Study: Medicare patients turn to telehealth for chronic care

Medicare beneficiaries continue to use telehealth widely, with virtual visit volumes for non-mental healthcare, including chronic conditions like diabetes, approaching those for telemental health visits.

The research, published in the Annals of Internal Medicine, comes less than a month after Medicare telehealth flexibilities were extended through Dec. 31, 2027. Though the extension gives telehealth providers some stability, proponents are still pushing for permanency. The authors of the research brief noted that their goal was to assess telehealth utilization data to examine how Medicare beneficiaries may be affected if the flexibilities are not made permanent.

The researchers examined data from the 2021-2023 Medical Expenditure Panel Survey. They included 14,950 respondents with Medicare coverage in the research. Of the study sample, 83.6% had only in-person visits, while 16.4% had one or more telehealth visits.

The study reveals that 45.1% of total mental healthcare-related visits were by telehealth, corresponding to an estimated 31 million visits annually. Among visits for non-mental healthcare conditions, 3.3% were by telehealth, representing about 29 million visits annually.

Among non-mental health conditions, telehealth was most frequently used to address uncomplicated diabetes, followed by hypertension and COVID-19. Anxiety and depressive disorders were the top telehealth use cases among mental health conditions.  

"We were surprised at the number of non-mental health conditions, like high blood pressure or diabetes, that were commonly addressed through telehealth," said Terrence Liu, M.D., first author on the study and an assistant professor of internal medicine at the University of Utah Health, in the press release.

"Even though a smaller percentage of these visits were conducted through telehealth, because these are very common conditions, the total number of estimated visits was very similar to telehealth visits for mental health conditions, numbering in the tens of millions."

Further, researchers observed that, compared to those who only participated in in-person visits, telehealth users were more likely to have a bachelor's degree or higher level of education, any physical or cognitive limitation, fair or poor health and a higher mean total number of outpatient visits.

Thus, the findings "suggest that withdrawal of telehealth flexibilities may disproportionately affect the most medically and functionally vulnerable Medicare beneficiaries," the study authors concluded.

"Curtailing coverage could reverse recent gains in access and continuity of care, leaving older patients with potentially significant barriers to care if it must be delivered in person."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.