Health Insurance

22% of Americans Using Telehealth in 2022 — Here’s Where They Use It Most and Why It’s Here to Stay

22% of Americans Using Telehealth in 2022 — Here’s Where They Use It Most and Why It’s Here to Stay

Data also details how consumers utilize services, by household income, age, gender, education and much more.
A mother utilizes a telehealth service.
A mother utilizes a telehealth service. Source: Getty Images

Telehealth has evolved over more than a century, from using radios to reach patients on faraway ships to reducing the risk of spreading the coronavirus, as recommended by the U.S. Department of Health and Human Services (HHS).

The convenient and often cheaper method of obtaining health care over the phone or through videoconferencing has staying power. These services from doctors, nurses and other health professionals were utilized by 22% of Americans in the past four weeks, according to a ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.

Telehealth is most prevalent in Hawaii, where a third of residents had a recent video or telephone medical appointment, perhaps due to traffic, the ongoing pandemic, the capacity to offer such services, the need for consultations with medical specialists outside the area and the acknowledged needs of the population.

For a deeper look at telehealth use, ValuePenguin analyzed the data by income, age, gender and more. Here are the findings.

Key findings

  • 22% of Americans utilized telehealth services in the past four weeks. According to the ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data, 9% of Americans had a phone appointment in this period, while 11% had a video one.
  • Low-income Americans were more likely to use telehealth services. 27% of Americans who earn less than $25,000 a year reported using telehealth services, versus 22% of Americans who make $200,000 or more. And 42% of Americans who reported using governmental rental assistance in the past week to pay their bills said they used telehealth.
  • Among every available demographic, transgender Americans — along with those who use governmental rental assistance to pay bills — reported the highest rate of telehealth use. 42% of transgender Americans had a phone or video appointment with a doctor, a nurse or another health professional in the past four weeks.
  • Hawaii residents were most likely to use telehealth services. 33% of Hawaii residents reported having a phone or video appointment with a doctor, a nurse or another health professional over the past four weeks. Behind Hawaii were the District of Columbia (30%) and Maryland (28%).
  • North Dakota residents were least likely to use telehealth services. Just 11% of residents here reported recently utilizing telehealth services. Iowa joined at the bottom at 12%, with another three states at 13%.
  • Telehealth is holding fairly steady, even as the threat from COVID-19 lessens. In April 2021 — the first time the Household Pulse Survey asked about telehealth — 26% of Americans reported having a phone or video appointment in the past four weeks, compared with 22% now.

More than 1 in 5 Americans using telehealth in 2022

Based on the latest U.S. Census Bureau Household Pulse Survey — fielded Jan. 26 to Feb. 7, 2022 — 22% of Americans utilized telehealth services in the past four weeks. A slightly higher percentage leaned toward video appointments (11%) over phone ones (9%).

Specifically, respondents were asked if, at any time in the last four weeks, they had an appointment with a doctor, a nurse or another health professional by video or phone — exclusive of others in the household. A fair number of Americans who had a telehealth appointment didn’t specify whether it was by phone or video.

"As the use of telehealth services grew during the pandemic,insurers expanded coverage to address the need," says Robin Townsend, a ValuePenguin life and health insurance expert. "But as coronavirus cases decline, some insurance companies have decided to maintain pandemic-level telehealth benefits."

Townsend says patients and health care providers prefer the flexibility and increased access they get with telehealth.

"For many, telehealth is more a need than a convenience," Townsend says. "For example, patients with impaired vision, hearing or mobility are more likely to use virtual care than those without such challenges."

Virtual behavioral health visits have been vital during the pandemic. According to HHS, a third of visits to behavioral health specialists in 2020 were done via telehealth, versus 8% of primary care visits and 3% of visits to other specialists.

How Americans utilize telehealth services, by household income, age, gender, education and much more

Researchers analyzed the data by various demographics to bring into focus how different groups organized by household income, age, gender, sexual orientation, race, education and spending needs use telehealth services.

Among every demographic available, transgender Americans and those who use governmental rental assistance to pay bills were most likely to utilize telehealth services.

Household income

While at least 1 in 5 Americans in households earning at least $25,000 annually used telehealth services in the past four weeks, those earning less were more frequent users. More than 1 in 4 (27%) Americans in households making less than $25,000 — the lowest income bracket — had a telehealth appointment with a medical provider in this period.

However, these Americans tended to use phone appointments more frequently to consult with their doctors or providers. While 14% of those with household incomes on this lower earnings scale had phone appointments, those in higher income brackets tended to choose video appointments. (To reiterate, some respondents didn’t specify the platform used.)

The second-lowest household income tier — $25,000 to $34,999 — also showed this pattern of slightly higher phone use than video in telehealth appointments.

The benefits of virtual care include easier access and cheaper visits. Many patients pay nothing for a telehealth session, compared to copays ranging from $5 to $50 at the doctor’s office, Townsend says.

On the other end of the scale, those in the wealthiest bracket ($200,000-plus annually) had a high percentage (14%) of video appointments in the past four weeks. This pushed the wealthiest’s overall total to 22%, the second-highest utilization after those in the least-wealthy households.

