 to 52.7 million in 2020.” Many northeast states such as Connecticut, Vermont, Rhode Island, and Massachusetts had the highest usage of telehealth in 2020, while southern and midwestern states had the lowest usage.
In New York State, telehealth was steadily growing before the pandemic in January 2018 until 2020, averaging 1,200 monthly visitors in 2018 to 5000 by 2020. In March 2020, coinciding with the escalation of the pandemic, New York Medicaid and telehealth utilization by beneficiaries increased into the hundreds of thousands, averaging over 208,000 visitors. According to CMS, telehealth services experienced a 2745 percent increase in from March to October 2020. Telehealth’s usage rate slowly declined by November 2020 with 40,000 visits, still eight times higher than January 2020 pre-pandemic.
As in-person care slowly became available again, telehealth remained a viable option for patients, albeit at a slightly smaller level. Besides using telehealth for physical issues, people relied on it for mental health care as well, with 3 in 10 adults having depression or anxiety-like symptoms since April 2020. According to a survey by KFF and Epic Resource, mental health and substance use disorder visits accounted for roughly 40% of telehealth visits from March 2020 to April 2021.
While depression and anxiety are common in all demographics, the usage of telehealth varied among beneficiary groups, including age. Adults older than 65 accounted for 24.6 percent of people who had a telehealth visit within any four-week period between April and October, in a study by the Assistant Secretary for Planning and Evaluation. By contrast, people age 18-24 accounted for the 17 percent of overall telehealth visits, but preferred to use more video telehealth sessions, accounting for 72.5 percent of telehealth visits by video.
Many other factors attribute to telehealth visits, such as location. People who live in rural areas typically rely on telehealth to receive care as they do not have access to the same resources as more urban areas. Beneficiaries who live in more rural areas accounted for 55 percent of telehealth visits for mental health disorders, compared to 35 percent from urban areas. For more rural people, telehealth appears to be a critical as opposed to in-person care because of its convenience and immediate availability.
As Covid-19 slowly recedes into the back of people’s minds, telehealth can still serve as a replacement from either driving or having to take a costly ambulance to the ER. Driving to the ER could have a two-hour wait on average once a patient arrives, according to the Harvard Business Review. The services are not cheap, either, as they are “12 times as expensive as visiting a physician’s office, and waste more than $32 billion a year.”
In 2022, the issue of covering the cost of a telehealth visit remains, as well as concern for the continuation of telehealth services. In November 2021, the Centers for Medicare and Medicaid Services announced that they will continue covering a list of telehealth services through the end of 2023. It is unsure if Medicare will permanently cover these services after 2023. The primary reason for this is to allow stakeholders to gather data and figure out what services they should request to add to Medicare’s health services list before the Public Health Emergency ends in 2023, which was originally created in response to the pandemic. According to the Kaiser family foundation, before the PHE, Medicare covered about 100 services that could be given through telehealth, but expanded greatly during the public health emergency to include additional resources such as, physical and occupational therapy.
In addition, it gives the stakeholders some free room to be flexible with testing telehealth options originally given during the PHE. It’s also unsure how the cost of telehealth could change for the average beneficiary going forward. As of March, the Consolidated Appropriations Act extends these flexibilities for up to 5 months after the end of the PHE.
Overall, more people became open about their physical and mental health issues during the pandemic and sought out resources via telehealth, which led to an explosion of growth for this service, with people still utilizing it for physical therapy, counseling sessions and more. Telehealth appears here to stay due to technology and its easy accessibility for people of all ages and locations, but it’s unclear how telehealth will evolve a year from now.
What is known is telehealth services are only expected to grow. The market is projected to increase at a CAGR of 14.9% through 2026 as more hospitals and healthcare organizations bring the technology online. Telehealth can reduce healthcare costs, while improving patient outreach and health outcomes. Lower cost and convenience seem to be the main factors driving success in telehealth services, although continued regulatory flexibility in Medicare coverage may prove to be an equal determinant.
