Although telehealth use surged in 2020, a new analysis by Trilliant Health found that utilization saw a significant dip in 2021—even as many health experts continue to push for expanding telehealth coverage in the future.
Telehealth usage dips significantly after rapid growth in 2020
According to a report released in December by HHS' Office of the Assistant Secretary for Planning and Evaluation (ASPE), telehealth use increased 63-fold among Medicare beneficiaries from 2019 and 2020.
Overall, ASPE found that Medicare telehealth visits increased from approximately 840,000 in 2019 to 52.7 million in 2020. In particular, behavioral health saw the highest telehealth use, increasing 32-fold from 2019 to 2020. Overall, visits to behavioral health specialists made up a third of all telehealth visits in 2020, compared with 8% of visits to primary care providers and 3% of visits to other specialists.
"During the Covid-19 pandemic, various telehealth flexibilities enabled patient access to their providers," said Rebecca Haffajee, HHS assistant secretary for planning and evaluation. "Pre-pandemic telehealth visits for Medicare beneficiaries went from hundreds of thousands to tens of millions, with many utilizing telehealth for the first time."
However, a recently published analysis by Trilliant Health found that telehealth use decreased by an average of 40.3% a month in 2021 compared to 2020. For the analysis, the company compared telehealth usage in commercial, Medicare Advantage, and Medicaid manage care claims during March to December 2021 with the same period in 2021.
Among all U.S. states, according to the analysis, South Dakota (60.2%), Wyoming (59%), and Mississippi (57.9%) saw the largest decreases in telehealth use from 2020 to 2021. In comparison, New Mexico (24.9%), Oregon (25.6%), and Arizona (25.9%) saw the smallest decreases in utilization.
What might be next for telehealth
According to Modern Healthcare, many health care professionals continue to push for expanded telehealth coverage, arguing that it will improve patients' access to care—particularly for behavioral health conditions.
For example, Marc Harrison, president and CEO of Intermountain Healthcare, wrote in the Harvard Business Review that greater telehealth usage will help the health care industry "meet people where they are as much as possible when delivering care."
Using telehealth effectively can help patients "remain in their communities, surrounded by their support systems, with the local hospital retaining most of the compensation," Harrison wrote. "That strengthens not only rural hospitals but also rural communities where the hospitals are often the largest employers."
Separately, CMS previously said it would use ASPE's report to help determine its future telehealth policies. "[The ASPE] report provides valuable insights into telehealth usage during the pandemic," said CMS Administrator Chiquita Brooks-LaSure. "CMS will use these insights—along with input from people with Medicare and providers across the country—to inform further Medicare telehealth policies." (Devereaux, Modern Healthcare, 1/3; Jain, Trilliant Health, 12/12/21; ASPE research report, 12/2021)