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The onset of the COVID-19 pandemic in the United States brought a rapid increase in telehealth availability and usage. Understanding who used these services can inform future policies that aim for equitable access in telehealth.

Prior studies indicated that racial/ethnic minorities, people without a college degree, people living in lower income neighborhoods, and people without private health insurance were less likely to use telehealth during the early months of the pandemic. This study aimed to compare the use of telehealth over a longer term by people with private health insurance.

Findings: Among a commercially insured population with chronic conditions, people in the highest socioeconomic status (SES) quartile had higher use of telehealth. However, the three remaining quartiles had similar telehealth use, indicating that insured individuals in lower SES quartiles did not experience lower access to care than middle SES quartiles during the first year of the COVID-19 pandemic.

“Elevance Health’s waiver of copays for telehealth during the first year of the pandemic meant that out-of-pocket costs would not have been a barrier for low-income individuals. This could have been a factor in the narrowing of socioeconomic disparities in telehealth usage,” said Andrea DeVries, vice president for Health Services Research at Elevance Health.

As expected, the group in the highest socioeconomic (SES) quartile had the most telehealth visits (1.74 visits per person over the course of the year). However, it was interesting and important to see that the lowest SES quartile and middle quartiles had similar usage (1.4 – 1.5 visits per person). This indicates that for the people in the lowest SES quartile, telehealth served a purpose of additional access to care.

What’s Next: While most community care providers have returned to in-person visits, Elevance Health continues to make telehealth available to members of its affiliated health plans through the Sydney Health app.

Methodology: Researchers analyzed claims from 2.3 million commercially insured people with chronic conditions from March 2020 to February 2021. They compared the use of telehealth and total outpatient visits by neighborhood-level socioeconomic status quartile.

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