OBJECTIVES: Telehealth access and reimbursement varied by payer and regionally prior to COVID-19. and its limited availability expanded in response to the pandemic. The health behavioral response by older adults to COVID-19 has varied over time with the geographic spread of the pandemic and affected access and utilization of medical services. The purpose of this paper is to examine changes in access to telemedicine in 2020 in response to the pandemic for the U.S. Medicare population.

METHODS: The first two waves in June and October 2020 of the rapid response survey fielded by the Centers for Medicare and Medicaid Services (CMS) to track and monitor the effects of the pandemic within the U.S. Medicare population. With a panel sample size of 9686 Medicare beneficiaries, the calculated statistics use replicate weights to adjust for the complex survey sample design and balanced repeated replication using Fay’s adjustment of 0.3 for variance estimation.

RESULTS: Nearly 45 percent of the Medicare population reported use of a telehealth appointment between June and October of 2020. The likelihood of using telemedicine increased for those with chronic conditions, such as depression, and for those with higher incomes and education. Medical practices were more likely to encourage telehealth visits for Medicare patients between March and June with 57 percent of the Medicare population reporting that their usual provider offered a telemedicine appointment to replace a regular office visit during the spring and 48% reporting the suggested telemedicine replacement from July through October 2020. Overall access to telehealth increased from 60% to 64% but varied by race/ethnicity, gender, Census regions, and rural status.

CONCLUSIONS: Access to telemedicine services expanded for the U.S. Medicare population during the pandemic but usage varied by chronic disease status, socioeconomic and demographic factors, and geography.