Upswing in Medicare Telehealth Awareness and Use: What Will Be Post-Pandemic Policy?

By Clive Riddle, June 3, 2021

Recent reports indicate that even for the supposedly more tech-phobic Medicare population, telehealth awareness and utilization caught on during the pandemic, and the GAO has some concerns about that. The big question is, what are the post-pandemic implications, and what would be future CMS policy?

A recent Kaiser Family Foundation report: Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future, found that: 

• 64% (or 33.6 million) of Medicare beneficiaries with a usual source of care say that their provider currently offers telehealth appointments, up from 18% who said their provider offered telehealth before the pandemic.
• 23% do not know if their provider offers telehealth appointments, and this share is larger among rural beneficiaries (30%).
• 56% of Medicare beneficiaries who had a telehealth visit report accessing care using only a telephone, while a smaller share had a telehealth visit via video (28%) or both video and telephone (16%).

 

GoHealth recently released a 34-page report: United States of Medicare: Similarities and Shared Potential Among Rural and Urban Medicare Beneficiaries, that included these telehealth survey results:

•  86% or urban, and 82% of rural Medicare beneficiaries have a device, such as a smartphone, tablet or computer that allows them to have video communications
• 44% of urban, and 31% of Medicare beneficiaries during the past year have used video communications (telehealth or virtual doctor visit) to access their care
• 77% of urban and 76% of rural Medicare beneficiaries said this their first time using video communications (telehealth or virtual doctor visit) to access care

However, The GAO last month released a report: MEDICARE AND MEDICAID: COVID-19 Program Flexibilities and Considerations for Their Continuation, that included Medicare telehealth waiver discussion, noting “Utilization of telehealth services—certain services that are normally provided in-person but can also be provided using audio and audio-video technology—increased sharply. For example, utilization increased from a weekly average of about 325,000 services in mid-March to peak at about 1.9 million in mid-April 2020.”

The GAO went on to caution about these risks to Medicaid and Medicare if waivers are continued: 

• Increased spending. Telehealth waivers can increase spending in bothprograms, if telehealth services are furnished in addition to in-person services.
• Program integrity. The suspension of some program safeguards has increased the risks of fraud, waste, and abuse that GAO previously noted in its High-Risk report series.
• Beneficiary health and safety. Although telehealth has enabled the safe provision of services, the quality of telehealth services has not been fully analyzed.