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Audio-Only Visits Common in California Federally Qualified Health Centers

Authors say given the low barriers to increase access to care and financial parity, audio-only calls likely to persist

By Lori Solomon HealthDay Reporter

TUESDAY, April 11, 2023 (HealthDay News) — One in five primary care visits and two in five behavioral health visits were audio only at Federally Qualified Health Centers (FQHCs) in California as of August 2022, according to a research letter published in the April 11 issue of the Journal of the American Medical Association.

Lori Uscher-Pines, Ph.D., from RAND Corporation in Arlington, Virginia, and colleagues examined trends in in-person, audio-only, and video visits among California FQHCs (2019 to 2022). The analysis included 30 multisite FQHCs that served 1.3 million patients.

The researchers found that for primary care, in-person visits per 1,000 patients increased between April 2020 and August 2022 (from 69.19 to 195.86 visits); audio-only visits decreased (from 154.81 to 58.79 visits) and video visits increased (from 8.77 to 19.81 visits). For behavioral health during the same time frame, in-person visits increased (from 10.02 to 19.17 visits), audio-only visits decreased (from 37.85 to 20.15 visits), and video visits increased (from 3.95 to 11.89 visits). Audio-only visits peaked in April 2020 for primary care and in March 2021 for behavioral health. More than half of FQHCs (53 percent) never adopted video visits for primary care or had phased them out completely as of August 2022, while 13 percent discontinued audio-only visits for primary care. For behavioral health, one-quarter had no video visits and 21 percent discontinued audio-only visits.

“FQHCs do not have a financial incentive to limit audio-only visits, and they are likely to remain widespread in coming years,” the authors write.

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