Disparities in Audio-only Telemedicine Use Among Medicare Beneficiaries During the Coronavirus Disease 2019 Pandemic

Abstract

Supplemental Digital Content is available in the text.

Using Administrative Data to Examine Telemedicine Usage Among Medicaid Beneficiaries During the Coronavirus Disease 2019 Pandemic

“… 23 However, in our results, audio-only telemedicine consultations accounted for a similar proportion of visits in rural and HPSA counties to urban and non-HPSA counties in Florida, suggesting additional barriers to telemedicine access than mere lack of access to a device with an Internet connection. This is in line with results from at least one prior study, 32 which found that nearly two-thirds of those who are offered audio-only telemedicine consultations have access to either a smartphone or a computer with Internet access.…”

“…For appropriate services, potentially lower cost phone consultations can expand access to low-income populations. This may involve less infrastructure investment than video-based telemedicine, which is also more difficult to access for older Medicaid beneficiaries, 32 though other underserved populations may benefit as well. [33][34][35][36][37][38] While we do not examine its effects on outcomes, a recent study found that pregnant women consuming audio-only prenatal care during 2020 had similar outcomes to pregnant women consuming in-person prenatal care in 2019.…”

Perceptions and Use of Telehealth Among Mental Health, Primary, and Specialty Care Clinicians During the COVID-19 Pandemic

“…One study found that one-third of Medicare enrollees were only offered phone visits, and not video, for remote appointments, despite the fact that most of them owned a video-enabled device. 31 Another study demonstrated that practice- and clinician-level factors explained significantly more of the variation in video visit utilization than did patient-level factors. 10 The findings of these studies 10 , 31 highlight the need to more closely examine the extent to which patient preference is being fully incorporated into the decision-making process when choosing a care modality.…”

“… 31 Another study demonstrated that practice- and clinician-level factors explained significantly more of the variation in video visit utilization than did patient-level factors. 10 The findings of these studies 10 , 31 highlight the need to more closely examine the extent to which patient preference is being fully incorporated into the decision-making process when choosing a care modality.…”

The Impact of Telehealth Adoption During COVID-19 Pandemic on Patterns of Pediatric Subspecialty Care Utilization

“…Nonetheless, even with more accurate broadband data, factors such as internet costs, device adequacy, technology familiarity and literacy, and interface navigability may all be important contributors to telehealth access 30 . For example, a study of Medicare beneficiaries conducted during summer and fall 2020 reported large portions of beneficiaries without smartphone/tablet devices and home internet; non-Hispanic Black and Hispanic individuals were twice as likely to face such barriers as non-Hispanic Whites 31 . Thus, these populations may rely more on cellular-enabled, smartphone-based connections to complete telehealth appointments, supplanting the need for high-speed broadband.…”