Table 4. Health system outcomes: healthcare utilization.

Title	Research design	Time of study	Number of visits/patients	Patient cohort	Findings
Trends in Outpatient Care and Use of Telemedicine After Hospital Discharge in a Large Commercially Insured Population	Retrospective review of multi-payer claims data	1/19–12/20	70 million patients; 1.6 million hospital discharges	Commercially insured and Medicare advantage enrollees age 50 and older discharged during study period	• Mean number of in-person visits went from 2.94 in 2019 to 2.35 in 2020
					• Telehealth visits increased from 0.02 in 2019 to 0.70 in 2020
					• The percentage of patients completing a post-discharge visit remained stable around 70%
An evaluation of telehealth use by Medicare beneficiaries in 2020	Retrospective review of Medicare claims data	1/19–12/20	~4.5 million monthly E&M services	20% random sample of fee-for-service Medicare beneficiaries	• Telehealth services made up 0.2% of all outpatient E&M services in February 2020
					• Telehealth peaked at 51% in April 2020
					• Total number of monthly telehealth and in-person services in 2020 did not exceeded the median monthly E&M services in 2019
Trends in telehealth use by Medicare fee-for-service beneficiaries and its impact on overall volume of healthcare services	Retrospective review of Medicare claims data	1/19–12/21	255–289 million E&M services	20% random sample of fee-for-service Medicare beneficiaries	• Total number of all outpatient E&M services was 289.0 million in 2019, 255.2 million in 2020, and 260.7 million in 2021
					• From April 2020 through December 2021, the monthly volume of telehealth services slowly declined and plateaued between 8.5–9.5% of all outpatient E&M services
The impact of expanded telehealth availability on primary care utilization	Retrospective review across 3 health systems	1/19–12/21	4,114,000 encounters; 939,000 patients without	Completed in-person or telehealth appointments for primary care	• Mean number of encounters from 2019 to 2021 for all patients were 2.30, 2.26, and 2.27 visits per year
					• Mean number of encounters for commercial insurance were 1.99, 1.99, and 2.01 visits per year
					• Mean number of encounters for Medicaid insurance were 2.53, 2.58, and 2.57 visits per year
					• Mean number of encounters for Medicare insurance were 3.01, 2.83, and 2.83 visits per year
Telehealth Visits Unlikely to Require In-Person Follow-Up Within 90 Days	Retrospective review of EMR data	3/20–5/22	35 million telehealth encounters across 180 health systems	Completed telehealth (synchronous and synchronous) visits across all specialties with >50,000 encounters	• Of 33 specialties included, only geriatrics, fertility, and OB/GYN required an in-person appointment in 3 months more than 50% of the time
					• Return for in-person care at 3 months was 92% for OB/GYN, 54% fertility, and 47% for geriatrics
					• For these 3 specialties, review of in-person encounters found that visits required in-office test, procedure or exam

E&M, evaluation & management; EMR, electronic medical record; OB/GYN, obstetrics & gynecology.