Patients with Low Incomes and Their Providers Agree: Continue Telehealth

Large numbers of patients and providers in California have turned to telehealth (care provided via either telephone or video) during the COVID-19 pandemic. What has been their experience, and how do they see the future of telehealth?

Below is a summary of key data points from surveys commissioned by the California Health Care Foundation and released in the fall of 2020. One surveyed Californians, age 18 to 64, who had received care between March 2019 and August 2020, asking about their experiences with telehealth specifically since the start of the pandemic. The other surveyed providers (including doctors, nurses, nurse practitioners, physician assistants, and behavioral health specialists) across the state.

This fact sheet highlights findings that specifically illuminate the experiences of patients with low incomes and the safety-net providers who serve them (providers with 30% or more patients who are covered by Medi-Cal or are uninsured).

Telehealth use is high among all patients and providers, with slightly higher use among patients with low incomes. Telephone visits are particularly prevalent among safety-net providers.

• 65% of patients with low incomes (and 62% of all patients) who received care reported receiving a telehealth visit.
• 76% of safety-net providers (and 79% of all providers) report using telehealth — a more than twofold increase from before the pandemic for both groups.
• Notably, safety-net providers use the telephone for 53% of their telehealth appointments, on average, compared to 41% of telehealth visits among non-safety-net providers.

Satisfaction with telehealth is high among patients and providers. Patients with low incomes find it easier to keep telehealth appointments than in-person appointments.

• 72% of all patients said they were just as, or more, satisfied with a phone visit than with their last in-person visit; 65% said they were just as, or more, satisfied with a video visit.
• 67% of patients with low incomes (and 66% of all patients) said their telehealth visit was a better experience than they thought it would be.
• 64% of patients with low incomes (and 56% of all patients) said they had an easier time keeping their appointment for a phone or video visit than they did keeping appointments for in-person visits in the past.
• 83% of safety-net providers (and 85% of all providers) using telehealth consider it “very” or “somewhat” effective for providing care to their patients.

Patients and providers want telehealth to continue. Around three-quarters of patients with low incomes who had a telehealth visit say they’d continue to use it.

• 79% of patients with low incomes (and 71% of all patients) who had a telehealth visit said they would always like the option for phone or video visits.
• 70% of patients with low incomes (and 57% of all patients) who had a telehealth visit said that they would likely choose a phone or video visit over an in-person visit whenever possible.
• 88% of safety-net providers (and 89% of all providers) currently using telehealth would continue to do so if payments for telehealth and in-person visits are comparable.

But payment parity and access to technology among patients with low incomes are key for maintaining or improving access to telehealth going forward.

• Only 43% of safety-net providers (and 42% of all providers) say they’ll continue telehealth if payment for telehealth is lower than payment for in-person visits.
• 45% of providers with uninsured and Medi-Cal patients say that only some (34%), few (10%), or none (1%) of their Medi-Cal or uninsured patients have adequate access to the technology needed for care via telehealth.

Explore the full findings from CHCF surveys of patients and providers.