Telehealth use plateaus in 2022

In the spring of 2020, when telehealth utilization for office visits and outpatient care peaked at 78 times the pre-pandemic rate, McKinsey famously projected that $250 billion of U.S. healthcare spending could be shifted to virtual care. As use has leveled off, the consultancy has since stated this claim is “not a foregone conclusion” but estimates that telehealth still accounts for between 13% and 17% of office and outpatient visits. 

Other estimates are more conservative: FAIR Health, which looks at commercial claims, puts the figure at 5%, while an analysis of claims and consumer data from Trilliant Health pegs the total telehealth market at just 1% of all visits. On top of that, the flexible rules that allowed telehealth use and reimbursement to expand during the pandemic are due to expire when the public health emergency ends – though STAT News reports that extensions may be put in place.

Related story: Bringing the power of the hospital to the home with high-acuity telehealth

Amid this uncertainty, healthcare organizations need to determine how telehealth fits into their overall care delivery strategy. Here are four lessons to keep in mind.

Set realistic expectations… From March 2020 to November 2021, 79% of patients using telehealth had four or fewer visits, according to Trilliant Health. The company estimates the post-pandemic market for frequent telehealth users in the United States will be less than 10 million patients – comparable to luxury brands like Porsche or Peloton. And behavioral health is the only specialty (given payment parity and shortage of providers and ancillary services) where both physicians and patients see telehealth as a true substitute for in-person care.

…but don’t underestimate demand. At the same time, organizations with limited telehealth options risk losing patients to new market entrants who are better positioned to provide virtual care. A McKinsey survey found patients more likely than physicians to agree that telehealth is more convenient than in-person care and provides a better patient experience. Additionally, 63% of patients are interested in digital offerings such as online scheduling and virtual-first appointments, but only 14% of physicians have invested in such offerings. 

Offer audio-only options. A report from the Office of Health Policy within the U.S. Department of Health and Human Services concluded that patients who are young, affluent, and covered by commercial insurance are most likely to use video visits. Barriers to participating in video-enabled telehealth include device ownership, lack of broadband access, digital literacy, limited English proficiency, social isolation, or lack of privacy. While work is underway at a national level to address these disparities, audio-only visits offer underserved populations access to virtual care with the technology they currently have.

Pursue a hybrid model. Not surprisingly, physicians told McKinsey they found telehealth most effective for follow-up visits and other types of appointments that don’t require physical examinations. In-person visits are preferred for pre- and post-operative consults and physical exams. Most physicians prefer no more than “a couple of hours” of virtual care, which is an important consideration for determining how to balance virtual and in-person visits in day-to-day schedules and long-term operational and staffing strategies.