Telehealth adoption will not meet initial pandemic-era projections

What's this about?

People disagree about whether telehealth use would stay as high as early pandemic forecasts said.

Telehealth means getting care by phone or video.

What supporters say

• Weak internet, low tech skills, low income, and where people live can limit telehealth use.
• Emergency needs, rule changes, and new payment plans pushed telehealth use far above normal levels.
• Telehealth visits fell from 41% in April 2020 to about 6% or 7% in 2023 and 2024.
• Early forecasts said up to 24% of office care might happen online, but later use stayed far below that goal.

What critics say

• Many patients still want telehealth for some care, such as checkups or help with long-term health needs.
• Telehealth use stayed much higher than before the pandemic, when it made up less than 1% of some visits.

How to read this

The number of points does not show which side wins; strong proof matters more than a longer list.

The bottom line

The evidence clearly supports the claim for the number of visits.

Telehealth did not vanish, but emergency-era use dropped sharply and did not match the biggest early forecasts.

The claim is that telehealth use after the pandemic would fall short of the sweeping forecasts made during its first year. The evidence largely supports that view for visit volume, but it does not show that telehealth itself disappeared.

The case for

The clearest evidence comes from the gap between the emergency-era peak and later use. Telehealth accounted for 41% of evaluation-and-management visits in April 2020, according to a later claims analysis. By 2023 and 2024, that share had fallen to roughly 5.7% to 7.0% (see Figure 2). Those figures come from a preprint, so the exact estimates should be treated cautiously, but the direction is clear: actual virtual visit volume ended up well below the most ambitious forecasts. 1

Early projections included McKinsey’s estimate that as much as 24% of office and outpatient care might be delivered virtually, representing a potential $250 billion market. That was a scenario for what could happen if patients and clinicians continued adopting telehealth—not a guaranteed forecast—but later visit levels still fell short of that broad vision.

The early surge was also shaped by unusual emergency conditions. McKinsey found that outpatient telehealth use in April 2020 was 78 times higher than in February, before usage peaked and then settled lower. Medicare data from the Department of Health and Human Services showed telehealth rising from less than 1% of Part B visits in 2019 to 5.3% in 2020. Temporary rules, reimbursement changes and the need to replace in-person care helped drive that jump, making it a weak basis for predicting normal, long-term behavior. 2

There are also limits to population-wide adoption. Research has found differences in telehealth access and use linked to geography, race, income and digital skills. These barriers do not mean telehealth lacks value; studies also find that it can improve continuity and access. But they make it less likely that the emergency-era pattern could be transferred equally to all patients. 3

The case against

A decline in the share of visits does not mean telehealth failed. Use and availability remained far above pre-pandemic levels. The Centers for Disease Control and Prevention reported that 37% of U.S. adults used telemedicine in 2021, while the share of physicians whose practices offered video visits rose from 16% in 2019 to 80.5% in 2021. In 2024, an American Medical Association analysis found that 71.4% of physicians were still working in practices that used telehealth. 4

Those figures measure people’s use and providers’ ability to offer care, rather than telehealth’s share of all visits. Even so, they show that the technology and the systems supporting it became a lasting part of health care rather than reverting to their pre-pandemic state.

Patient demand also remains durable in particular situations. A systematic review found high satisfaction in many studies and reported that substantial numbers of patients wanted future telehealth visits. A post-pandemic survey found that preferences varied according to previous experience, cost, perceived benefits and practical barriers. This points to selective, lasting demand, especially for services where a physical examination is less important—not necessarily a shift to predominantly virtual outpatient care. 5

The bottom line

The evidence moderately favours the claim, but only when it is understood as a statement about post-pandemic visit volume falling below the most expansive pandemic-era projections. The strongest direct evidence is the sharp retreat from the 2020 peak, and later measured visit shares appear well below scenarios such as 24% of outpatient care being delivered virtually.

The claim is too broad if it means that telehealth adoption generally failed to persist. Provider capability, patient use and demand in selected services remain substantially higher than before the pandemic. The two sides are therefore not equally strong on every question: the case for the claim is clearer on overall visit volume, while the opposing evidence is strong on lasting infrastructure and targeted use.

The remaining uncertainty comes from the benchmark being used. Early projections described potential virtual care, while later studies measure different things, including visit share, provider availability, users, revenue and audio-only care. Government and peer-reviewed evidence makes the broad direction reliable, but differences in populations, time periods and definitions make the precise size of the shortfall less certain.