A cohort study of more than 36 million people in the United States found a dramatic increase in telehealth use during the first four months of the COVID-19 pandemic.  

Using data from Blue Health Intelligence data repository – an independent data and analytics company that is a licensee of the Blue Cross and Blue Shield Association – researchers from the Johns Hopkins Bloomberg School of Public Health compared claims data from March through June 2019 with March through June 2020.  

During the first four months of the pandemic, telehealth visits accounted for 23.6% of all interactions – compared with 0.3% of contacts in 2019.  

"The spring of 2020 represented the first time in US history that such a large proportion of Americans had wide access to telehealth services. By undertaking this study, we sought to gain an understanding of the patterns of virtual care during this initial phase of the COVID-19 era," wrote the researchers.  

WHY IT MATTERS

The study, which was published this week in the Journal of the American Medical Association Network Open, supports existing data showing skyrocketing telehealth rates amid the pandemic.  

Researchers limited the study population to individuals covered through employer-based, Affordable Care Act and other private health insurance plans, but not Medicare or Medicaid – an important limitation, given emerging evidence about virtual care's role in exacerbating the digital divide.  

Still, researchers found that virtual care use rates were higher in the most "socially advantaged" neighborhoods versus the least socially advantaged neighborhoods.  

Rates were also higher in states with high rates of COVID-19 during the study and in urban locations.   

"Age and disease burden appear to be associated with telehealth uptake, with those aged 18 to 49 years and with 2 or more chronic conditions using more telehealth," noted the study.  

Behavioral health encounters were far more likely than medical contacts to take place virtually.  

In addition, people receiving COVID-19 care had substantially increased medical costs, as well as visit rates and telehealth-use rates.  

The researchers noted that relying on claims-based data can have limitations.  

"Any claims-based research is sensitive to missing or inaccurate coding that corresponds to variations in policies or benefit structures across health plans," they wrote.  

THE LARGER TREND  

"Telehealth is here to say," has become a frequently cited mantra among a wide range of stakeholders, but the question still remains: how?

Although members of Congress have frequently introduced legislation to safeguard virtual care access in some capacity, none of the bills have made it into law.  

Meanwhile, the Medicare Payment Advisory Commission told policymakers earlier this month that they should temporarily continue some of the telehealth flexibilities allowed during the public health emergency to gather more evidence about the impact of telehealth on care access, quality and program spending.  

ON THE RECORD

"Although some of the associations we uncovered may be unique to the COVID-19 environment, arguably the insights we gained will be relevant to the future trajectory of telehealth no matter what direction it takes," wrote the research team.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.