Medicare OIG Report – Most Medicare beneficiaries received telehealth services only from providers with whom they had an established relationship
- Patients are seeing their own providers – Most beneficiaries received telehealth services from providers with whom they had an established relationship. Notably, 84 percent of beneficiaries received telehealth services only from providers with whom they had an established relationship. Those enrolled in traditional Medicare were more likely to receive services from providers with whom they had an established relationship, compared to beneficiaries in Medicare Advantage. This pattern persisted among virtually all of the most common telehealth services. Beneficiaries tended to see their providers in person about 4 months prior to their first telehealth service, on average. As demonstrated, beneficiaries and the community do not need arbitrary guardrails like established relationships and in-person requirements to ensure beneficiaries are getting the care they deserve. Patients are maintaining their own providers when possible and appropriate. We believe this will continue but as telehealth models evolve, patients should have the choice to see other providers with whom that do not have a previous relationship.
- HHS OIG concludes that this data should be used to inform decisions about how to best use telehealth in Medicare and should be taken into account as policymakers continue to examine telehealth utilization and concerns about telehealth being vulnerable to fraud, waste, and abuse. This includes decisions about which services to allow to be delivered via telehealth on a more permanent basis and to what extent Medicare should require that beneficiaries have a relationship with their providers prior to receiving certain telehealth services.