California’s Medi-Cal program is leveraging telehealth to meet patient needs. Many of the telehealth coverage and reimbursement flexibilities enacted during the pandemic were made permanent in 2022, including payment parity for services provided in person or by telehealth. With the end of the public health emergency, there are important questions about how telehealth is being used to meet patients’ needs and which flexibilities should remain in place over the long term.

This issue brief uses data from the 2021 California Health Interview Survey (CHIS) to explore how telehealth use varies across subpopulations of adults in the state and reports how people rate their telehealth experience compared to in-person care. The brief concludes with a discussion of potential policy implications of the findings, and areas for future data collection and research.

Key findings:

• Telehealth use varies by coverage type, race/ethnicity, and language
• People on Medi-Cal use less telehealth
• Less English proficiency is associated with less telehealth use
• Black Californians are more likely to use telehealth
• Most Californians who use telehealth like it as much as or better than in-person care

Our findings suggest that telehealth use follows the variation in the use of doctor visits overall. People who report more doctor visits also tend to use more telehealth, and people less likely to go to the doctor also tend to use less telehealth, with some important exceptions, including by coverage type, race/ethnicity, and language. Often, telehealth does not exacerbate overall disparities in health care access. However, while many people report that telehealth improves access to care, more telehealth use did not eliminate access to care disparities at the population level during the pandemic. The likely cause is the persistence of structural barriers, such as limited provider availability, even as telehealth use has grown.