Telehealth Growth and the Administrative Workload It Creates

Question: What do published data show about telehealth utilization in the United States, and what do those trends imply — and not imply — about the administrative workload facing peptide clinics, telehealth practices, and related businesses?

Type: Sourced desk research.

Method

This review combines peer-reviewed utilization studies retrieved through PubMed with the Centers for Medicare & Medicaid Services (CMS) telehealth policy resource. Sources were read in abstract or page form and are reported with their populations and periods. Because the sources measure utilization rather than administrative labor, the review labels utilization figures as source facts and treats workload implications as interpretation or qualitative synthesis. Where no direct measurement of administrative burden exists in the reviewed sources, a measurement framework is proposed explicitly rather than asserted.

Sources reviewed:

1. Barnett ML, et al. "Trends in Outpatient Telemedicine Utilization Among Rural Medicare Beneficiaries, 2010 to 2019." JAMA Health Forum. 2021;2(10):e213282. PMID 35977168.
2. Staloff JA, et al. "National Trends of Telehealth Use in Medicare Annual Wellness Visits." J Am Board Fam Med. 2025;38(2):375-377. PMID 40578910.
3. Lu M, Liao X. "Access to care through telehealth among U.S. Medicare beneficiaries in the wake of the COVID-19 pandemic." Front Public Health. 2022;10:946944. PMID 36148338.
4. CMS, Telehealth (Medicare coverage and policy resource): https://www.cms.gov/medicare/coverage/telehealth

What the sources measure

Prepandemic telemedicine grew steadily among rural Medicare beneficiaries. Barnett et al. analyzed telemedicine utilization by 10.4 million fee-for-service Medicare beneficiaries from 2010 to 2019. Telemedicine visits grew by 23.1 percent annually over the period. In 2019, 0.9 percent of rural fee-for-service beneficiaries had a telemedicine visit, compared with 0.2 percent in 2010. In 2019 there were 257,979 telemedicine visits, or 34.8 visits per 1,000 rural beneficiaries, and most (75.9 percent) were for mental health conditions. Over the period, mental health telemedicine shifted from psychiatrists (71.2 percent to 35.8 percent of visits) toward nonphysician clinicians such as nurse practitioners, psychologists, and social workers (21.4 percent to 57.2 percent). Utilization varied widely across counties. (Source facts.)

Telehealth in Medicare Annual Wellness Visits grew in volume but declined as a share of visits. Staloff et al. used 100 percent Medicare data on physician service payments for 2020 to 2022. Physicians performed 24.7 million Annual Wellness Visits corresponding to $3.2 billion in payments. Utilization rose from 7.8 million services in 2020 to 8.6 million in 2022. Telehealth Annual Wellness Visits accounted for 6.7 percent of all such visits in 2020 but only 2.1 percent in 2022. Primary care physicians provided 96.8 percent of telehealth Annual Wellness Visits. The authors note this pattern may highlight challenges in delivering these visits via telehealth at broader scale while also showing feasibility. (Source facts.)

Access and awareness remained uneven during the pandemic. Lu and Liao analyzed 31,907 Medicare beneficiaries across three waves of the Medicare Current Beneficiary Survey COVID-19 Supplement (Summer 2020, Fall 2020, Winter 2021). Reported forgone medical care because of COVID-19 fell from 22.89 percent to 3.31 percent, while reported telehealth coverage rose from 56.24 percent to 61.84 percent. Overall, 21.97 percent of respondents did not know whether their primary care provider offered telehealth services. (Source facts.)

CMS maintains the payment and coverage framework. The CMS Telehealth resource describes Medicare telehealth coverage and policy and is the authoritative source for what Medicare covers and under what rules. The reviewed page is primarily a policy hub rather than a dataset, so it supports statements about the existence of the coverage framework, not about visit volumes. (Source fact and interpretation.)