Utilizing telehealth services (by household income)

Household income
Phone appointment
Video appointment
Total
Less than $25,00014%11%27%
$25,000 to $34,99910%8%21%
$35,000 to $49,9998%10%20%
$50,000 to $74,9999%10%22%
$75,000 to $99,9998%11%21%
$100,000 to $149,9998%11%21%
$150,000 to $199,9997%12%20%
$200,000 and above8%14%22%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Age

Older Americans — but not the oldest — were most likely to have used telehealth in the past four weeks.

One in 4 Americans in their 70s and almost as many octogenarians (and older) took to the phone or a video platform for a telehealth visit.

The ongoing COVID-19 pandemic appears to be a factor, as older, more vulnerable Americans found telehealth appointments beneficial, according to a November 2021 study in the Journal of the American Geriatrics Society.

Utilizing telehealth services (by age)

Age
Phone appointment
Video appointment
Total
18 to 297%11%18%
30 to 398%14%22%
40 to 4910%12%22%
50 to 599%10%22%
60 to 6910%8%22%
70 to 7911%8%25%
80 and above12%6%24%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Gender

While cisgender women used telehealth at a higher clip than cisgender men, transgender Americans utilized it substantially more — overall, and in phone and video formats.

Forty-two percent of transgender Americans utilized telehealth services in the past four weeks, almost double that of cisgender women (24%) and more than double that of cisgender men (19%). Transgender patients were far more likely to use a video format (33%) than just a phone call (15%) for their visits.

Telehealth can play a vital role in gender reassignment surgery and its associated treatment or services.

Matthew Wetschler, who co-founded Plume — a virtual gender-affirming health care provider group — told Fierce Healthcare in September 2020 that the platform was designed to help the many transgender patients who prefer the continuous connection of a care team. Traditional care can be a negative experience for this vulnerable population facing potential discrimination and harassment.

Utilizing telehealth services (by gender)

Gender
Phone appointment
Video appointment
Total
Cisgender male9%8%19%
Cisgender female10%12%24%
Transgender15%33%42%
None of these12%12%24%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Sexual orientation

Straight Americans used telehealth to a lesser degree than gay, lesbian or bisexual Americans and those who identified their sexual orientation as something else.

Just 21% of straight individuals had a telehealth appointment in recent weeks, while their peers used telehealth services to a noticeably higher degree than the 22% national average.

Those who are bisexual reported the highest use of telehealth services in the past four weeks at 28%. This demographic also heavily favored video doctor visits at 21%.

Utilizing telehealth services (by sexual orientation)

Sexual orientation
Phone appointment
Video appointment
Total
Gay or lesbian9%16%26%
Straight9%10%21%
Bisexual10%21%28%
Something else9%19%26%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Race

At least 1 in 4 Americans who are Black or two or more races (or another race not listed) used telehealth services in the past four weeks. A similar percentage of Hispanic or Latino Americans (24%) participated in a health appointment by video or phone.

Asian Americans utilized telehealth services the least overall and by video. That said, a fair percentage of Asian Americans (19%) were still using telehealth services in the past four weeks, though below the national average. And their video appointment use was only 7%, far below the 16% cited among those who are two or more races (or another race not listed).

Other studies have uncovered similar trends. A January 2022 study published in Cancer Medicine found that Asian cancer patients across San Diego County were 21% less likely to have a telehealth appointment than white patients, while Hispanic patients were 14% less likely.

Cancer treatment specifically showed significant racial disparity. Research in the Journal of Telemedicine and Telecare also highlighted suppressed telehealth use by East and Southeast Asian populations in the U.S. during the pandemic, which it attributed in part to being uninsured or having limited broadband coverage.

Utilizing telehealth services (by race)

Race
Phone appointment
Video appointment
Total
Hispanic or Latino12%10%24%
White8%11%21%
Black12%11%25%
Asian10%7%19%
Two or more races and other races13%16%28%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Education

Education levels didn’t neatly correspond to telehealth use. Those with some college (but not a bachelor’s degree or higher) had the highest percentage of telehealth appointments in the past four weeks.

However, education levels tracked with video appointments as a platform for a visit with a doctor or another medical professional. As education levels increased, Americans were incrementally more likely to report video over phone.

Seven percent of those with less than a high school education used video in the past four weeks, compared with at least 12% of those with a bachelor’s degree or higher.

Utilizing telehealth services (by education)

Education
Phone appointment
Video appointment
Total
Less than high school14%7%22%
High school or GED9%9%20%
Some college/associate degree10%11%23%
Bachelor’s degree or higher8%12%22%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Spending needs

When the U.S. Census Bureau Household Pulse Survey asked respondents about their spending needs in the past seven days, those who answered that they or someone in their household had used government rental assistance were twice as likely to have had a phone or video appointment in the past four weeks than those who relied on regular income sources like those received before the pandemic for spending needs.

A full 42% of those reporting government rental assistance used telehealth, compared with 21% of those who used their regular income.

