Following a telehealth boom in 2020 propelled by the COVID-19 pandemic, hospital virtual visits are leveling off to below 20% of total medical appointments.
About 40% of hospital executives report that up to 10% of their appointments are done virtually and the same percentage said 11% to 20% of their volume is virtual, according to a recent survey by KLAS Research and the Center for Connected Medicine.
The small handful of respondents (12%) are currently conducting more than 30% of their appointments virtually but note that their volumes are still inflated by the pandemic and expect their long-term volumes to be lower, the survey report said.
Telehealth use overall has stabilized at levels 38 times higher than before the COVID-19 pandemic, ranging from 13% to 17% of visits across all specialties, according to an analysis from McKinsey released in July.
In April 2020, overall telehealth utilization for office visits and outpatient care was 78 times higher than in February 2020, McKinsey reported.
About a year ago, the consulting firm projected that telehealth was poised to take a bigger share of the healthcare market, estimating that up to $250 billion, or 20% of all Medicare, Medicaid, and commercial outpatient, office, and home health spend could be done virtually.
Today, current utilization trends reflect more than two-thirds of what McKinsey anticipated as visits that could be virtualized.
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Fair Health also reported that national telehealth utilization declined in June 2021, falling 10% nationally month-over-month.
Telehealth utilization, measured as a percentage of all medical claim lines, dropped from 5% of medical claim lines in May to 4.5% in June, according to Fair Health's Monthly Telehealth Regional Tracker. By comparison, telehealth utilization rose 2% nationally from April to May 2021, following decreases each month from February to April. The data represent the privately insured population, including Medicare Advantage and excluding Medicare Fee-for-Service and Medicaid.
Nationally and in every region, mental health conditions remained in the number one spot among telehealth diagnoses and continued to increase in the percentage of telehealth claim lines, Fair Health reported.
Telehealth use cases and ongoing challenges
According to the KLAS Research and CCM report, hospitals are using telehealth services most frequently for primary care and behavioral health. Initial success is prompting provider organizations to grow these services as well as expand into other clinical service lines. Two areas likely to see telehealth expansion are chronic care management and urgent care, according to the report.
The report's authors note that the wide-scale implementation and mass migration of patients to telehealth was a watershed moment in the technology’s development.
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"But it remains unclear what the future holds. Certainly, telehealth isn’t likely to go back to pre-pandemic utilization—health systems have too much invested to let these solutions gather dust," the report authors wrote. "And many patients have experienced the ease and convenience of e-visits and other digital health solutions. Yet, as the findings in this report demonstrate, usage has fallen with the reopening of doctor offices and hospitals."
Moving forward, healthcare organizations should focus on the value telehealth can deliver both to patients and the health care system overall, the report authors said.
The report found that the number of health systems measuring telehealth usage and patient satisfaction increased, compared with an earlier survey.
In October 2020, 77% of respondents were using at least one metric to measure their telehealth program; that percentage has now jumped to 92%. Measurement of visit volumes and patient satisfaction ratings has increased significantly since the 2020 report, and these metrics are now the ones most commonly used to measure success.
However, the number of hospitals attempting to link telehealth use to patient outcomes remains relatively low, the report found.
Hospital executives report that integrating their telehealth solution with their electronic health record (EHR) system is less of a challenge now compared to 18 months ago. But there remain major barriers to advancing telehealth services.
The lack of patient access to technology and broadband issues prevent patients, especially those in rural areas, from accessing virtual care options. To address this challenge, respondents are using grant funding and advocating with the government for improved technology/broadband access, according to the report.
Uncertainty around reimbursements for virtual care appointments continues to be a major barrier for providers.
One manager of virtual health said, “COVID-19 legislation has been an enabler for reimbursement. I hope we don’t go back to 2019 rules when those waivers expire.”