Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic - United States, June 26-November 6, 2020

Abstract

Telehealth can facilitate access to care, reduce risk for transmission of SARS-CoV-2 (the virus that causes coronavirus disease 2019 [COVID-19]), conserve scarce medical supplies, and reduce strain on health care capacity and facilities while supporting continuity of care. Health Resources and Services Administration (HRSA)-funded health centers* expanded telehealth^† services during the COVID-19 pandemic (1). The Centers for Medicare & Medicaid Services eliminated geographic restrictions and enhanced reimbursement so that telehealth services-enabled health centers could expand telehealth services and continue providing care during the pandemic (2,3). CDC and HRSA analyzed data from 245 health centers that completed a voluntary weekly HRSA Health Center COVID-19 Survey^§ for 20 consecutive weeks to describe trends in telehealth use. During the weeks ending June 26-November 6, 2020, the overall percentage of weekly health care visits conducted via telehealth (telehealth visits) decreased by 25%, from 35.8% during the week ending June 26 to 26.9% for the week ending November 6, averaging 30.2% over the study period. Weekly telehealth visits declined when COVID-19 cases were decreasing and plateaued as cases were increasing. Health centers in the South and in rural areas consistently reported the lowest average percentage of weekly telehealth visits over the 20 weeks, compared with health centers in other regions and urban areas. As the COVID-19 pandemic continues, maintaining and expanding telehealth services will be critical to ensuring access to care while limiting exposure to SARS-CoV-2.

FIGURE 1

Average percentage of weekly telehealth visits among consecutively responding Health Resources and Services Administration (HRSA)–funded health centers (N = 245) and 7-day average number of incident COVID-19 cases, by U.S. Census region — United States June 26–November 6, 2020 Abbreviation: COVID-19 = coronavirus disease 2019. * Percentage of weekly visits conducted virtually. ^† Health centers that responded to the voluntary weekly HRSA Health Center COVID-19 Survey each week for 20 weeks. ^§ Health centers include HRSA-funded Federally Qualified Health Centers, which fall under the Consolidated Health Center Program (Section 1905(l)(2)(B) of the Social Security Act). Only data from HRSA-funded Federally Qualified Health Centers are included in this analysis. ^¶ Seven-day average number of incident COVID-19 cases was calculated for each week of the study period for the 210 counties where 245 consecutively responding health centers are located. ** Dependent areas are not included because of the low number (five) reporting from this region.

FIGURE 2

Average percentage of weekly telehealth visits among consecutively responding Health Resources and Services Administration (HRSA)–funded health centers (N = 245) and 7-day average number of incident COVID-19 cases, by urbanicity — United States, June 26–November 6, 2020 Abbreviation: COVID-19 = coronavirus disease 2019. * Percentage of weekly visits conducted virtually. ^† Health centers that responded to the voluntary weekly HRSA Health Center COVID-19 Survey each week for 20 weeks. ^§ Health centers include HRSA-funded Federally Qualified Health Centers, which fall under the Consolidated Health Center Program (Section 1905(l)(2)(B) of the Social Security Act). Only data from HRSA-funded Federally Qualified Health Centers are included in this analysis. ^¶ Seven-day average number of COVID-19 cases was calculated for each week of the study period for the 210 counties where 245 consecutively responding health centers are located. ** Data presented do not include health centers in U.S. dependent areas because daily COVID-19 county-level case data were not available from USAFacts (https://usafacts.org/).