Primary care telehealth utilization by access-challenged populations in Medicare Advantage
Emily Boudreau, Amanda Sutherland, Debra Bozzi, Melanie Canterberry, Gosia Sylwestrzak
Abstract
Although telehealth utilization in primary care has decreased markedly since 2020, it remains higher than before the COVID-19 pandemic. There is debate about its role in a post-pandemic healthcare system, particularly for certain groups of patients that may experience greater access challenges related to in-person care. To inform this debate, we examined the use of audiovisual telehealth for primary care as a share of total primary care outpatient visits among Medicare Advantage beneficiaries with and without 3 characteristics associated with potential access challenges (low-income status, disability, and frailty). Primary care visits when the beneficiary was frail were 39.4% (OR: 1.39 [95% CI, 1.37-1.42]) more likely to be telehealth; when the beneficiary was disabled or low-income status, visits were 20.1% (OR: 1.20 [95% CI, 1.18-1.22]) and 8.3% (OR: 1.08 [95% CI, 1.05-1.12]) more likely to be telehealth, respectively. The differential use of telehealth among beneficiaries with low-income status or disability, compared with those without, was significantly larger among providers with a 2-sided risk contract compared with fee for service (low-income status: OR: 1.19 [95% CI, 1.04-1.35]; disability: OR: 1.07 [95% CI, 1.01-1.13]).