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After taking a nosedive during the initial wave of the COVID-19 pandemic, then rising and plateauing, weekly outpatient visits in the United States have rebounded and now slightly exceed levels seen in late February, according to new data.
Overall visits plunged by almost 60% at the low point in late March and did not start recovering until late June, when visits were still off by 10%. Visits began to rise again — by 2% over the March 1 baseline — around Labor Day.
As of October 4, visits had returned to that March 1 baseline, which was slightly higher than in late February, according to data analyzed by Harvard University, the Commonwealth Fund, and the healthcare technology company Phreesia, which helps medical practices with patient registration, insurance verification, and payments, and has data on 50,000 providers in all 50 states.
The study was published online by the Commonwealth Fund.
In-person visits are still down 6% from the March 1 baseline. Telemedicine visits — which surged in mid-April to account for some 13% to 14% of visits — have subsided to 6% of visits.
Many states reopened businesses and lifted travel restrictions in early September, benefiting medical practices in some areas. But clinicians in some regions are still facing rising COVID-19 cases, as well as “the challenges of keeping patients and clinicians safe while also maintaining revenue,” write the report authors.
Some specialties are still hard hit. For the week starting October 4, visits to pulmonologists were off 20% from March 1. Otolaryngology visits were down 17%, and behavioral health visits were down 14%. Cardiology, allergy/immunology, neurology, gastroenterology, and endocrinology also saw drops of 5% to 10% from March.
Patients were flocking to dermatologists, however. Visits were up 17% over baseline. Primary care was also popular, with a 13% increase over March 1.
At the height of the pandemic shutdown in late March, Medicare beneficiaries stayed away from doctors the most. Visits dipped 63%, compared with 56% for the commercially insured, and 52% for those on Medicaid. Now, Medicare visits are up 3% over baseline, while Medicaid visits are down 1% and commercially insured visits have risen 1% from March.
Interestingly, the over-65 age group did not have the steepest drop in visits when analyzed by age. Children ages 3 to 17 saw the biggest decline at the height of the shutdown. Infants to 5-year-olds have still not returned to pre-pandemic visit levels. Those visits are off by 10% to 18%. The 65-and-older group is up 4% from March.
Larger practices — with more than six clinicians — have seen the biggest rebound, after having had the largest dip in visits, from a decline of 53% in late March to a 14% rise over that baseline. Practices with fewer than five clinicians are still 6% down from the March baseline.
Wide Variation in Telemedicine Use
The researchers reported a massive gap in the percentage of various specialties