Health
Telehealth became more widely used throughout the US during the COVID-19 pandemic. Data indicates that about 80% of physicians plan to continue using it. At the beginning of the pandemic, telehealth visits increased from about 5 million to more than 53 million among Medicare recipients alone. Data collected from April 14, 2021, through August 8, 2022, shows that while telehealth usage rates peaked during the pandemic, they remain higher than pre-pandemic levels.
The Department of Health and Human Services (HHS) defines telehealth as access to a healthcare provider without an in-person office visit. This includes video chats over computers, tablets, or phones.
Telehealth also includes phone calls and digital communication with a provider, such as email or data exchange through a portal. It may also encompass the use of remote monitoring devices like a blood pressure monitor or glucose meter.
Interest in telehealth was slowly rising until spring 2020, when the pandemic and subsequent lockdowns made it a necessity. To promote contact-free prevention measures, former President Donald Trump expanded Medicare’s telehealth benefits via executive action, granting millions of Americans access to telehealth services. Up until then, Medicare coverage for telehealth was only available in very specific circumstances.
The term telehealth is often used interchangeably with telemedicine. According to the Office of the National Coordinator for Health Information Technology, telemedicine refers to clinical services, while telehealth includes non-clinical services. For example, non-clinical services may include things like administrative meetings, while clinical services include patient consultations.
However, the official Medicaid website no longer uses the term telemedicine, and instead refers to all consultations, diagnoses, meetings, and health assessments completed across a distance as telehealth.
The differences between telehealth and in-person care depend on the patient’s condition. For example, telehealth may be appropriate for consultations, follow-up visits, or common ailments. However, it may be less suitable for conditions that require a physical examination or bloodwork.
Telehealth protects patients from potential exposure to communicable diseases in the doctor’s office. Virtual doctor visits give patients access to specialists who may otherwise be inaccessible because they live too far away.
However, telehealth may prove more challenging than in-person care for either provider or patient if they have difficulty communicating via video chat. Some telehealth providers may need to make appropriate accommodations for patients with disabilities.
Not everyone has access to the broadband internet necessary to access video telehealth services. Others may not have the technical knowledge required to operate telehealth platforms or monitoring devices.
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From April 2021 to August 2022, telehealth use rates fluctuated between 20.5% and 24.2%, with an average of 22.0% of adults reporting telehealth use . The lowest rates were observed among people who are uninsured (9.4%), young adults ages 18 to 24 (17.6%), and residents of the Midwest (18.7%). The highest rates were among those covered by Medicaid (28.3%) and Medicare (26.8%), Black individuals (26.1%), and people earning less than $25,000 (26.4%).
According to data gathered by the Centers for Disease Control and Prevention (CDC), in 2021, 37% of adults had accessed telemedicine in the previous 12 months.
In 2021, telemedicine use was most prevalent among women, non-Hispanic whites, and non-Hispanic American Indians or Alaskan Natives.
People living in the Northeast and Western US accessed telemedicine more than people in other parts of the country.
Telemedicine use also increased with a patient’s age and education level, as well as when their family income was at or above 200% of the federal poverty level.
Telemedicine use was highest in larger metropolitan areas.
Regulations vary, but in most states, telehealth practitioners can prescribe antibiotics and other medications that are not considered controlled substances. However, some states may require an in-person exam before a telehealth provider can issue a prescription.
In some instances, telehealth providers can prescribe controlled substances.
Prescription controlled substances include medications such as:
Pre-pandemic guidelines required a patient to visit their physician for an in-person exam at least once before they could receive a prescription for a controlled substance via telehealth. The COVID-19 public health emergency waived this requirement. While this waiver officially ended May 11, 2023, the Drug Enforcement Administration (DEA) has issued a temporary rule to extend current flexibilities for controlled prescriptions and telehealth until November 11, 2023.
While the public health emergency officially ended in May 2023, the Consolidated Appropriations Act extends some of the telehealth coverage for people with Medicare through December 31, 2024.
The Consolidated Appropriations Act also permanently expanded some telehealth Medicare coverage to include expanded access to behavioral and mental telehealth services.
Federal law does not govern Medicaid benefits regarding telehealth. Therefore, each state varies in its regulations.
This article was compiled with data from various government sources, including the US Department of Health and Human Services, the CDC, and the Office of the National Coordinator for Health Information Technology.
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