Pandemic Telehealth Growth Mostly in Urban, Upscale Areas

By John Commins

The great promise that telehealth will bring remote care access to rural and underserved communities across the nation isn’t happening yet, a new RAND Corporation study suggests.

The study — published this month in the American Journal of Preventive Medicine — looked at more than 6 million employer-based private insurance claims in 2019 and 2020, representing 200 employers across all 50 states. It found that most of the telehealth claims were for more affluent beneficiaries who lived in metropolitan areas.

The study authors said their findings suggest that the pandemic is worsening healthcare access and use disparities.

“This study expands our understanding about the growing use of telehealth as the pandemic progresses,” said lead author and RAND researcher Jonathan Cantor. “Given our findings, policymakers should consider increasing efforts to reach populations that are deferring in-office care and not replacing it with telehealth visits.”

The study found a dramatic, 20-fold increase in telemedicine use when the pandemic began in March 2020, as office-based visits fell nearly 50%.

The researchers also examined the number and types of care received by enrollees from January 2019 through July 2020.

The increase in telemedicine was greatest among patients in counties with low poverty levels — about 48 visits per 10,000 people versus 15 per 10,000 people in high-poverty areas — and among patients in urban areas — about 50 visits per 10,000 people versus about 31 visits per 10,000 people in rural areas.

Adults were more likely to have a telehealth visit as compared to children aged 12 and younger — about 65 visits per 10,000 adults as compared to about 50 visits per 10,000 children.

Cantor said the finding suggest that “more intensive training for parents and pediatricians about telehealth, as well as efforts to address barriers to children’s access to telemedicine, may be necessary.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.