Findings

1. Telehealth adoption is real, sustained, and uneven. The reviewed studies show multi-year growth before the pandemic, large pandemic-era shifts in access, and variation by service type, geography, and beneficiary group. (Synthesis of Barnett et al., Lu and Liao, Staloff et al.)
2. The published measurements are about visits and access, not back-office labor. None of the reviewed sources directly measures scheduling volume, intake handling, documentation time, eligibility checks, or patient support contacts generated by telehealth. (Interpretation.) The administrative workload claim is therefore an inference from the service model, not a measured result.
3. A shift toward nonphysician clinicians changes coordination patterns. Barnett et al. document a substantial shift in mental health telemedicine toward nurse practitioners, psychologists, and social workers. More clinicians, and a different mix, implies more scheduling and coordination surfaces — though the study does not measure that. (Source fact plus interpretation.)
4. Telehealth is complementary, not a complete substitute. Staloff et al. found telehealth Annual Wellness Visits declined as a share even as total visits rose, and the authors discuss challenges of broad-scale telehealth delivery. This cautions against planning operations around the assumption that every service migrates online. (Synthesis.)

Operational implications

Read carefully, these trends support a few practical postures for peptide and telehealth businesses:

• Plan for a hybrid service model. The reviewed data describe mixed in-person and telehealth utilization rather than a full migration, so scheduling, intake, and records work must handle both channels.
• Expect coordination load as clinical rosters broaden. The documented shift toward more nonphysician clinicians suggests more coordination across schedules and tasks, even though the reviewed studies do not measure it.
• Treat patient awareness as an operational task. The finding that a substantial share of beneficiaries did not know whether their provider offered telehealth suggests that clear, proactive patient communication is part of the work, not an afterthought. (Interpretation.)
• Do not budget administrative capacity from visit counts alone. Because no reviewed source measures back-office effort, capacity decisions should be based on locally measured queue volumes.
• Keep policy monitoring separate from operations. CMS sets coverage rules, so a recurring policy check belongs in the operating calendar.

A proposed measurement framework (not sourced) is to instrument the specific queues telehealth creates: scheduling requests and reschedules, intake forms by channel, eligibility and benefits checks, patient questions about telehealth logistics, and documentation routing. Tracking volume per patient encounter would produce the administrative-burden estimate the literature lacks.

It is worth being precise about what these trends can and cannot support. A utilization study can tell an operator that telehealth demand exists and how it changed over a period in a defined population. It cannot tell an individual peptide business how many administrative hours its own telehealth volume will require, because that depends on its service mix, payer relationships, systems, and patient communication. Treating a national trend as a local forecast is a common error. The responsible use of this evidence is to justify building measurement capacity — not to justify a specific headcount. Once a business can see its own queue volumes, the national data becomes context rather than a planning input.

There is also a sequencing implication in the data. Because telehealth utilization shifted by service type and geography, a clinic that adds telehealth capacity uniformly across all services may overbuild in some areas and underbuild in others. The measured variation argues for reviewing telehealth administrative load service by service, then consolidating only the queues that behave similarly.

Limitations

The reviewed utilization studies use Medicare populations and may not generalize to commercial, cash-pay, or peptide-specific services. Their designs are observational, and several rely on claims or survey data with known limitations. The Lu and Liao study is cross-sectional and descriptive. None of the reviewed sources measures administrative labor, so all workload statements above are interpretive. The CMS page is a policy resource, not a dataset. This review is purposive and limited to sources that could be read directly; a systematic review of telehealth administrative burden could reach different or more precise conclusions. Nothing here should be used to predict demand for a specific business.

Sources

• Barnett ML, et al. Trends in Outpatient Telemedicine Utilization Among Rural Medicare Beneficiaries, 2010 to 2019. JAMA Health Forum. 2021;2(10):e213282. https://pubmed.ncbi.nlm.nih.gov/35977168/
• Staloff JA, et al. National Trends of Telehealth Use in Medicare Annual Wellness Visits. J Am Board Fam Med. 2025;38(2):375-377. https://pubmed.ncbi.nlm.nih.gov/40578910/
• Lu M, Liao X. Access to care through telehealth among U.S. Medicare beneficiaries in the wake of the COVID-19 pandemic. Front Public Health. 2022;10:946944. https://pubmed.ncbi.nlm.nih.gov/36148338/
• CMS, Telehealth: https://www.cms.gov/medicare/coverage/telehealth