Patient characteristics associated with frequent telehealth utilization in 2022: Evaluation of a national virtual integrated medical and behavioral health practice within the United States.

Objectives: As permanent telehealth policies are considered in the United States (U.S.), it is important to understand who uses telehealth most often following the pandemic. We described patients who used a national virtual care practice frequently, identified how they differed from patients who used it less often, and characterized the types of care frequent telehealth patients utilized. Methods: We used video visit data for commercially-insured patients, aged 18+, from a national virtual integrated medical and behavioral health practice in 2022 in the U.S. Patients were categorized into three groups: one visit ('minimal use'), two to four visits ('some use'), and five or more visits ('frequent use'). We compared patient and geographic characteristics between the three groups and estimated an ordinary least squares linear regression to identify predictors of 'frequent' use relative to 'minimal' or 'some' use. Results: The probability of being a frequent user declined with age (-0.4 percentage points (p.p.) per year; 95 % CI, -0.4 - -0.3), was higher for females (5.4 p.p.; 95 % CI, 4.1 - 6.7) and patients with greater clinical complexity (7.9 p.p. for highest relative to lowest quartile risk score; 95 % CI, 5.9 - 10.0), and lower for patients in the Northeast (-9.2 p.p.; 95 % CI, -15.5 - -2.9) or West (-3.2 p.p.; 95 % CI, -5.7 - -0.7) regions relative to the Southern region of the U.S. The five most common diagnoses were mental health conditions. Conclusions: Our results highlight the need for comprehensive telehealth policy that enables access, particularly for patients who rely on it as their primary source of care.