The Year Ahead: The Future of Telehealth

This article is the second part of a four-part series on the most important topics for health information professionals to be aware of in 2022. You can read part one here.

The use of telehealth—telecommunications technologies and electronic tools to provide health care from a distance¹—grew significantly during the COVID-19 public health emergency.² Data from 2020 indicate that utilization was 38 times higher than at any point in 2019. Even after utilization stabilized after the initial wave of the pandemic, the use of telehealth services is still between 13 to 17 times greater than at any time in either 2019 or 2018.³

Telehealth offers patients and providers significant benefits at a lower cost and easier way to access quality health care services. There has also been an increase in demand for telehealth services by consumers who appreciate the convenience and improved access to care. Apart from the necessity of telehealth services caused by the closure of medical facilities across the country due to COVID-19, the rising costs of healthcare are driving a shift toward lower-cost alternatives for quality health care. Estimates from the Centers for Medicare and Medicaid Services (CMS) forecast that healthcare spending will grow at an average rate of 5.5 percent per year through 2027 and that healthcare costs will represent 19.4 of gross domestic product at the same time.⁴

Given the rise and sustained higher use of telehealth over the past 20 months, as well as the increased acceptance of digital telehealth tools to deliver health care more efficiently, it is worth examining the future trends, benefits, and use of telehealth as we enter a new year.

• Some of the restrictions on telehealth use and reimbursement will be permanently lifted. The onset of the pandemic brought about the removal of geographic and site-of-service restrictions and an expansion in the number of CPT codes approved for delivery by telemedicine in the Medicare program.⁵ With the consistent high utilization levels of telehealth even after the peak of the pandemic, these restrictions will almost certainly be permanently waived and the number of telehealth services that are reimbursable by public payers will continue to expand
• Telehealth business models will continue to evolve. Telehealth will not completely replace in-person care, but models that combine virtual and in-person care to optimize health outcomes will proliferate. These hybrid treatment approaches offer greater convenience to the patient, increase access to care, enhance affordability, and generate the potential for better outcomes.
• Some services may switch to a virtual model. To ascertain the urgency of a patient’s clinical condition, the use of a “digital front door,” which provides triage and assessment services virtually to determine the appropriate course of action, will become more established.
• The types of care that can be provided through telehealth will continue to expand. A recent study by the Center for Telehealth and eHealth Law (CTEL) showed the cost benefit of using telehealth for several clinical conditions, such as mental and behavioral health, cancer, diabetes, and respiratory disease.⁶ The delivery of care by these and other specialists will expand access to care in medically underserved areas.
• Telehealth will serve as a catalyst to expand the range of mental and behavioral health services. Data from numerous sources across the country identified mental and behavioral health as the most prevalent diagnosis among patients using telehealth. Given the shortage of mental health providers—56 percent of the counties within the United States do not have a psychiatrist⁷—the use of telehealth may be the only way to reach a needed professional for mental or behavioral health care.

Telehealth will continue to be an essential means of delivering care to individuals across the United States, and future research will demonstrate its effectiveness, utility, and benefit in delivering high quality services and increasing access to care for those most in need.

Notes:

1. Adapted from Center for Connected Health Policy. What is telehealth? – CCHP (cchpca.org). https://www.cchpca.org/what-is-telehealth.
2. CMS: Medicare Telemedicine Snapshot, Medicare Claims and Encounter data March 1, 2020 through Feb 28, 2021. Received by September 2021.
3. McKinsey and Company. Telehealth: A quarter-trillion-dollar post-COVID-19 reality? Published July 9, 2021. Retrieved December 15, 2021. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality.
4. Centers for Medicare and Medicaid Services (CMS). National Health Expenditure Projections. 2018-2027. Forecast Summary. https://www.cms.gov/newsroom/press-releases/cms-office-actuary-releases-2018-2027-projections-national-health-expenditures.
5. McKinsey and Company. Telehealth: A quarter-trillion-dollar post-COVID-19 reality? Published July 9, 2021. Retrieved December 15, 2021. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality.
6. Center for Telehealth and eHealth Law. The Cost-Benefit of Telehealth During COVID-19. Published December 10. 2021. www.ctel.org.
7. Erica Coe, Lisa Crystal, Kana Enomoto, and Razili Lewis, “A holistic approach for the US behavioral health crisis during the COVID-19 pandemic,” August 6, 2020, McKinsey.com.

Jason Goldwater (jgoldwater@lh-advisors.net) is the president and chief operating officer of Laurel Health Advisors LLC.

Yael Harris (yharris@lh-advisors.net) is the chief executive officer at Laurel Health Advisors LLC.

Register for the upcoming AHIMA live webinar: Evolving Healthcare Series: The Impact of Telehealth, being held January 20.