Telehealth and Outpatient Visits Among Individuals with Chronic Conditions by Socioeconomic Status in the First Year of the COVID-19 Pandemic: Observational Cohort Study

OBJECTIVE: We investigated telehealth usage for individuals with chronic conditions by neighborhood-level socioeconomic status (SES) during the first year of the COVID-19 pandemic. METHODS: We split the population of 2.3 million commercially insured adults in the United States with at least one chronic condition in claims into four quartiles of SES using address of residence. After balancing groups on baseline characteristics, we examined telehealth and total outpatient evaluation and management (E&M) visits from March 2020 to February 2021. RESULTS: Quartile 4 (highest SES) had more telehealth visits per person (0.054–0.100 more visits over each 3-month period) and a higher percentage of visits that were telehealth (1.8–5.9 percentage points higher) than other quartiles. Quartile 4 had higher levels of total outpatient E&M use throughout the year. Differences in telehealth between Quartiles 1 and 3 were small. CONCLUSIONS: Commercially insured individuals in the highest SES quartile had higher use of telehealth and total E&M visits than other quartiles.