New data make a case for expanded, permanent telehealth coverage for Medicare patients

Bowling Green, Kentucky (December 8, 2021) – The Centers for Medicare and Medicaid Services (CMS) released a new Medicare Telemedicine Data Snapshot on Friday, December 3.

This kind of government data can sometimes get overlooked especially during the end-of-the-year frenzy. However, Connected Nation has been studying telehealth trends in Michigan since 2019 and noticed something in this recent federal data release not seen before—a record uptick in telehealth usage among Medicare users.

In actuality, “record uptick” might be an understatement, especially when you consider that the number of Medicare beneficiaries using telemedicine services between March 1, 2020 and February 28, 2021 increased over 30 times the number of users as the prior year (March 2019 to February 2020).

Let us put that into real numbers. Pre-pandemic, 910,490 Medicare patients filed telemedicine claims— a combination of telehealth, e-visits, and virtual check-ins—between March 2019 and February 2020. During the pandemic that number swelled to a whopping 28,255,180, representing a majority (53%) of Medicare users.

In this latest snapshot, CMS supplies additional details based on geography, ethnicity, gender, and other characteristics. Some key findings include*:

• Percentage of Medicare patients using telemedicine services by geography:
  • 44% rural areas | 55% urban areas
    
    
• Percentage of Medicare patients using telemedicine services by demographic and beneficiary characteristics:
  • 50% of male users | 55% of female users
  • 51% 65 or older| 63% disabled | 67% ESRD (end stage renal disease)
  • Minority groups:
    • 58% American Indian/Alaska Native
    • 57% Asian/Pacific Islander
    • 57% Black/African American
    • 64% Hispanic

*Please note: the percentages are from each category not the total numbers. So, for example, “44% rural areas” refers to 44% of the total number of Medicare users living in rural areas and “64% Hispanics” refers to 64% of the total number of Hispanics with Medicare coverage.

The snapshot goes on to break down the usage among those who are eligible for both Medicare and Medicaid. Those with dual coverage used telehealth overall at a higher rate than those with just Medicare.

We all know that telehealth usage increased as COVID-19 forced patients and doctors to find new ways to limit exposure and the spread the disease. But a key component that made that even a possibility was a change in the regulations surrounding telehealth—including compensation.

CMS directly points to this in the overview of the snapshot through the following statement: “In response to the COVID-19 public health emergency, telemedicine services have been expanded to increase access to care including: lifting of geographic area restrictions with services allowed to be delivered from patients’ home; allowing for both new and established patients; expanding eligible services and the types of providers; and allowing for a select set of audio-only telehealth services.”

Connected Nation has heard from primary care physicians, mental health practitioners, and other health care providers throughout the 18 months that the simple lifting of regulations that limited their ability to use telehealth—and to be compensated for that service—made it possible to expand access and reach more people.

CMS goes on to say that although the agency “observed large increases in telemedicine use with variation across geographic and demographic groups. These differences may be driven by a number of factors, including access to broadband internet, varying state-level policies on the delivery of telemedicine across state lines and the timing and degree to which the pandemic affected geographic areas differently.”

We would argue that among the critical needs is to expand not only access to broadband but also working to ensure it is affordable and that others understand both how to access the technology and how it can benefit them.

According to the Department of Health and Human Services, Medicare providers offer health care coverage for some of our nation’s most medically vulnerable populations—age 65 or older, younger people with disabilities, and people with End State Renal Disease (permanent kidney failure requiring dialysis or transplant).

These latest numbers prove that when given the resources and opportunity to use telemedicine many of these patients will opt to use the technology.

Although the data provided in the snapshot do not explore the reasons why people opt for telemedicine, we have learned through our research in Michigan that it can save individuals and families money and time. In Connected Nation Michigan’s (CN Michigan) comprehensive study released in February 2020, our researchers found that in just five counties alone telehealth usage stood for a savings of nearly $4.7 million per year for just simple 15-minute visits to general practitioners.

In addition, “with studies showing that the average doctor’s visit requires approximately two hours between travel, waiting rooms, and the visits themselves, this represents nearly $1 million ($985,000) in lost productivity per year, totaling a savings of $5.7 million per year in the five counties” included in the CN Michigan study (as of this writing a follow-up study is set to be published in the next few weeks).

This latest federal data shows that our most medically fragile patients could also receive help from expanded and permanent telehealth coverage. Now is an opportunity for rule makers to rethink our nation’s long-term approach to telemedicine and help create proactive and positive change in the lives of all Medicare users.  

We urge them to do so.

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Editor’s note: The above numbers may continue to grow as Medicare claims and encounter data are processed. That is because there can be a delay or “claims lag” between when a service occurs and when the claim is processed. As CMS writes in the snapshot, “The length of the lag depends on the service type and program. There may also be longer claims lag due to the pandemic, but we’re not sure of the impact.”