Telehealth is often touted as a way to expand healthcare access, particularly in rural communities. However, a new study found that rural populations continue to use telehealth at lower rates than their non-rural counterparts.
The study from the Elevance Health Public Policy Institute was published last week and used claims data from Elevance Health-affiliated health plans. The researchers created a sample of adults aged 18 and older who were enrolled in commercial, Medicare Advantage, Medicare Supplement or Medicaid plans. This population consisted of 11.5 million members.
The study found that between 2022 and 2025, telehealth accounted for about 5% to 8% of chronic condition visits among patients in non-rural areas, compared with 3% to 5% among those in rural areas. These findings come as previous research shows that people living in rural areas have a higher chronic disease burden than those living in urban areas.
Those living in rural areas used telehealth less frequently than those in non-rural areas across all 15 chronic conditions included in the study and across all insurance types. These chronic conditions include diabetes, hypertension, chronic obstructive pulmonary disease and more.
“Despite the potential for telehealth to mitigate access barriers, lower uptake in rural areas merits further study to determine contributing factors,” the report said. “For instance, people living in rural areas were disproportionately represented in lower socioeconomic status quartiles, which may contribute to reduced telehealth engagement due to barriers such as device availability, internet availability and affordability, and lower digital and health literacy.”
The findings also suggest that expanding telehealth alone may not be enough to improve access, according to the report. The researchers said policymakers should also invest in digital infrastructure, patient support services and other resources that influence health outcomes.
In addition, the report shows that different insurance populations have different healthcare needs. Therefore, a one-size-fits-all telehealth strategy likely won’t work.
“Medicare members demonstrated higher prevalence of cardiometabolic conditions and higher overall healthcare utilization, which points to opportunities for telehealth-supported care management,” the researchers stated. “Members enrolled in Medicaid showed elevated rates of obesity, dietary counseling utilization, and emergency department use. However, we also observe higher rates of telehealth utilization among Medicaid members for obesity and dietary counseling. Accordingly, tailored telehealth strategies that account for population-specific characteristics and clinical complexity may be necessary to maximize effectiveness across health plan types.”
The report called on policymakers, health plans and other healthcare stakeholders to consider the “unique resource limitations and healthcare needs” of rural populations when building telehealth programs.
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