This week’s Paragon Pic highlights the trend in telehealth services delivered for Medicare patients.
By every measure, telehealth utilization was low prior to the pandemic and jumped with the onset of the pandemic as in-person visits were restricted and barriers to telehealth were eased. In addition, telehealth became more attractive due to peoples’ voluntary actions—such as staying home and avoiding close contact—to diminish the risk of contracting COVID-19. However, the sharp increase in telehealth utilization was relatively short-lived. Telehealth visits, with the exception of mental and behavioral health services, began a rapid decline as in-person visits rebounded.
For Medicare, according to the Government Accountability Office, telehealth increased tenfold from about 5 million services pre-pandemic (April to December 2019) to more than 53 million services (April to December 2020) after Medicare issued various waivers to expand access to telehealth. Medicare spending on telehealth increased at a similar rate, rising from more than $306 million pre-pandemic to about $3.7 billion over the same period in 2020. Mental and behavioral health services were the most used services, and the increase was sustained throughout the year. Other types of telehealth services increased initially in April but then declined over the year. The Congressional Budget Office confirmed this pattern persisted over 2020-2023, with mental telehealth services remaining elevated.
The percentage of Medicare Part B beneficiaries who received telehealth services just prior to the pandemic at the beginning of 2020 was 5 percent. It jumped to over 30 percent in the second quarter of 2020 and then rapidly declined to just over 20 percent in the third quarter of 2020. Since then, there has been a more or less continual decline to approximately 10 percent by the second quarter of 2023, where it held steady through the end of the year.
