Panel Examines What's Next for Telehealth After Pandemic Boom

by Jane Anderson

Telemedicine utilization boomed during the COVID-19 pandemic, filling some of the unprecedented gaps in care. But its greatly expanded use uncovered some areas where more investment is needed to encourage adoption, while at the same time creating fears that because of its convenience, the pendulum could swing to overutilization, stakeholders said in a webinar held June 8 by CareFirst BlueCross BlueShield.

A study in Health Affairs published in February and co-authored by panel participant Ateev Mehrotra, M.D., associate professor of health care policy and medicine at Harvard Medical School, found that during the pandemic, 30.1% of all visits were provided via telemedicine. In addition, the weekly number of telemedicine visits increased 23-fold compared with the pre-pandemic period. Telemedicine use was lower in communities with higher rates of poverty.

"There's [also] been a lot of other ways that people have been interacting — huge increases in portal messages and other mechanisms of e-consults — every form of telehealth really expanded quite rapidly during the pandemic," Mehrotra said. "I'm worried a bit about the identification of new patients, new problems and new diagnoses. That's where the research is going to have to focus."

Melisa Byrd, senior deputy director and Medicaid director for the District of Columbia Dept. of Health Care Finance, said during the webinar that telemedicine utilization jumped from "probably one to two tenths of a percent" just prior to the pandemic to around 20% of outpatient visits in March through September 2020, touching about 37% of beneficiaries. As the pandemic winds down, she said, continuing to support telemedicine will "reinforce and stabilize our provider network."

The fact that patients' internet data plans might not be sufficient to support video calls — or that the patients might need their limited data to support other priorities — became a surprise issue for the D.C. Medicaid program as it attempted to ramp up telemedicine visits within its low-income population, Byrd added.

Policymakers may have another concern: If telemedicine is adopted widely and is made convenient for everyone, "utilization will go through the roof and they will have an increase in spending," Mehrotra said. "Whether that's true or not is something we can debate; there has been very limited research on that."

From Health Plan Weekly