The ValuePenguin analysis showed that as borrowing or credit use increases or supplemental government help is needed, telehealth appointments (which Townsend has noted are cheaper) tend to increase.

Utilizing telehealth services (by spending needs)

Used in the last 7 days to meet spending needs
Phone appointment
Video appointment
Total
Regular income sources like those received before the pandemic8%10%21%
Credit cards or loans11%14%25%
Money from savings or selling assets or possessions (including withdrawals from retirement accounts)11%13%26%
Borrowing from friends or family14%14%28%
Unemployment insurance benefit payments13%11%27%
Stimulus (economic impact) payment14%14%29%
Child tax credit payment11%13%24%
Money saved from deferred or forgiven payments16%16%33%
Supplemental Nutrition Assistance Program (SNAP)17%15%32%
School meal debit/EBT cards16%14%29%
Government rental assistance24%21%42%
Other13%11%26%

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

States where residents utilize telehealth the most

The states where residents used telehealth the most were Hawaii, the District of Columbia and its neighboring jurisdiction, Maryland.

While Hawaii — where 1 in 3 residents used telehealth services — and the nation’s capital — where 30% did — are on opposite sides of America, they may have similar traffic issues or health policies that encourage virtual care.

Hawaii has the highest percentage of adults who identify as transgender, according to a 2016 report from the UCLA School of Law’s Williams Institute. As noted earlier, transgender Americans have a higher-than-average utilization of telehealth services.

The District of Columbia and Maryland — where 28% of the population recently had a video or phone appointment with a medical professional — have many federal workers who might be more aware of telehealth opportunities made possible by HHS.

In addition, the Maryland General Assembly, unlike in some other states, is supportive of virtual care for Medicare and other recipients. Meanwhile, Johns Hopkins Medicine in Maryland says it’s charted more than 1.25 million telehealth visits for more than 375,000 unique patients during the pandemic — with Medicaid accounting for 45,000 of them, according to health policy group State of Reform.

States where residents utilize telehealth the least

The state where the fewest Americans relied on telehealth appointments was North Dakota, where only 11% had such an appointment in the past four weeks. Iowa was also lagging at 12%, followed by Mississippi, Wisconsin and Wyoming, which were tied for third-to-last at 13%.

North Dakota and Iowa have state legislatures that have sometimes been hostile toward payment parity for telehealth services alongside in-person visits. HHS also found in a recent report that people used telehealth services more in urban areas than in rural communities, which encompass much of the Midwest and Western states.

Full rankings

Where residents utilize telehealth the most, least

Rank
State
Phone appointment
Video appointment
Total
1Hawaii16%18%33%
2District of Columbia16%14%30%
3Maryland10%18%28%
4California16%12%27%
4Delaware10%14%27%
4New Jersey9%17%27%
7Massachusetts9%15%26%
8Connecticut10%13%25%
8New Mexico14%8%25%
10Oregon8%15%24%
11Virginia7%13%23%
11Rhode Island14%8%23%
Show All Rows

Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data; respondents could select both phone and video if applicable.

Telehealth holding fairly steady, even as threat from COVID-19 lessens

Even with the pandemic loosening its grip, it appears as if telehealth is here to stay for the benefits it offers and the new digital flexibility the government has made possible.

In April 2021, before many Americans were fully vaccinated or eligible, telehealth usage stood at 26%, compared with 22% not quite a year later. As of March 15, 2022, 81.5% of eligible Americans — including children 5 and older — have had at least one vaccination dose, according to the U.S. Centers for Disease Control and Prevention (CDC), offering protection against severe disease.

HHS has greatly eased restrictions and otherwise sought to make it easier for patients and doctors to engage in two-way communication by phone or video during the pandemic.

The federal agency encouraged telehealth services through platforms including FaceTime, Google Hangouts, Zoom and Skype, even if the applications didn’t fully comply with national privacy rules. It also promoted telehealth in rural areas by allowing federally qualified health centers and rural health clinics to act as distant telehealth sites.

HHS also allowed health care providers to reduce or waive cost-sharing for telehealth visits and other virtual care paid for by federal programs such as Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).

The Trump and Biden administrations allowed Medicare to reach homes regardless of where covered patients lived. On the state level, doctors were allowed to diagnose and treat a patient in other states. Another of many eased restrictions permitted doctors to prescribe controlled substances via telehealth without the need for an in-person visit.

Looking forward, Medicare telehealth waivers in place since the beginning of the pandemic will remain until five months after the public health emergency (PHE) officially ends. That period expires on April 16, 2022, though another extension is expected.

Methodology

ValuePenguin researchers analyzed U.S. Census Bureau Household Pulse Survey data to estimate how many Americans use telehealth services.

Specifically, researchers estimated the percentage of Americans who had a phone or video appointment with a doctor, a nurse or another health professional in the past four weeks. Researchers ranked the states from highest to lowest based on this metric.

The Household Pulse Survey was fielded Jan. 26 to Feb. 7, 2022. Data collection for the latest survey phase ended Feb. 7, so we’re presenting the most recently available data.