Telemedicine Visits in US Skilled Nursing Facilities

Area of Science:

• Gerontology
• Health Services Research
• Digital Health

Background:

• Skilled nursing facilities (SNFs) face challenges in providing timely access to care.
• Telemedicine offers a potential solution to improve care access and timeliness in SNFs.
• The COVID-19 pandemic accelerated telemedicine adoption, but its long-term patterns in SNFs remain unclear.

Purpose of the Study:

• To describe the patterns of telemedicine utilization within skilled nursing facilities (SNFs).
• To analyze changes in telemedicine use in SNFs before and after the COVID-19 pandemic.
• To investigate the association between telemedicine use and access to specific healthcare services in SNFs.

Main Methods:

• A cohort study analyzing Medicare fee-for-service claims and MDS 3.0 data from 2018-2022.
• Included 15,434 SNFs and over 4.4 million residents, differentiating between routine SNF visits and other outpatient visits.
• Employed a difference-in-differences approach to assess changes in visit types based on SNF telemedicine use levels.

Main Results:

• Telemedicine visits in SNFs increased from 0.15% (pre-pandemic) to 15% (May 2020), then decreased to 2% by 2022.
• Facilities with high telemedicine use were more likely to be rural and showed a significant increase in psychiatry visits.
• Limited changes were observed in outpatient visits for residents with mobility issues or for new specialist consultations.

Conclusions:

• Telemedicine adoption in SNFs surged in 2020 but stabilized at a level higher than pre-pandemic rates.
• Increased telemedicine use in SNFs was linked to better access to psychiatric care.
• Policies encouraging continued telemedicine use could enhance access to essential services as the technology evolves.