The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “What will happen to patient demand for telehealth in 2022?” The majority (40%) said “stay the same,” while 30% responded “increase” and 30% stated “decrease.”
The poll was conducted Oct. 19, 2021, with 810 applicable responses.
For practice leaders who are not so bullish on patient demand for telehealth heading into next year, the primary response was that it isn’t a good fit for their specialty. Other responses include:
- “Many patients have difficulties with telehealth electronic requirements.”
- “Uncertainty of changing waivers and insurance coverage.”
Among respondents who expect demand to remain the same, the changes they are planning to implement to sustain their services in 2022 include:
- “If CMS reimbursement continues, we will stay the same or increase. If no reimbursement, we will be forced to scale back.”
- “We have chronically ill patients who are often unable to come into the office. They have greatly embraced telehealth. Our staff loves it.”
Practice leaders who anticipate demand to increase beyond current levels expect to do the following to prepare to meet patient needs:
- “Investing $100K in equipment for virtual visits, leveraging AI technology for expanded capabilities, focused staffing, provider and patient resources/training/education.”
- “Build clinic schedule templates with slots specifically for telehealth/med visits including after hours; monitor reimbursement rates and adjust appointment capacity accordingly.”
Although telehealth visits plateaued in recent months, patient demand has not waned. Uncertainty remains around telehealth’s future, as it relates to access, eligible practitioners, reimbursement and other restrictions. Regardless of what happens after the public health emergency (PHE) ends, several studies show that demand for telehealth is at an all-time high:
- According to a McKinsey & Company study, the use of telehealth is 38 times higher than before the COVID-19 pandemic.
- A J.D. Power study revealed that 36% of patients surveyed used telehealth services in 2021, a 27% increase from 2020 and a 29% increase from 2019.
- A Kaiser Family Foundation study found more than one in four (15 million) Medicare beneficiaries used telehealth during the summer and fall 2020.
- In a COVID-19 Healthcare Coalition study, 75% of patients surveyed said they had a “strong interest” in using telehealth.
- A Medicare Payment Advisory Commission report to Congress indicated that 91% of Medicare beneficiaries were satisfied with their telehealth video visits.
A vital care option for patients and practices
The demand for telehealth is driven by several factors that make it an appealing care option for patients:
- Care continuity — In the beginning of the pandemic, telehealth served as a bridge to care for patients, particularly those with chronic and/or comorbid conditions, when in-person visits were limited or suspended. Going forward, telehealth can help providers manage care through remote patient monitoring, coaching, therapeutics and virtual visits. In addition, on-demand virtual urgent care can conceivably reduce ER visits. For more on the potential of virtual care, see the McKinsey & Company study.
- Efficiency — Telehealth can help with practice efficiency by making it possible for patients to be seen more frequently — and in less time — during follow-up appointments. Virtual care also helps reduce no-shows, which can cut into revenue and wreak havoc on schedules. One study at a primary and specialty care clinic conducted in spring 2021 found that telehealth no-show rates were nearly 30% lower (7.5% vs. 36.1%) than in-office visits during the pandemic and more than 22% lower than in-office visits prior to the pandemic (7.5% vs. 29.8%).
- Convenience — Telehealth has long been lauded for use in rural areas, where distance and a shortage of providers make it difficult for patients to receive adequate care. Virtual care can also potentially close the care gap by addressing healthcare access and quality, one of five social determinants of health (SDoH) outlined by the Centers for Disease Control and Prevention (CDC). Even for low-income and underserved patients who might lack digital literacy or don’t have access to broadband or a smart device, audio-only visits via telephone can improve access to care. Furthermore, virtual care and audio-only visits can ultimately help address transportation issues, minimize time away from work, and can provide a means to communicate with culturally sensitive providers.
Throughout the pandemic, respondents to MGMA Stat polls have expressed the importance of telehealth for practices and patients alike.
- A Feb. 9 poll revealed that 65% of respondents believed that telehealth utilization would increase or stay the same in 2021. In that poll, respondents cited patient demand and convenience as the primary reasons telehealth utilization would increase.
- A Feb. 16 poll showed that 43% of respondents measured telehealth patient satisfaction. Among those practices that did, 61% said that patient satisfaction scores for telehealth had improved in the past year. This trend will likely continue as more providers become familiar with telehealth and/or receive more training in best practices.
- A Dec. 8, 2020, poll indicated that adding telehealth was a priority for practices in improving patient experience. Further, telehealth was crucial in serving as a bridge for retaining care connections before practices could fully reopen or patients felt comfortable returning to the office.
Physicians, particularly in primary care, echo the sentiments of patients. A recent survey by the Larry A. Green Center and the Primary Care Collaborative (PCC), which polled more than 1,200 primary care physicians, revealed that nearly two-thirds (64%) of respondents agreed that telehealth is essential in sustaining patient access to care.
However, as some states have begun to pull back virtual care coverage and Congress debates long-term telehealth legislation, providers have also voiced concern about how the removal of these services will affect their practices. According to the Larry A. Green Center/PCC survey, 41% of physicians polled said that it would be difficult to continue to offer telehealth if pre-pandemic regulations are reimposed. In fact, 21% of respondents said they’ve already had to cut telehealth visits due to payments being reduced.
Telehealth advocacy and legislation
Currently, there are a variety of telehealth bills that tackle different telehealth priorities, including:
- Allowing for the continued reimbursement of audio-only visits post-PHE
- Permanently waiving geographic and originating site restrictions so patients have better access to care
- Permanently allowing rural health clinics (RHCs) and federally qualified health centers (FQHCs) to offer virtual services
- Allowing critical access hospitals (CAHs) to bill directly for telehealth services.
Since the start of the pandemic, MGMA Government Affairs has been advocating for the continuation of telehealth flexibilities after the PHE, including promoting high-quality care, removing geographic and originating site restrictions for patients and providers, allowing permanent coverage of audio-only services and reimbursing telehealth visits equally, all of which were covered in its March 1 advocacy letter to the Subcommittee on Health.
In addition to the aforementioned issues, in a July 26 letter to Congress, MGMA Government Affairs, along with several other leading healthcare organizations, outlined priorities for Medicare telehealth reform. The letter advocated for removing the in-person visit requirement for mental telehealth services and providing flexibility to the Department of Health & Human Services in expanding the list of eligible practitioners.
Most recently, as part of its Sept. 13 advocacy letter to the Centers for Medicare & Medicaid Services, MGMA Government Affairs recommended that CMS retain the 135 codes on its telehealth list, consider modifying its definition of “telecommunications system” to include audio-only services, and eliminate in-person visit requirements for patients before they are able to see a provider via telehealth or audio-only visits.
These recommendations provide flexibility to all patients, while promoting continuity of care and improved access to the practices that serve them.
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