One in Six Medicare Beneficiaries Use Telehealth for Essential Care

1. In  this cross-sectional study, 16.4% of Medicare beneficiaries had at least one telehealth visit between 2021 and 2023, with users more likely to have higher education, physical or cognitive limitations, and greater outpatient healthcare use.
2. Anxiety and depressive disorders were the most common conditions managed via telehealth, while uncomplicated diabetes mellitus was the most frequent non-mental health condition.

Evidence Rating Level: 3 (Average)

Study Rundown: Telehealth services for people covered by Medicare expanded substantially during the COVID-19 pandemic. Despite this growth, long-term coverage for telehealth visits addressing non-mental health conditions has not been guaranteed, raising concerns about reduced access to care for individuals who face barriers to attending in-person appointments. This study used data from the 2021-2023 Medical Expenditure Panel Survey to examine patterns of telehealth use across the United States and to identify the types of medical conditions managed through virtual visits. Among respondents, a minority reported engaging with a telehealth visit during the study period. Individuals who used telehealth were more likely to have higher levels of education, report physical or cognitive limitations, describe their health as fair or poor, and have greater overall outpatient healthcare use. Virtual care accounted for a substantial proportion of visits related to mental health, while representing only a small share of visits for other medical conditions. Anxiety and depressive disorders were the most frequently addressed concerns through telehealth. In contrast, the most common non-mental health conditions managed virtually included uncomplicated diabetes, hypertension, and COVID-19. Due to the findings rely on self-reported survey data, they may be subject to recall bias and limited generalizability. Nonetheless, the results suggest that eliminating telehealth coverage for non-mental health conditions could disproportionately affect Medicare beneficiaries with greater health needs and higher healthcare utilization, potentially worsening existing barriers to accessing care.

Click to read this study in AIM

Relevant Reading: Use of Telehealth Among Medical Visits in the United States: Results From the 2021 Medical Expenditure Panel Survey

In-Depth [cross-sectional study]: This cross-sectional study assessed telehealth use across the United States and identified the medical conditions most frequently addressed during virtual visits. The analysis included adults aged 18 years and older who self-reported Medicare coverage and at least 1 outpatient visit in the 2021–2023 Medical Expenditure Panel Survey, a nationally representative survey that captures outpatient and inpatient healthcare utilization. Telehealth users were compared with individuals who relied exclusively on in-person care, and the primary conditions managed during telehealth encounters were examined. Among 14,950 respondents, 83.6% reported only in-person visits, whereas 16.4% had at least 1 telehealth visit. Compared with non-users, telehealth users were more likely to report a bachelor’s degree or higher (53.5% vs. 43.1%), any physical or cognitive limitation (59.0% vs. 46.7%), and fair or poor health status (28.9% vs. 20.6%). They also had a higher mean number of total outpatient visits (25 [95% confidence interval [CI], 23 to 27] vs. 14 [95% CI, 14 to 15]), suggesting greater overall healthcare utilization. Telehealth visits accounted for 45.1% of all mental health visits, corresponding to an estimated 31,338,227 visits annually. In contrast, telehealth comprised 3.3% of visits for non-mental health conditions, representing an estimated 29,081,847 visits per year. The conditions associated with the highest estimated annual telehealth visit volume were anxiety-related disorders (9,449,133 visits) and depressive disorders (8,766,332 visits). Among non-mental health conditions, uncomplicated diabetes mellitus (2,192,213 visits), hypertension (1,527,758 visits), and COVID-19 (1,101,947 visits) were the most common. Overall, these findings suggest that approximately 1 in 6 Medicare beneficiaries used telehealth at least once, particularly individuals with health limitations and higher outpatient visit frequency, for both mental health and select chronic medical conditions.

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