The study explores the narrowing gaps in internet use among Medicare beneficiaries, emphasizing disparities across demographic lines. Despite a positive trend with 77.1% reporting internet use in 2023, persistent gaps affect telehealth access. Increases are notable in certain groups, such as Hispanic and older beneficiaries. However, racial, income, health, and linguistic disparities persist. While initiatives address the digital divide, approximately 42 million Americans lack broadband access, hindering telehealth. Surprisingly, recent research questions the assumption that high-speed internet and telehealth close healthcare gaps. Achieving equitable access demands ongoing efforts to ensure comprehensive internet access for all, irrespective of age, race, income, or health status.
In the realm of healthcare, the digital divide among Medicare beneficiaries has garnered attention, particularly concerning internet use. The Journal of the American Geriatrics Society recently published a study illuminating the progress in narrowing internet use gaps among this population. The COVID-19 pandemic accelerated digital healthcare adoption, underscoring the digital divide’s impact. Despite concerted efforts to bridge gaps, disparities persist across demographics, affecting telehealth access. The study, drawing on extensive survey data, delves into the nuanced changes, revealing both positive trends and ongoing challenges. Understanding the dynamics of internet use in this context is paramount for addressing persistent healthcare inequalities.
Digital Healthcare Adoption and the COVID-19 Pandemic:
The COVID-19 pandemic acted as a catalyst for the rapid adoption of digital healthcare. However, this surge exposed the digital divide, characterized by economic, educational, and social inequalities related to computer and online access. In response to this gap, various initiatives were implemented during the pandemic, such as expanding broadband coverage, providing subsidized internet plans, and offering technology assistance to low-income households.
Research Methodology:
Researchers from Rand Corporation and the Centers for Medicare & Medicaid Services conducted a comprehensive study to assess changes in internet use among Medicare beneficiaries. The study utilized data from 823,262 respondents to the 2019, 2021, and 2023 Medicare Consumer Assessment of Healthcare Providers and Systems Survey. The analysis considered person-level characteristics, including sex, self-reported race and ethnicity, and age.
Key Findings:
The study revealed a positive trend, with 77.1 percent of Medicare beneficiaries reporting internet use at home in 2023, compared to 72.7 percent in 2021 and 68.6 percent in 2019. Notably, the increase in internet use rates was more significant among certain demographic groups. Hispanic Medicare beneficiaries responding in Spanish experienced an 18.1 percentage point jump from 2019 to 2023, while the increase was smallest for White beneficiaries at 7.4 percentage points.
Demographic Disparities:
Disparities persisted across racial and ethnic lines, with White beneficiaries having the highest internet use rates at 80.9 percent in 2023. Other groups, including Asian American and Native Hawaiian or other Pacific Islander (76.3 percent), Black (62.3 percent), and American Indian, Alaska or Native beneficiaries (54.3 percent), displayed varying rates. Internet use rates were lowest among Hispanic beneficiaries who responded in Spanish (46.1 percent) but higher for those who responded in another language (65.4 percent).
Age and Socioeconomic Factors:
While internet use increased more among Medicare beneficiaries aged 85 and older, those with limited income, and individuals with ‘fair’ or ‘poor’ self-rated health, certain groups, such as those younger than 69, higher-income individuals, and those with ‘excellent’ or ‘very good’ self-rated health, exhibited higher rates of internet use overall in 2023.
Telehealth Implications:
The study’s implications extend to telehealth access, suggesting that racial or ethnic minorities, low-income individuals, those in poorer health, Spanish-speaking beneficiaries, and older adults may face challenges accessing telemedicine due to unreliable internet access. Approximately 42 million Americans lack access to terrestrial broadband internet, highlighting a critical barrier to telehealth nationwide.
Barriers to Telehealth Access:
Access to high-speed internet remains a significant barrier to telehealth access. A 2021 survey by the Bipartisan Policy Center revealed that 45 percent of adults cited technology-related issues, including broadband and computer access, as barriers to telehealth. Additionally, rural residents faced inferior internet access, limiting their utilization of digital health tools for communication with healthcare providers.
Challenges in Closing Healthcare Utilization Gaps:
Contrary to expectations, recent research published in JAMA Network Open challenges the idea that access to high-speed internet and telehealth can effectively close healthcare utilization gaps. The study, focusing on adult Wisconsin Medicaid beneficiaries, found that while telehealth and high-speed internet may boost primary care receipt, they generally do not close utilization gaps.
The study’s findings underscore a positive trajectory in narrowing internet use gaps among Medicare beneficiaries. However, significant disparities persist, posing challenges to achieving equitable telehealth access. Racial, income, health, and linguistic factors continue to influence internet use rates. The digital divide remains a critical barrier, with 42 million Americans lacking broadband access. Surprisingly, recent research questions the efficacy of high-speed internet and telehealth in closing healthcare utilization gaps. Achieving comprehensive and affordable internet access for all demographics is imperative for realizing the full potential of digital health. Ongoing efforts are essential to bridge remaining gaps and ensure healthcare equity for every segment of the population.
