With telehealth coverage on the brink, study shows it hasn’t driven up total visits

With another Congressional deadline looming this month for most telehealth coverage under Medicare, a new University of Michigan study adds more data to the debate. It shows that the total number of patient visits hasn’t gone up since most patients gained the ability to see doctors and other health care providers virtually . In fact, among non-surgical medical specialties and mental health providers, the total number of visits stabilized and even declined slightly through June 2024, the most recent period available to analyze. The data come from more than 60 million people who had nearly 539 million appointments during a five-year period. The findings could help inform policymakers who must vote by January 30 to either temporarily renew or permanently extend Medicare telehealth coverage standards that have been in effect since March 2020. If they don’t meet that deadline, older and disabled Americans with traditional Medicare coverage could find themselves receiving messages like they did last fall, when there was a lapse in telehealth coverage during the government shutdown that began October 1. Such letters told them that if they had a telehealth visit during that time, they may be responsible for paying the entire cost, or that their appointment was being converted to in-person or being canceled or rescheduled. Just before Thanksgiving, Congress authorized retroactive payment for telehealth visits that patients with traditional Medicare had decided to keep during the shutdown. But the budget agreement only provided for coverage of future care under current standards through the end of January 2026. New findings could inform telehealth policy The new findings, published in the peer-reviewed publication Health Affairs Scholar by a team from the U-M Institute for Healthcare Policy and Innovation, build on findings that the researchers published as a preprint nearly a year ago during a prior period of uncertainty about Medicare coverage of telehealth. The new analysis includes data from January 2019 through June 2024 and breaks down telehealth and in-person visit trends for surgical, non-surgical and behavioral (mental) health care. Telehealth was possible only under very limited circumstances in Medicare before March 2020. That month, the COVID-19 pandemic prompted a rapid emergency pivot to virtual care. Since then, such care has become routine for most people. In fact, the study shows that telehealth now accounts for 44% of all behavioral health visits and 9% of primary care visits among beneficiaries in traditional Medicare. However, despite this sustained adoption, the study finds that overall healthcare visits have remained stable or declined over time. The researchers used a special type of statistical analysis to look at visit patterns among specialties with high, medium and low telehealth use. They found that even in fields where telehealth was widely adopted, the total number of visits, including in-person and virtual visits, stayed steady or even declined over time. Contrary to some predictions, overall visits didn’t climb higher as telehealth became more popular. Lead author James D. Lee, M.D., M.P.H., said that it’s important to look at the overall trajectory of both telehealth...

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