It’s no secret that telehealth took off last year, as loosened regulations and halted in-person visits led virtual visits to increase several-fold. But access to virtual visits hasn’t been equal, according to research published this month in the American Journal of Preventive Medicine.
The study, which was conducted by the RAND Corporation and based on claims data from 200 employers through Castlight Health, found “substantial disparities” in telehealth. While telehealth use increased by as much as 20-fold in March, it still wasn’t enough to offset a 50% drop for in-person visits.
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Looking at per-capita telehealth use by county, they found that “the increase disproportionately benefited higher-income, metropolitan dwelling adults.”
People living in zip codes with the lowest poverty rates saw a bigger increase in telehealth use than people living in areas with higher poverty rates. The study also found a bigger increase for people living in metropolitan areas — though before the pandemic, telehealth was more widely used in rural areas. Finally, significantly more older adults (ages 46 and up) used telehealth than children under 12.
The study included data from 6.8 million members of employer-based health plans in 2020, and 6.4 million in 2019.
However, it had one significant limitation: it only focused on people covered by employer-based insurance, leaving out older adults covered by Medicare, as well as younger and low-income patients covered by Medicaid.
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In addition to Medicare’s sweeping expansion of telehealth coverage during the pandemic, many states have also opted to expand services that can be provided virtually for Medicaid plans.
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