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Telehealth: Pandemic-driven growth may lead to permanent change

Stephen M. Angelette (sangelette@polsinelli.com) is Shareholder in the Dallas office, Sara Iams (siams@polsinelli.com) is Shareholder in the Washington, DC, office, and Joelle M. Wilson (jmwilson@polsinelli.com) is an Associate in the Chicago office of Polsinelli.

The US medical community has witnessed increased demand for telehealth services both in rural and urban settings alike. Telehealth, as described by the New England Journal of Medicine, is often used as a blanket term that covers all components and activities within the healthcare system that are conducted through telecommunications technology, which includes telemedicine and other technologies like wearable devices and services like remote patient monitoring and virtual healthcare education, while telemedicine is often considered to be the use of technologies and telecommunication systems to administer healthcare to patients who are geographically separated from providers.[1]

The benefits of telehealth, namely increased patient access to care, have become increasingly present and overwhelmingly relevant in recent years, but a combination of inconsistent reimbursement and onerous state and federal regulatory requirements have stalled the penetration of telehealth among providers of healthcare services. Even so, the US has continued to see growth when it comes to the usage of telehealth, particularly in the past five years.[2]

Following years of inconsistent implementation, physician adoption of televisits/virtual visits doubled from 14% in 2016 to 28% in 2019, according to a study of 1,300 physicians conducted by the American Medical Association. Similarly, the Centers for Medicare & Medicaid Services (CMS) recently analyzed Medicare fee-for-service (FFS) claims data from March 17 through June 13, 2020[3] —although claims data are preliminary as providers have 12 months from the date of service to submit claims to CMS. The data show that more than nine million beneficiaries received telehealth services during that time frame. CMS reports that approximately 1.7 million beneficiaries received telehealth services in the last week of April 2020 alone. Claims data show that a significant number of beneficiaries are seeking services via telehealth, often at similar rates across demographics.

Table 1: Pandemic telehealth use statistics[4]
Beneficiary use of telehealth by location

Rural

22%

Urban

30%

Beneficiary use of telehealth by sex and age

Female

30%

Male

25%

Below age 65

34%

Age 65–74

25%

Age 75–84

29%

Over age 85

28%

Beneficiary use of telehealth by race/ethnicity

Asian

25%

Black

20%

White

27%

Hispanic

28%

Other

26%

Beneficiary use of telehealth by dually eligible (beneficiaries that qualify for both Medicare and Medicaid) vs Medicare-only beneficiaries

Dually eligible

34%

Medicare-only

26%

In this article, we explore the historic factors limiting widespread adoption of telehealth and how the public health emergency (PHE) instituted as a result of the SARS-CoV-2 (COVID-19) pandemic has shifted the conversation and telehealth policy, perhaps permanently.

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