Special Report: Telehealth and the Medicare Population: Building a Foundation for the Virtual Health Care Revolution

From 2019 to 2020, the use of telehealth by Medicare beneficiaries increased over 6,000%. As the United States slowly emerges from the COVID-19 pandemic, this exponential expansion of telehealth and virtual care options are poised to change our nation’s health care landscape, with the enticing potential of improving access to care. With significant change also comes significant challenges, however, and when considering how to grow telehealth in a way that benefits all equally, it will be essential to examine and address the racial, social, and economic disparities that are already beginning to drive a “digital divide” in this country that could impact the quality of care that people receive.

The Center for Medicare Advocacy (the Center) has recently released an examination of these issues through a report entitled Telehealth and the Medicare Population: Building a Foundation for the Virtual Health Care Revolution. Authored by Chiplin Medicare and Health Policy Fellow Cinnamon St. John, the Center’s report explores current gaps in accessibility and infrastructure, discusses how these gaps could stand in the way of ensuring that all Medicare beneficiaries have equal access to the advantages that telehealth can provide, and highlights key policy priorities that should inform the design of future regulation and legislation.

While grounded in research, the report’s findings were additionally informed by interviews with experts from around the nation about the experiences (both challenges and conveniences) that older adults and people with disabilities have had when utilizing virtual care. We examined these issues through the lens of what we call “T.A.P. Challenges: Technology, Accessibility, and Peopleware.” Throughout the report, we describe driving factors and key considerations behind each of these three categories of T.A.P. challenges, illustrated by examples from the field.

While the Center recognizes the value of telehealth services and is heartened by the potential to increase access to the country’s health care system, we are also committed to ensuring that no beneficiaries are caught in the chasm created by the digital divide – created through disparities between those who can afford access and are able to utilize technology, and those who cannot. Furthermore, telehealth must supplement, not replace, in-person care options. In the early days of the pandemic, as the critical role of virtual care solutions became clear, the Center published 11 guiding principles to aid in making decisions about whether and how to expand Medicare coverage for telehealth. In addition to the findings and recommendations included in our most recent report, these guiding principles still hold true today.

The Centers for Medicare & Medicaid Services (CMS) has professed a commitment to addressing health disparities as a foundation of all its work “in every program and across every community.” In recognizing “systemic racism, persistent poverty and other disparities,” the Biden Administration, too, pledged a commitment to pursuing a comprehensive approach to advancing equity for all. This special telehealth report is aimed at advocates, lawmakers, and policy makers to aid in the creation of holistic policies that, as much as possible, do not create an unintended consequence of widening the digital divide.

Let us build upon the lessons learned through the pandemic to help create a future where better health, quality care, and equality are realized.

Read or download the full report here: https://medicareadvocacy.org/wp-content/uploads/2022/05/Telehealth-Report_CMA_final.pdf