Study Finds Inequities in Telehealth Care

A recent study found inequities in the use and access to telemedicine during the COVID-19 pandemic, with older adults, low-income individuals, non-English speaking individuals and minority groups most affected. The study looked at 148,402 patients scheduled for primary care and medical specialty ambulatory telemedicine visits at a large academic health system during the early phase of the COVID-19 pandemic. The study authors note that this is the first large-scale study to characterize inequitable access to telehealth care. Unfortunately, the findings from the study revealed troubling inequities in access to telemedicine.

The study, published in JAMA Network Open, “found that older age, Asian race, and non-English language as the patient’s preferred language were independently associated with fewer completed telemedicine visits and that older age, Black race, Latinix ethnicity, and lower household income were associated with lower video use.”

The JAMA study found that the “COVID-19 pandemic has devastated communities of color and marginalized populations, exposing the deep inequities of our US health care system. The findings of this study demonstrate that significant inequities are also present among patients in accessing necessary telemedicine care.”

The study’s conclusion includes a call to “intentionally design our system to mitigate inequity.”  As the pandemic rages on, and with the current low vaccination rates, telehealth will likely continue to be viewed as a safe means to offer health care, while protecting patients from the spread of the virus. Therefore, it is essential that policy be informed by such studies and that health equity be central to the development of new policies.

The Center for Medicare Advocacy has long raised concerns regarding unchecked expansion of telehealth because it could worsen inequities in health care. During the summer of 2020, as some stakeholders began to push for the temporary COVID-19 related flexibilities that allowed expanded telehealth to be made permanent, the Center raised concerns regarding inequities and urged careful study. To guide the discussions, the Center for Medicare Advocacy, jointly with Medicare Rights Center, released telehealth principles, with a focus on safeguarding consumer protections and beneficiary access to care. The JAMA study confirms the validity of our concerns and the critical need to mitigate inequity in telehealth going forward.