Fewer than 1% of rural Medicare beneficiaries received care via telemedicine in 2013, study finds

Telemedicine is touted as a way to get more specialty care to people in rural areas without making them travel to urban centers. Despite a 28 percent increase in rural telemedicine visits among Medicare beneficiaries from 2004 to 2013, only 0.7 percent of rural beneficiaries received a telemedicine visit in 2013, says a study by researchers at Harvard Medical School, published in The Journal of the American Medical Association. More than 40,000 rural Medicare beneficiaries received a telemedicine visit in 2013, averaging 2.6 visits each for 107,955 total visits, up from 7,015 visits in 2004. (Harvard graphic: Rates of telemedicine visits per 1,000 rural Medicare beneficiaries in states with and without telemedicine parity laws)

The study found that "most visits occurred in outpatient clinics; 12.5 percent occurred in a hospital or skilled nursing facility. Mental health conditions were responsible for 79 percent of visits. Rural beneficiaries who received a 2013 telemedicine visit were more likely to be younger than 65 years, have entered Medicare due to disability, have more illnesses, and live in a poorer community compared with those who did not receive a telemedicine visit."

Researchers wrote: "Proposed federal legislation would encourage greater use of telemedicine through expanded reimbursement. In contrast to others, we found that state laws that mandate commercial insurance reimbursement of telemedicine were not associated with faster growth in Medicare telemedicine use. Our results emphasize that nonreimbursement factors may be limiting growth of telemedicine including state licensure laws and restrictions that a patient must be hosted at a clinic or facility."