Telehealth availability and use among beneficiaries in Traditional Medicare and Medicare Advantage.

Sungchul Park, Hye-Young Jung, Jiani Yu
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Abstract

Background: Medicare Advantage (MA) plans must cover all telehealth services offered by Traditional Medicare (TM), but have flexibility to provide additional telehealth services. It is not known whether these flexibilities are associated with telehealth availability and use. In this study, we examined differences in telehealth availability and use between TM and MA beneficiaries.

Methods: This cross-sectional study analyzed beneficiaries who participated in the 2021 Medicare Current Beneficiary Survey. Our primary outcomes were telehealth availability and use, assessed both overall and by modality (telephone only, video only, and both). Our key independent variable was full-year enrollment in MA versus TM. Differences in outcomes between TM and MA beneficiaries were estimated using logistic regression models that adjusted for beneficiary characteristics. The analysis of telehealth availability included all beneficiaries in the sample, while the analysis of telehealth use was limited to those offered telehealth services. In a secondary analysis, we examined differences between TM and MA beneficiaries in the availability of technology that may enable telehealth use and experience using the internet to seek information.

Results: Among 8130 Medicare beneficiaries, MA beneficiaries were 2.9 (95% CI: 0.6-5.2) percentage points more likely to have a provider who offered telehealth services than TM beneficiaries, including both telephone and video options. However, MA beneficiaries were 3.5 (-6.7, -0.4) percentage points less likely to use telehealth services than TM beneficiaries. Video-only options were used less frequently among MA beneficiaries compared to those in TM (-2.7 [-5.1, -0.3]). Despite lower telehealth use, MA beneficiaries had comparable or higher rates of technology access and internet experience compared to TM beneficiaries.

Conclusion: Our findings suggest that greater access to telehealth services among MA beneficiaries did not translate into greater telehealth use. Future research is warranted to explore the underlying mechanisms behind lower use of telehealth services among MA beneficiaries.

传统医疗保险和医疗保险优势计划受益人的远程医疗可用性和使用情况。
背景:医疗保险优势计划(MA)必须涵盖传统医疗保险(TM)提供的所有远程医疗服务,但可以灵活提供额外的远程医疗服务。目前尚不清楚这些灵活性是否与远程医疗的可用性和使用相关。在本研究中,我们考察了 TM 和 MA 受益人在远程医疗可用性和使用方面的差异:这项横断面研究分析了参与 2021 年医疗保险当前受益人调查的受益人。我们的主要结果是远程医疗的可用性和使用情况,按总体和方式(仅电话、仅视频和两者)进行评估。我们的关键自变量是医疗保险与远程医疗的全年注册情况。使用调整了受益人特征的逻辑回归模型估算了 TM 受益人与 MA 受益人之间的结果差异。对远程医疗可用性的分析包括样本中的所有受益人,而对远程医疗使用情况的分析则仅限于提供远程医疗服务的受益人。在一项辅助分析中,我们研究了 TM 受益人和医疗保险受益人在远程医疗技术可用性方面的差异,以及使用互联网寻求信息的经验:在 8130 名医疗保险受益人中,医疗保险受益人拥有提供远程医疗服务的医疗服务提供者(包括电话和视频选项)的可能性比传统医疗受益人高 2.9 个百分点(95% CI:0.6-5.2)。然而,医疗保险受益人使用远程医疗服务的可能性比传统医疗受益人低 3.5 (-6.7, -0.4)个百分点。与 TM 受益人相比,MA 受益人使用纯视频选项的频率较低(-2.7 [-5.1, -0.3])。尽管远程医疗的使用率较低,但与 TM 受益人相比,MA 受益人的技术使用率和互联网经验相当或更高:我们的研究结果表明,医疗保险受益人获得远程医疗服务的机会越多,远程医疗的使用率就越高。未来有必要开展研究,探索医疗保险受益人远程医疗服务使用率较低的根本原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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