Though outpatient visits conducted through telehealth have declined since the beginning of the COVID-19 pandemic, telehealth visits have remained elevated even as more patients return to in-person care, according to an analysis by Epic Research and the Kaiser Family Foundation.

The brief, which analyzed visits from March 2019 to August 2021, found in-person outpatient visits during the first six months of the pandemic declined to 72% of visits a year earlier. Telehealth care helped boost total visits, but there was still a gap compared with 2019. 

However, by March 2021 to August 2021, utilization was back to pre-pandemic levels. In-person outpatient visits were higher than the same period two years earlier, and another telehealth bump meant total outpatient visits were 19% higher than in 2019.

Still, outpatient telehealth visits have declined since their pandemic high, though they remain elevated compared with the limited visits conducted virtually before COVID-19. During the March 2020 to August 2020 period, 13% of outpatient visits were conducted via telehealth. That number dropped to 11% by September 2020 through February 2021, and then to 8% by the March 2021 to August 2021 time frame.

"With increased use of in-person care in the most recent months of the pandemic, the share of outpatient visits delivered through telehealth has decreased," analysis authors Justin Lo, Matthew Rae, Krutika Amin and Cynthia Cox wrote. 

"The number of outpatient visits delivered over telehealth [has] declined since the first six months of the pandemic. The share of outpatient visits delivered via telehealth is about 60% of what it was during the first six months of the pandemic (13% vs. 8%)."

The study also found that while urban and rural residents, as well as men and women, were using telehealth services at similar rates, older adults weren't using the modality as often as younger people.

The share of outpatient visits conducted via telehealth for non-elderly adults was 8% from March 2021 to August 2021, while it was only 5% for seniors. It had declined from 10% in 2020. 

"These patterns may reflect differences in enrollees’ comfort with the technology, internet access and the types of services used," the authors wrote. 

Though telehealth certainly improved access to care during the pandemic, the analysis notes there are still questions about how it will affect costs and quality. The authors said it's not clear what role telehealth will play in the future or where it will be most useful, but so far mental health services and substance-use care have utilized telehealth the most. 

Payers will also have a say in how the modality develops.

"Private and public payers’ telehealth coverage and licensing policies will unquestionably also affect telehealth use in the future," they wrote. "Some payers and employers have signaled continued coverage of more telehealth services beyond the pandemic."