6 Key Trends: Which Medicare Patients are Adopting Telehealth the Fastest?

TREND #1

Use Of Telehealth Services Varies By Geography, Race And Ethnicity, Reason For Medicare Eligibility, And Dual Enrollment In Medicare And Medicaid (Figure 1).

Geography: Rates of telehealth use in 2023 were higher among beneficiaries living in urban areas than those in rural areas (27% vs. 19%), which may be due in part to access to broadband and other communication technologies. Beneficiaries in rural or underserved areas may lack the infrastructure to support reliable video telehealth visits or the means to afford internet access, which may further impede access to telehealth if coverage of audio-only services is reduced or eliminated.

Race and ethnicity: Rates of telehealth use in 2023 were highest among Asian and Pacific Islander (31%) and Hispanic (30%) beneficiaries, and somewhat lower among Black (26%), American Indian or Alaska Native (25%), and non-Hispanic White beneficiaries (24%). Given that beneficiaries of color are more likely than non-Hispanic White beneficiaries to report difficulty accessing needed health services, telehealth use may help to improve access to care for certain groups.

TREND #2

Medicare Eligibility and Care at Home

Rates of telehealth use in 2023 were higher among beneficiaries who qualify for Medicare based on having end-stage renal disease (ESRD) (37%) or a long-term disability (37%), relative to those who qualify based on age (23%). This may be due in part to higher overall rates of service use among people with ESRD and disabilities (whether in-person or via telehealth) but may also reflect a preference for telehealth services among these populations, or a greater ease of accessing care via telehealth relative to in-person care.

Beneficiaries under age 65 who qualify for Medicare based on having long-term disabilities are more likely than older beneficiaries  to report having three or more limitations in activities of daily living and may be more likely to benefit from the increased flexibility of receiving health care services from their home via telehealth.

TREND #3

Dual-Eligible Beneficiaries Have Higher Rates

Rates of telehealth use in 2023 were higher among beneficiaries dually eligible for both Medicare and Medicaid compared to Medicare beneficiaries who were not Medicaid-eligible (34% vs. 23%). Dual-eligible individuals are four times more likely  than other Medicare beneficiaries to live on incomes of less than $20,000. Prior studies have found that having lower income or living in a socioeconomically deprived neighborhood is associated with higher rates of telehealth use, suggesting that telehealth may have the potential to improve health care access for beneficiaries with limited access to in-person services.

TREND #4

Rural Patients Are Leading the Way in Telehealth Adoption

With limited access to healthcare facilities and specialists, rural Medicare patients are among the most significant adopters of telehealth. For these patients, telehealth provides a convenient alternative to long travel distances, especially for routine check-ups or follow-ups. Expanding telehealth access in rural areas could further reduce barriers to essential healthcare for this group.

TREND #5

Chronic Condition Management Drives Usage

Medicare patients with chronic conditions, such as diabetes, heart disease, and hypertension, are increasingly turning to telehealth for ongoing care and disease management. Telehealth offers these patients consistent and regular check-ins with providers, which is essential for managing their health. Telehealth care management also supports better medication adherence, lifestyle adjustments, social determinants, and early intervention when issues arise, making telehealth a valuable resource for the Medicare population.

TREND #6

Older Adults are Embracing Telehealth, Especially for Mental Health

While telehealth was initially more popular among younger adults, the COVID-19 pandemic pushed older adults to adopt it, especially for mental health services. Many Medicare patients now use telehealth for therapy, counseling, and mental health check-ins. The flexibility of telehealth reduces the stigma and logistical challenges often associated with seeking mental health care, contributing to improved well-being for these patients.

These trends highlight a growing acceptance of telehealth across specific segments of the Medicare population. By understanding these patterns, home care providers can better address patient needs, streamline resources, and advocate for expanded access to telehealth services to meet these evolving demands.

MEDICARE AND HOSPICE TELEHEALTH FLEXIBILITIES SET TO EXPIRE DECEMBER 2024

Telehealth flexibilities for individuals with Medicare are set to expire on Dec. 31, 2024. These flexibilities were created during the COVID-19 pandemic and then were extended for two years post-pandemic. This includes reimbursement for telehealth services in any geographic area, allowing patients to remain in their homes for telehealth visits rather than requiring travel to a health care facility, and delivering telehealth using audio-only technology if a patient cannot use both audio and video, among other flexibilities.

The use of telehealth to conduct face-to-face encounters before recertifying eligibility for hospice care during an emergency period is also set to expire. Multiple committees have already proposed bipartisan legislation to extend telehealth coverage for at least two years or make it permanent, such as the Telehealth Modernization Act (H.R. 7623), Preserving Telehealth, Hospital and Ambulance Access Act (H.R. 8261) and CONNECT for Health Act of 2023 (H.R. 4189/S.2016).

Without congressional action, Medicare faces potential changes in telehealth flexibilities as of December 2024.

Some key flexibilities set to expire include:

• The ability for patients to receive telehealth services from their homes;
• The expansion of telehealth services to urban and suburban areas;
• The inclusion of audio-only services in telehealth coverage; and
• The ability of certain providers, such as physical therapists and occupational therapists, to offer telehealth services.