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HHS Study Analyzes Telehealth Growth, Access, Disparities in Care

February 04, 2022

A new report from the U.S. Department of Health and Human Services (HHS) found that telehealth usage increased dramatically during the pandemic, but some groups struggled to access video-enabled services.

The report, released this week from the Office of the Assistant Secretary for Planning and Evaluation (ASPE), analyzes data about telehealth use from the Census Bureau’s Household Pulse Survey from April to October 2021.

The report found that overall rates of telehealth use were similar across most demographics, but use of video-enabled telehealth services varied significantly, “with rates lower among underserved populations including those with lower incomes; adults without a high school degree; Black, Latino, and Asian respondents; and those without health insurance.”

“Several barriers can prevent patients from engaging with their providers via telehealth, including disparities in technology and device ownership, lack of broadband access, digital literacy, limited English proficiency, and social isolation,” the report notes. “These barriers likely have disproportionate impacts across different populations in the U.S.”

Among the key takeaways from the report:

  • One in four:  From April to October 2021, about 23 percent of respondents reported use of telehealth during the previous four weeks
  • Least Common Users:  Telehealth use rates were lowest among the uninsured (9.4%) and young adults between 18 and 24 (17.6%)
  • Overall prevalence: The highest rates of telehealth visits were among those with Medicaid (29.3%) and Medicare (27.4%), Black individuals (26.8%), and those earning less than $25,000 (26.7%)
  • Disparities in video:  The groups that accessed video telehealth services at lower rates included those without a high school diploma (38.1%), adults 65 and older (43.5%), and Latino (50.7%), Asian (51.3%) and Black individuals (53.6%). The groups that utilized video services the most were: young adults ages 18 to 24 (72.5%), those earning at least $100,000 (68.8%), those with private insurance (65.9%), and White individuals (61.9%)

The report noted that policy initiatives that prioritize equitable access may help ensure the “disparities that emerged during the pandemic do not become permanent.”

“The disparities evident in our results suggest new approaches beyond those strategies implemented during the pandemic will be needed to ensure equitable access to telehealth, particularly video-enabled services,” the report notes.

HAP continues to monitor the latest trends in telehealth and is committed to supporting policies and legislation that improve patient access and address disparities in care. In addition, HAP supports the extension of critical reforms that have increased telehealth access beyond the pandemic.

The ASPE report is available for review online.