Telehealth Visits Among Medicare Beneficiaries: ASPE Reports

It is no surprise that telehealth has grown. Still, for readers seeking statistics related to recent Medicare telehealth utilization of video conferencing and telephone services, this article offers two good US Department of Health and Human Services reports. Telehealth visits for behavioral health and specialist services for Medicare beneficiaries increased from 2019, when about 840,000 virtual visits were recorded, to over 52 million in 2020, according to a research report conducted by the Assistant Secretary for Planning and Evaluation (ASPE), Office of Health Policy. These totals represent a significant increase in telehealth usage among Medicare beneficiaries, a rise credited to increased Medicare telehealth flexibilities initiated in 2020. According to the report, telehealth visits for behavioral health specialists alone reached 10.1 million.

Medicare beneficiaries used audio-only telehealth visits in 2020. This telehealth method increased from about 25% of all Medicare telehealth to one-third of visits in 2020. Medicare flexibilities were also responsible for the increase in Medicare beneficiaries using telehealth visits from urban areas. This contrasts the typical divide in telehealth visits in rural versus urban areas. Medicare telehealth occurred approximately 50% more often in urban locations than rural areas.

Medicare Telehealth Beneficiary Characteristics

In terms of state usage of telehealth, Medicare beneficiaries in Massachusetts, Vermont, Rhode Island, New Hampshire, and Connecticut often used telehealth visits. The lowest use was seen in Tennessee, Nebraska, Kansas, North Dakota, and Wyoming. Black Medicare beneficiaries participated in telehealth visits slightly less often than White members, at 4.7% and 5.3 %, respectively. However, Hispanics and Asians showed leading numbers in Medicare telehealth at 6.2% and 6.4%. Individuals of low-income who have both Medicare and Medicaid used telehealth services more than those with Medicare alone at 6.3% and 5%, respectively. Beneficiaries using alternate payment models (APMs) showed slightly higher usage in telehealth. People with serious illnesses, such as end-stage renal disease, as well as Medicare beneficiaries who require home health care, used telehealth services more often in 2020 compared to overall fee-for-service beneficiaries.

Efforts For Medicare Telehealth Visits Expansion

The ASPE report highlights many areas where Medicare beneficiaries are making more use of telehealth. The Centers for Medicare and Medicaid Services (CMS) maximize Medicare telehealth use by increasing its use among seniors. Such efforts include removing geographic barriers that have historically prevented Medicare beneficiaries from using telehealth services to receive behavioral health from their homes. CMS is also allowing audio-only telehealth visits in its efforts to expand use among seniors. Additionally, other telehealth services made permissible to Medicare beneficiaries during the pandemic will remain in effect through December 31, 2023, providing even further options and flexibility for Medicare telehealth.

According to CMS administrator Chiquita Brooks-LaSure, the ASPE report details important information on changes in telehealth visits during the pandemic. Brooks-LaSure also explained that CMS uses this data in conjunction with feedback from providers who use Medicare telehealth to continue expanding and advancing additional Medicare telehealth regulations that will allow for improved care for seniors.

Telebehavioral Health Models 2021

Readers particularly interested in Medicare telehealth models may also be interested in a report published in April of 2021, entitled Workforce Implications of Behavioral Health Care Models: Final Report. It details the overall behavioral health context for how several telebehavioral health models have recently been used to fill gaps in service availability and extend the reach of the existing workforce. It also examines the impact of telehealth on Medicare and Medicaid service delivery. Areas covered include:

• Synchronous interactions, such as real-time video and phone calls,
• Asynchronous interactions that are not reviewed in real-time,
• Remote patient monitoring that allows direct transmission of a patient’s clinical measurements from a distance.
• Consumer-provider interaction via mobile applications.