Dive Brief:

• The use of telehealth for patient visits seems to have leveled off at 20% or fewer of all appointments, more than a year and a half after COVID-19 first spurred an unprecedented jump in utilization, according to a new survey from KLAS Research and the Center for Connected Medicine.
• More than 80% of hospital executive respondents to the survey fielded in May and June this year said one-fifth or fewer of their facility's appointments were being conducted virtually. Of the hospitals and health systems reporting 30% or more of their volume is virtual, many said they expected that percentage to decline over the long term as the pandemic wanes in the U.S.
• Despite use of telehealth dwindling from last year's peak, many provider organizations say they're looking to expand their virtual care services to better manage patient populations while keeping costs down. The top three areas for future telehealth expansion cited by survey respondents were chronic care management, behavioral health and urgent care.

Dive Insight:

The pandemic resulted in a historic increase in telehealth use last year, as providers quickly pivoted to handling non-emergent visits virtually to recoup lost in-person volume. According to data from EHR provider Epic, telehealth made up almost 70% of all ambulatory visits by mid-April of 2020. Before the pandemic, they made up fewer than 0.01%.

However, telehealth utilization has oscillated since its peak, generally linked to rising and falling COVID-19 cases, experts say. In 2021, usage has more or less fallen off with the reopening of doctor's offices and hospitals and widespread vaccination efforts, though its unclear how the recent resurgence in cases tied to the highly infectious delta variant may have affected virtual visits.

There's a general consensus in the industry that telehealth utilization will never go back to its low pre-pandemic levels, but market watchers are curious where it will level off. That will have huge repercussions for the sustainability of the recent telehealth boom.

KLAS and CCM's survey of roughly 100 hospital executives — taken before the uptick in COVID-19 cases due to the delta variant — jibes with other research on current levels of telehealth utilization. A McKinsey study released in mid-July found telehealth use is currently ranging from 13% to 17% of visits across all specialties.

CCM and KLAS also found high interest among hospitals and health systems in providing telehealth over the long term, with respondents pointing at its ability to reach previously underserved populations, especially those without easy local access to healthcare like in rural areas, and provide more cost-effective care.

In research conducted last fall by KLAS and CCM, 77% of respondents said their organizations were measuring use of telehealth by patients to try to understand its value. In the latest survey, that figure rose to 92%.

And about a quarter of respondents reported measuring health outcomes for patients using telehealth in the latest survey, up from 12% in the 2020 report.

However, providers still said there were significant obstacles to advancing virtual care, citing top challenges as patients' access to technology and broadband, and uncertainty around reimbursement.

Both the Trump and Biden administrations benchmarked grants to ameliorate the digital divide and expand rural access to telehealth over the past year and a half. Most recently, the Biden administration in August gave $19 million in grants to expand telehealth in rural and underserved communities, with the funding allocated to help train primary care providers, bolster groups providing virtual care, pilot new telehealth services and research the efficacy of digitally delivered care in rural areas.

And Washington is currently deliberating what laxer regulations should be permanently codified after the public health emergency expires. Bipartisan support for broader Medicare reimbursement and access is a bright spot for the future of the industry, though current flexibilities like equal coverage for audio-only telehealth and the ability to use non-HIPAA-covered platforms like FaceTime or Skype for medical visits are unlikely to remain, experts say.

Pittsburgh-based CCM was established in 2009 and is jointly operated by Pittsburgh-based nonprofit UPMC and Finland-based telecommunications and electronics giant Nokia.