Telehealth usage continues to decline as Americans return to medical facilities, new data show.
In April, telehealth utilization fell 12.5%, a trend mirrored by a gradual shift back to in-person visits at hospitals and other healthcare settings, according to FAIR Health's Monthly Telehealth Regional Tracker.
Claims for telehealth services have receded for consecutive months. Telehealth represented 4.9% of all medical claims in April, down from 5.6% the prior month. Southern states experienced the greatest decline in telehealth claim lines during that time, at 12.2%.
The COVID-19 clinic forced many medical facilities to close temporarily or scale back, and many patients were nervous about catching the virus. Utilization of telehealth services dramatically increased to narrow the access gap last year. To better serve patients—and to generate badly needed revenue—clinics worked to integrate telehealth and virtual care services into their practices.
Rising vaccination rates and falling COVID-19 cases, at least in parts of the country, are encouraging patients to resume in-person medical appointments.
Apart from mental health, telehealth utilization has contracted. Mental health conditions are the top diagnoses treated via telehealth, according to FAIR Health. Mental health telehealth claims rose from 57% of all mental health claims in March to 58.6% in April.
Acute respiratory diseases and infections also rose as a percentage of telehealth claims in April in parts of the country, as did visits for minor ailments such as colds and stomach viruses, the report says.
Telehealth usage rose to unprecedented and inflated levels during the worst of the pandemic, so it's only natural that trend would reverse as people return to more normal activity, said Ari Gottlieb, principal at A2 Strategy.
Moreover, public and private payers had encouraged the use of telehealth but are scaling back this year, Gottlieb said. "There were a lot of incentives in 2020 in the form of copays and cost-sharing reduction that health plans were driving to try and extend telehealth," he said. "Those have expired now. In a lot of cases, telehealth is now treated as any other claim."
Even so, there is sustainability, innovation and staying power in telehealth that gives the virtual space a sense of security, said Bret Anderson, principal with the Chartis Group.
"Pre-pandemic adoption levels of telehealth are a thing of the past," Anderson said. "There is a lot of reason to believe that telehealth is here to be a substantial part of care delivery models for the foreseeable future."
As technology evolves, telehealth will likely see a gradual increase over time, Gottlieb said. The absence to date of a federal law requiring Medicare and Medicaid to pay for telehealth services will be constraint on the sector's growth, he said. That's even though vendors have established a model for direct-to-consumer telehealth services and patients responded well to the option over the past year, he said.
"In-person [care] is always going to be alive and well," said Krista Drobac, executive director of the Alliance for Connected Care. "It's up to us as advocates to create a regulatory environment where telehealth can be an option in the long term." A subset of patients has chosen telehealth as a substitute for in-person visits, rather than a supplement to it, she said.
Utilization data and other trends suggest patients are willing to switch providers to find one with robust digital and telehealth offerings, Anderson said. "It's important for hospitals and health systems to be looking at virtual care as one of those items in their toolkit to maintain [and attract] strong patient relationships," he said.
This article has been updated with additonal expert commentary.