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Seniors' Telehealth Use Holds Steady, but Rural Access Lags

Analysis  |  By John Commins  
   October 19, 2021

One-third of rural older adults had at least one virtual visit in 2020, compared with nearly half of seniors in suburban and urban areas.

About 16% of doctor's visits by seniors were done remotely, either by phone or online over the past two years, but the rural elderly appear to be behind the curve, according to a new analysis of telehealth visits billed to Medicare.

The total number of virtual visits – the kind focused on evaluating a medical condition or symptom and making a plan for managing it – didn't rise from 2019 to 2020, the analysis shows, despite concerns that widespread access to telehealth because of the COVID-19 pandemic would lead to an increase in the total number of such visits.

However, the data showed that one-third of rural older adults had at least one virtual visit in 2020, compared with nearly half of seniors in suburban and urban areas. Researchers from the University of Michigan say the data suggest that policymakers need to find a way to improve telehealth access among the rural elderly.

"Before the pandemic, Medicare's telehealth provisions focused mainly on rural areas, to increase access to specialists through virtual visits originating from their local physician's office, but uptake was low," said study lead author Chad Ellimoottil, MD, an assistant professor of urology at Michigan Medicine.

"In the pandemic era, coverage for telehealth has led to a steady percentage of evaluation and management appointments being conducted virtually. For the most part, these visits have been a substitute for in-person care," he said.

At the height of the first pandemic surge in April 2020, about half of Medicare participants' appointments to evaluate a medical concern and get a treatment recommendation took place online or over the phone. That declined to between 13.5% and 18.3% for the rest of 2020, the data showed.

However, the overall number of evaluation and management appointments didn't rise past the median number of such visits in 2019. In fact, seniors had fewer such appointments for all of 2020, which the researchers said suggests that telehealth visits are being used as a substitute for in-person care, not an add-on, and that some adults are avoiding care.

“In the pandemic era, coverage for telehealth has led to a steady percentage of evaluation and management appointments being conducted virtually. For the most part, these visits have been a substitute for in-person care.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

At the height of the first pandemic surge in April 2020, half of Medicare evaluations and consultations took place online or over the phone. That declined to between 13.5% and 18.3% for the rest of 2020.

However, the overall number of evaluation and management appointments didn't rise past the median number of such visits in 2019. In fact, seniors had fewer such appointments for all of 2020.

Researchers say the data suggest that telehealth visits are being used as a substitute for in-person care, not an add-on, and that some adults are avoiding care.


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