Telehealth provision, though remaining a significant aspect of medical delivery since the start of the COVID-19 pandemic, differs widely among physician age groups and practice areas, a new study published in Health Affairs.
Other research has previously documented telehealth patterns in terms of the demographic characteristics of Medicare beneficiaries, but the report is among the first national comparisons of such rates across Medicare-billing physicians and practices to also include data from more than two years after the start of the pandemic.
As such, the study could help offer insight into longer-term telehealth use and delivery, the authors said.
“Determining how physician and practice characteristics influence telehealth uptake is important for understanding how telehealth may affect health care access and patient outcomes,” the report said. ”These trends require ongoing attention as policy makers consider the future of telehealth policy in the US.”
The report may be particularly topical as Congressional telehealth flexibilities extended following the end of the public health emergency are due to expire at the end of 2024.
Some major findings of the report:
- Female physicians were still "significantly more likely" to deliver telehealth visits once adjustments were made for specialty and practice characteristics. This could be because telehealth offered the flexibility needed for female physicians who tend to have greater family responsibilities, the report’s authors suggested. Older physicians also tended to use telehealth more, but, when similar adjustments for specialty and practice characteristics were made, there was no difference between older and younger physicians.
- Telehealth provision differed widely by the services offered. Psychiatrists were the leading specialty in terms of such provision with 23% of such physicians offering all or most of their services via telehealth. Neurologists and infectious disease providers were next highest on the list. Dermatologists and ophthalmologists were among the lowest users of telehealth services.
- Rural areas offered less telehealth provision. While physicians in metropolitan areas offered 8.3% of their overall services via telehealth, their rural counterparts offered only 5.3%. Further research is needed into how telehealth can reduce barriers to care for patients in such rural areas and others where primary care shortages may be more common.
- Primary care physicians with greater use of telehealth tended to see "more medically and social complex patients"; psychiatrists using more telehealth tended to see fewer such patients.
As well as such findings, telehealth also differed by region. For example, such provision by primary care physicians and medical specialists ranged from 1.4% to 17.3% across states. Higher rates of telehealth services were concentrated in the northeast and the west.
Overall, 77.9% of primary care physicians provided less than 10% of their services via telehealth.
The report used Medicare fee-for-service data from 2022.