CMS telehealth expansion increased use in disadvantaged neighborhoods, study shows

The expansion of Medicare coverage for telehealth visits during the pandemic increased use among socioeconomically disadvantaged beneficiaries in both rural and urban areas, according to a study published May 2 in Health Affairs.

The researchers analyzed 30 million Medicare fee-for-service claims from 2019 to 2021 to determine how much outpatient telehealth use grew throughout the pandemic. CMS expanded telehealth coverage to all patients in March 2020. Before that waiver, telehealth visits were covered only for certain medical facilities and for those living in designated rural areas.

Before the waiver, 0.42 percent of patients had at least one outpatient telehealth visit, with no notable differences between people living in the most versus the least disadvantaged neighborhoods. However, odds of telehealth use were more than four times higher in rural areas than for metropolitan areas, according to the study.

After the waiver, 10 percent of patients had at least one outpatient telehealth visit, with the highest odds of use among those living in the most disadvantaged neighborhoods and those living in metropolitan areas.

"Our data suggest that the coverage waiver increased access to telemedicine for all Medicare populations, including people residing in the most disadvantaged neighborhoods, although the odds of use were persistently lower with increasing age," the study's researchers wrote. "Overall, these findings are encouraging, but they illuminate a need for targeted interventions to improve telemedicine access further."

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