HHS released new CMS data and an Assistant Secretary for Planning and Evaluation (ASPE) report of Medicare telehealth utilization in 2020 and early 2021. Overall, nearly 53 million virtual visits occurred in traditional Medicare in 2020, compared to about 840,000 in 2019. Of those, nearly all (92%) of visits occurred in patients’ homes, which was not permissible prior to the pandemic. Furthermore, 44% of Medicare visits were in rural areas and 55% were in urban areas, demonstrating beneficiaries, regardless of location, utilized telemedicine for access to health care services during the pandemic.

CMS Medicare Telemedicine Snapshot
ASPE: Medicare Use of Telehealth in 2020
  • HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE): Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location (12/3) – HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report of Medicare Part B visits and use of telehealth in 2020 during the COVID-19 PHE, including by beneficiary characteristics, provider specialty and location. The analysis found that the share of Medicare visits conducted through telehealth in 2020 increased 63-fold, from approximately 840,000 in 2019 to 52.7 million. The report also found insightful trends on the kinds of services Medicare beneficiaries sought through telehealth. In 2020, telehealth visits comprised a third of total visits to behavioral health specialists, compared to 8 percent of visits to primary care providers and 3 percent of visits to other specialists.
  • CMS: Medicare Telemedicine Data Snapshot Overview (12/3) – CMS released a new data snapshot of Medicare fee-for-service and Medicare Advantage telehealth utilization from March 1, 2020 through February 28, 2021. Overall, more than 28 million beneficiaries used telemedicine – representing a more than 3,000% increase over the previous pre-pandemic period. In addition, 44 percent of rural beneficiaries and 55 percent of urban beneficiaries used telemedicine.

Below are additional key findings and discussions from the agency.

  • Overall utilization: 52.7 million or 5% of Medicare FFS clinician visits, were provided via telehealth in 2020 – a 63-fold increase from 2019.
    • Overall total health care utilization in 2020 was 11.4% below levels from 2019, reflecting 179 million fewer visits, even after accounting for the increased use of telehealth services in 2020.
    • CMS found 53 percent of beneficiaries in traditional Medicare and private Medicare Advantage plans used telehealth between March 2020 and the end of February 2021.
  • Visits by specialty: Prior to the pandemic, telehealth made up less than 1% of visits across all visit specialties but increased substantially in 2020.
    • Telehealth increased to 8% of primary care visits, while specialty care had the smallest shift towards telehealth (3% of specialist visits).
    • Visits to behavioral health specialists showed the largest increase in telehealth in 2020. Telehealth comprised a third of total visits to behavioral health specialists, with up to 70% of these telehealth visits during 2020 potentially reimbursable for audio-only services.
  • Visits broke down by race: Black people had slightly lower telehealth use than White people, while Asian people and Hispanic people had higher use. However, all groups had a similar overall decrease in health care services in 2020.
    • White beneficiaries had more telehealth visits overall, but the percentage of beneficiaries who had at least one telehealth visit was higher among Black beneficiaries.
    • Telehealth made up 6.4 percent of Asian beneficiaries’ visits, 6.2 percent of Hispanic beneficiaries’ visits, 5.3 percent of white beneficiaries’ visits, 4.7 percent of Black beneficiaries’ visits and 5.6 percent of American Indian/Alaska Native beneficiaries’ visits.
    • HHS suggested that barriers to internet access could be behind racial and geographic disparities, as well as patients’ preferences and comfort with using digital technology.
  • Telemedicine use by Geography: Telehealth use varied by state, with higher use in the Northeast and West, and lower in the Midwest and South.

Discussion of health outcomes and costs findings:

  • HHS indicates that more research is needed on the impact of telehealth on health outcomes and costs, as well as the role of value-based purchasing in supporting telehealth.
  • HHS acknowledged the difficulty predicting how much virtual visits will substitute for in-person care in a post-pandemic world and states that “extending telehealth flexibilities in a post-pandemic world could lead to higher health care utilization, especially if providers are paid the same rates for telehealth as in-person visits.”
  • Note that overall total health care utilization in 2020 was 11.4% below levels from 2019, reflecting 179 million fewer visits, even after accounting for the increased use of telehealth services.