Utilization of Telemedicine Among Rural Medicare Beneficiaries

Mehrotra, Ateev; Jena, Anupam B.; Busch, Alisa B.; Souza, Jeffrey; Uscher‐Pines, Lori; Landon, Bruce E.

doi:10.1001/jama.2016.2186

Cited by 162 publications

(144 citation statements)

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“…Similar patterns have emerged from studies of telehealth applications in the Medicare program. For example, Mehrotra and associates reported that in 2013, mental health conditions were the reason for nearly four‐fifths of telehealth visits by rural residents enrolled in traditional Medicare. Gilman and Stensland reported that in 2009, 62% of all telehealth claims in Medicare were for mental health services, and 47% were for psychopharmacological treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Before questions like these can be answered, it is necessary to generate baseline descriptive statistics on telehealth use by rural and urban Medicaid beneficiaries. Recent studies have documented rates and patterns of telehealth use in Medicare before the implementation of federal policies designed to encourage the provision of telehealth services to Medicare beneficiaries . Few analogous studies have been conducted for Medicaid populations.…”

mentioning

confidence: 99%

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Patterns of Telehealth Use Among Rural Medicaid Beneficiaries

Talbot

Burgess

Thayer

et al. 2018

The Journal of Rural Health

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Purpose Few studies have examined telehealth use among rural Medicaid beneficiaries. This study produced a descriptive overview of telehealth use in 2011, including the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use. Methods Using data from the 2011 Medicaid Analytic eXtract (MAX), we conducted bivariate analyses to test the associations between rurality and prevalence and patterns of telehealth use among Medicaid beneficiaries. Findings Rural Medicaid beneficiaries were more likely to use telehealth services than their urban counterparts, but absolute rates of telehealth use were low—0.26% of rural nondual Medicaid beneficiaries used telehealth in 2011. Psychotropic medication management was the most prevalent use of telehealth for both rural and urban Medicaid beneficiaries, but the proportion of users who accessed nonbehavioral health services through telehealth was significantly greater as rurality increased. Regardless of telehealth users’ residence, mood disorders were the most common reason for obtaining telehealth services. As rurality increased, significantly higher proportions of telehealth users received services to address attention‐deficit/hyperactivity disorder (ADHD) and other behavioral health problems usually diagnosed in childhood. Conclusions These findings provide a baseline for further policy‐relevant investigations including examinations of changes in telehealth use rates in Medicaid since 2011. Reimbursement policies and unique rural service needs may account for the observed differences in rural‐urban Medicaid telehealth use rates.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Patterns of Telehealth Use Among Rural Medicaid Beneficiaries

Talbot

Burgess

Thayer

et al. 2018

The Journal of Rural Health

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“…In addition, adoption of telemedicine in the US commercial health care system has been relatively slow due in part to lower reimbursement rates, regulations preventing physicians from practicing across state lines, patient and provider unfamiliarity with technology, and lack of information technology capacity necessary to support real‐time video telemedicine . Recently, commercial providers of telemedicine report rapid growth in users and use among Medicare beneficiaries has also increased rapidly, although absolute rates of use remain low …”

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confidence: 99%

Utilization of Interactive Clinical Video Telemedicine by Rural and Urban Veterans in the Veterans Health Administration Health Care System

Adams

Mader

Bollinger

et al. 2019

The Journal of Rural Health

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Purpose Interactive clinical video telemedicine (CVT) has the potential to benefit health care systems and patients by improving access, lowering costs, and more efficiently distributing providers. However, there is a gap in current knowledge around the demand for and potential uses of CVT in large integrated health care systems. Methods We conducted an observational study using Veterans Health Administration (VHA) administrative databases to analyze trends in CVT utilization, and types of care received, among 7.65 million veterans during fiscal years (FY) 2009‐2015 (October 1, 2008‐September 30, 2015). Trends were stratified by veteran rurality and analyzed using linear regression. Among 4.95 million veterans in FY2015, we used logistic regression to identify characteristics associated with CVT utilization for any care, mental health care, and major specialties. Findings Over 6 years, the annual CVT utilization grew from 30 to 124 encounters per 1,000 veterans (>300% increase), with faster growth among rural veterans than urban veterans. Over the study period, ≥50% of all CVT‐delivered care was mental health care. In FY2015, 3.2% of urban and 7.2% of rural veterans utilized CVT for nearly 725,000 clinical encounters. Rural residence, younger age, longer driving distance to VHA facilities, one or more comorbidities, and higher rates of traditional, non‐video utilization were independently associated with higher odds of CVT use. Conclusions CVT utilization in VHA has increased quickly and exceeds published rates in the private health care market. The availability of CVT has likely increased access to VHA care for rural veterans, especially for mental health care.

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“…Clinician licensing is also an obstacle. Currently, physicians must be licensed in their state as well as the state of residence of their patients . This is particularly pertinent to laryngologists and speech pathologists who receive out‐of‐state referrals, or who treat vocal professionals who travel as part of their occupation.…”

Section: Discussionmentioning

confidence: 99%