OIG Brief Identifies Which Medicare Beneficiaries Were More Likely to Use Telehealth During First Year of COVID-19 Pandemic

The Office of Inspector General (OIG) is conducting oversight work assessing telehealth services to provide recommendations that can help policymakers and stakeholders consider changes to telehealth policies.[1] Part of that work involves assessing the impact of the public health emergency (PHE) telehealth flexibilities that were established by the Centers for Medicare & Medicaid Services (CMS) in response to the COVID-19 pandemic. The PHE has been in effect since January 2020.[2]

OIG examined the characteristics of Medicare beneficiaries who used telehealth the most during the first year of the pandemic, which gave the agency insight into how the flexibilities impacted different groups of beneficiaries.[3] The analysis was conducted by reviewing traditional Medicare claims data, Medicare Advantage encounter data, and data from the Medicare Enrollment Database.

It found:

• Medicare beneficiaries in urban areas were more likely than those in rural areas to use telehealth (45% urban compared to 33% rural).
• A large majority of beneficiaries (93%) used telehealth from home, regardless of whether they lived in urban or rural areas.
• Dually eligible beneficiaries were more likely than Medicare-only beneficiaries to use telehealth services (53% dually eligible compared to 40% Medicare-only)
• Hispanic beneficiaries were more likely than any other group to use telehealth regardless of whether the beneficiaries lived in rural or urban areas, or whether or not they were dually eligible (23% Hispanic compared to 21% Black and 19% White)
• Female beneficiaries were more likely than male beneficiaries to use telehealth (46% compared to 39%)
• Older beneficiaries were more likely to use audio-only services, as were dually eligible and Hispanic beneficiaries (23% of beneficiaries 75 and older, compared to 16% of those between 65-74).

While optimistic, the Center recommends caution in the expansion of telehealth services for beneficiaries. Telehealth should supplement, not replace in-person care. 

OIG states that these findings “demonstrate the important role that telehealth played in Medicare beneficiaries’ access to care when telehealth became more broadly available during the pandemic.” Among other things, it concludes that because dually eligible, Hispanic, and female beneficiaries were more likely to use telehealth, the service can be a valuable tool to advance health equity.

The Center recently published this report which provides more information about telehealth and health equity issues. 

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[1] OIG. Telehealth. HHS. (Date n/a). Available at: https://oig.hhs.gov/reports-and-publications/featured-topics/telehealth/ 
[2] ASPR. Renewal of Determination that a Public Health Emergency Exists. COVID-19: Renewal of Determination that a Public Health Emergency Exists. (July 15, 2022). Available at: https://aspr.hhs.gov/legal/PHE/Pages/covid19-15jul2022.aspx 
[3] OIG. Certain Medicare Beneficiaries, Such as Urban and Hispanic Beneficiaries, Were More Likely Than Others to Use Telehealth During the First Year of the COVID-19 Pandemic. OEI-02-20-00522 09-02-2022. (September 2, 2022). Available at: https://oig.hhs.gov/oei/reports/OEI-02-20-00522.asp