Nearly all stakeholders have been pursuing a telehealth expansion strategy with an eye toward the post-pandemic future. Provider organizations, health care disruptors in retail, payers and equity firms alike have been investing significantly with a less than complete picture of what virtual care’s future holds.
Questions remain about who the primary telehealth users are, where utilization is concentrated, how patients prefer to access care and how physicians feel about delivering care in this manner. Two recent reports looked at these issues and came to a similar finding: Absent significant change, telehealth will continue to shrink.
Among the findings in a Trilliant Health report based on a view of 56 million telehealth patients sourced from its all-payer claims database between March 1, 2020, and Nov. 30, 2021:
- Only one in four Americans have used telehealth during the pandemic, including those who had audio-only visits.
- By way of comparison, nearly 80% of patients received only in-person care during the same period, up from about 70% who received in-person care in 2020.
- 7% of telehealth patients only had one visit during the pandemic.
Meanwhile, comparing attitudes about the usefulness of telehealth, a McKinsey & Company report last month noted that consumers value telehealth — especially for behavioral health — significantly more than physicians, and the gap is widening.
The data from these reports provide a contextual and sometimes contrary view of trends from other surveys and analyses and shed light on the sharp divide between how consumers and physicians view digital engagement.
3 Key Provider Takeaways
1 | Telehealth isn’t bridging the gap in lost primary care.
Even though more primary care is being delivered via telehealth than prior to the pandemic, that increase is insufficient to make up for declining primary care volumes, the Trilliant report states. Aggregate visit volumes for telehealth and in-person primary care visits in October 2020 were 7% lower than the volume of solely in-person primary care visits in October 2019.
Carefully assess the competitors, including disruptors like Amazon, Walmart, CVS Health and others and prioritize telehealth service areas most in demand. Prioritizing behavioral health can be a great first step in targeting and building strategies going forward and can also help in identifying other use cases that might be better treated in a short telehealth visit rather than in-person visits (e.g., dermatology, prescription renewals and refills), says Sanjula Jain, Trilliant Health’s chief research officer and senior vice president of market strategy.
2 | Convenience is in the eye of the beholder.
Two-thirds of physicians and 60% of patients that McKinsey surveyed said telehealth is more convenient for consumers than in-person care. However, only 36% of physicians find it more convenient for them.
Perception and reimbursement levels may be leading physicians to rethink telehealth. Most said they plan to return to a primarily in-person care delivery model over the next year. Sixty-two percent said they recommend in-person over virtual care to their patients. These physicians may be underestimating patient demand. Forty percent of patients surveyed in May 2021 said they plan to continue using telehealth after the pandemic.
3 | Know your telehealth primary and superusers.
Females age 21-40 are the only population segment that is using primary care services more now than before the pandemic. This, in part, is attributable to increased and sustained telehealth utilization, the Trilliant report found. For the rest of the population, primary care levels with telehealth remain below pre-pandemic levels. Less than 3% of telehealth patients were classified as “superutilizers,” with 25 or more visits during the 20-month timeframe.
Not everyone is interested in telehealth. Much of the hype in health care misses the mark, Jain says. There is a defined market and profile for the telehealth “buyer.” For telehealth strategies to be successful, hospitals and provider organizations must measure where telehealth patients are pursuing care (both within and outside their network) to quantify loyalty. This will ultimately help organizations measure the effectiveness of their digital front doors.