Health centers rapidly expanded their provision of telemedicine but total visits remained below 2019 levels

 Table 1 shows how health centers’ operational capacity changed from 2019 to 2020. There was modest growth in staffing, as measured by full-time equivalent staff members, as well as in the number of health center sites. Total visits dropped by nearly 8.6 million, or seven percent, with a much greater decline in clinic visits, which fell by 36.6 million, or 30 percent. HRSA has tracked the effect of the COVID-19 pandemic on health centers’ visit volume since the early months of the pandemic through its Health Center COVID-19 Survey.[6] The decline in health center visits compared to pre-pandemic visit volume peaked at 53 percent in April 2020. While visits increased throughout the remainder of the year and one year later[7] stood at 13 percent below pre-pandemic levels, visits were still down by seven percent as of September 24, 2021,[8] more than a year and a half after the World Health Organization declared COVID-19 a pandemic,[9] indicating that the recovery in activity remains incomplete.

Community health centers responded to the pandemic by rapidly adopting virtual visits, with the help of greater reimbursement flexibility for telehealth services.[10] While less than half (43 percent) of community health centers reported telemedicine use in 2019, nearly all (99 percent) did in 2020.[11] The number of virtual visits grew from less than 480,000 in 2019 to more than 28.5 million in 2020, a nearly 6,000 percent increase (Table 1). Accordingly, in 2020, telehealth visits accounted for 25 percent of all visits compared to 0.4 percent in 2019 (Figure 6). In April 2020, telehealth use peaked with more than half (54 percent) of weekly visits conducted virtually, on average;[12] this share fell to 24 percent by April 2021 and as of September 2021, telehealth visits accounted for 19 percent of visits, on average.[13]

 Table 1

Figure 6

2019

2020