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AMA SURVEY

Telehealth utilization plateaus but pandemic surges are still a game changer

Digital technology has laid the groundwork for the long-term shift of medical care from in-person to virtual settings. And while it didn’t start the movement, the COVID-19 pandemic certainly accelerated it. The American Medical Association’s latest Physicians Practice Benchmark Survey offers new insight into the extent and direction of physician practice utilization of telehealth services both before and during the pandemic. Punchline: Between September 2018 and September 2020, telehealth utilization grew from 25 percent to nearly 80 percent.

Telehealth Utilization Patterns

The AMA’s Division of Economic and Health Policy Research has conducted the Physician Practice Benchmark Survey evaluating physician practice arrangements and payment methodologies for every year since 2012. The analysis draws from the responses of thousands of post-residency physicians who take care of patients for at least 20 hours per week and who don’t work for the federal government.

The 2020 Benchmark Survey found that 58 percent of physicians used telehealth to diagnose or treat a patient in 2020, as compared to just 15.6 percent in 2018. The survey also breaks down telehealth utilization by particular applications:

  • Video-based patient visits skyrocketed from less than 15 percent in 2018 to 70.3 percent in 2020;
  • Two of three physicians (67 percent) reported that they met with patients over the phone in 2020;
  • Use of telehealth for chronic care management jumped from 20 percent in 2018 to nearly 60 percent in 2020; and
  • Remote patient monitoring (RPM) was used by 20 percent of physicians, nearly double the 2018 percentage, with one-third of specialists reporting that they used RPM during the year, led by cardiologists (63.3 percent) and endocrinologists and diabetes care physicians (41.6 percent).

Telehealth utilization extended beyond patient diagnosis and treatment, with 26.2 percent of physicians reporting that their practice used videoconferencing to consult with colleagues in 2020, as opposed 11.6 percent in 2018.

2021-10-07-MOM-Exhibit1-Telehealth-1

Telehealth Utilization by Specialty

Broken down by physician types, 76 percent of primary care specialties (including family/general practice, general internists and pediatricians) said they were likely to adopt telehealth. Psychiatrists scored the highest in this category at over 85 percent. Dermatologists reported the highest use of video visits, at 87.3 percent, with urologists close behind at 87.2 percent.

Sustainability of Telehealth Growth

The findings of the AMA 2020 Benchmark Survey are in line with other studies and surveys reporting significant increases of telehealth during the pandemic, including a March 2021 Sykes survey in which 61 percent of respondents reporting that they’ve had a telehealth appointment, compared to 19.5 percent in March 2020.

The caveat is that almost all of these studies were done during the height of the pandemic when in-person visits was a far more limited option. Telehealth utilization has declined significantly since it was believed the worst was over and things were getting back to normal. Thus, for example, in a survey conducted by the Center for Connected Medicine and KLAS Research, 80 percent of hospitals and health system respondents reported that telehealth visits accounted for less than 20 percent of total appointments between May and June 2021. Of course, that was before the Delta variant surge.

Conclusion
Although telehealth utilization has plateaued, its long-term prospects look brighter than ever. While ultimately not sustainable, the massive gains during the pandemic, particularly in primary care, have had a game changing effect in demonstrating the workability of the model. Having experienced telehealth, patients clearly liked it and want to do more of it; and physicians, hospitals and health systems feel much the same. In addition to expanding capacity and investment, the telehealth experiment/expedient has changed the views of many in Congress and the regulatory community who are now looking for ways to make the temporary relaxation of
restrictions on telehealth utilization during the pandemic permanent. Thus, while barriers remain, particularly in regard to making technology accessible and broadening of reimbursement for telehealth services, a corner has been turned.

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