Overview: A Landmark Study on Telehealth Use
Older Americans insured by Medicare logged roughly 60 million telehealth visits each year between 2021 and 2023. That striking figure comes from a new study published in the Annals of Internal Medicine, co-authored by Terrence Liu, Assistant Professor at the University of Utah. The findings confirm what many healthcare providers already suspect: telehealth has moved from a pandemic workaround to a permanent fixture of senior care.
Researchers drew their data from the Medical Expenditure Panel Survey (MEPS), a nationally representative tool that tracks how Americans across different demographics access and pay for healthcare. Consequently, the study offers one of the most reliable national estimates of telehealth use among Medicare beneficiaries to date.
How COVID-19 Transformed Medicare Telehealth Access
Pre-Pandemic Use Was Minimal
Before 2020, telehealth remained a niche service. Only about 1.7% of Medicare patients — roughly 910,000 people — used virtual care in 2019. Moreover, access was largely limited to rural populations, and only certain approved clinics could offer it.
Pandemic Policies Opened the Floodgates
The COVID-19 crisis changed everything. The federal government quickly expanded telehealth coverage for Medicare enrollees to maintain access during lockdowns. Private insurers followed suit. As a result, Medicare telehealth usage soared to 53% in 2021 — nearly 28.3 million users at the pandemic’s peak.
Usage Remains Elevated Post-Pandemic
Although telehealth appointment volumes have declined since the height of the pandemic, they still far exceed pre-2020 levels. Data from Epic, the country’s largest electronic medical records company, confirms this sustained elevation. Furthermore, the shift reflects a broader behavioral change across all age groups, not just older adults.
Who Uses Telehealth — And Why It Matters
Sicker Patients Turn to Virtual Care More Often
One important finding stands out clearly: Medicare beneficiaries who used telehealth were generally in worse health than those who only used in-person visits. They also faced greater physical and functional limitations in daily life. This suggests telehealth specifically serves those who need care most — and face the greatest barriers to getting it in person.
Telehealth Reduces Barriers for Vulnerable Seniors
For seniors with limited mobility, chronic illness, or living in rural areas, virtual visits remove a critical obstacle: transportation. Additionally, avoiding crowded waiting rooms lowers exposure to infectious illness — a genuine concern for immunocompromised older adults. Telehealth, therefore, functions not just as a convenience but as an equity tool.
Mental Health Leads Telehealth Demand Among Seniors
Of the 60 million annual visits recorded, approximately 31 million addressed mental health needs, while 29 million covered other medical conditions. This split reveals an important pattern. Mental health services — including therapy, psychiatric consultations, and medication management — have become the dominant use case for telehealth among Medicare enrollees.
Encouragingly, 2021 legislation made Medicare’s coverage of mental health telehealth services permanent. This provides long-term stability for beneficiaries relying on virtual mental health support.
Coverage Expiration Threatens Telehealth Access in 2027
Non-Mental Health Services Face a Deadline
Not all telehealth coverage enjoys the same permanence. Coverage for managing conditions like respiratory infections and diabetes through virtual visits is currently set to expire in 2027. Policymakers are still debating whether to extend it. Without action, millions of seniors could lose access to virtual care for the chronic conditions they manage most.
What’s at Stake for Beneficiaries
The potential expiration creates real uncertainty. Seniors who depend on telehealth for diabetes management, cardiac care, or routine follow-ups could face significant disruption. Advocates argue that maintaining coverage is essential to preserving the access gains achieved since 2020.
What the Research Gets Right — And What’s Still Missing
Strengths of the Study
The research uses a rigorous, nationally representative dataset. Its estimates reflect real patterns across the entire Medicare population — not just one region or health system. In addition, the study aligns closely with prior research on post-pandemic telehealth use, reinforcing the credibility of its conclusions.
Key Limitations to Keep in Mind
However, the study does not evaluate care quality. It does not determine whether a telehealth visit for diabetes produces outcomes equal to an in-person appointment. Furthermore, the findings apply specifically to Medicare enrollees. Patterns may differ substantially for younger adults or those covered by Medicaid or private insurance.
The research team plans to examine telehealth quality for specific conditions — including diabetes — in future studies. That next step is critical for fully understanding telehealth’s role in long-term health outcomes.
The Road Ahead for Medicare Telehealth Policy
Telehealth has clearly earned its place in the American healthcare system. For older adults, in particular, it offers meaningful improvements in access, convenience, and continuity of care. The evidence — including this study — strongly supports its continued expansion.
Yet the future depends heavily on policy decisions. Congress must act before 2027 to preserve non-mental health telehealth coverage for Medicare beneficiaries. Simultaneously, researchers must deepen their understanding of how virtual care affects clinical outcomes.
Taken together, the data make a compelling case: telehealth is not a temporary fix. Instead, it is a vital, growing component of how seniors access care in the United States — and protecting that access should be a policy priority.
