This story is part of Critical Condition, a monthlong project focusing on the issues Massachusetts residents face in accessing health care.

AS THE COVID-19 pandemic surged, homes became workplaces, schools, and day care centers. And with the rise of telehealth, they became remote doctors’ offices too.  

Now half a decade from the first lockdowns, most major providers offer telehealth options, but new polling finds nearly two-thirds of Bay State residents are still primarily receiving their health care the old-fashioned way: in person. 

Telehealth involves a clinician providing a patient medical services, in real time or asynchronously, generally by phone or video conferencing. While technological developments like laptops and cell phones made the practice more convenient in recent decades, KFF research in March 2020 found use of telemedicine in the US was minimal. Growth was slow, hampered by irregular insurance coverage policies and hurdles like high startup costs, workflow reconfiguration, clinician buy-in, and patient interest.  

That all changed in 2020. With the onset of the pandemic, usage soared. Massachusetts lawmakers passed a suite of pandemic-focused reforms to enable broad use of telehealth. The new regulations made coverage for telehealth services and cost parity between telehealth and in-person behavioral health services permanent. For primary care and chronic disease management, in person and telehealth cost parity changes were temporary. 

Two-thirds of covered outpatient visits in Massachusetts in April 2020 were telehealth visits, settling at about 31 percent of those visits over the course of the year. “As the most acute phase of the pandemic has ended,” the Massachusetts Health Policy Commission wrote in 2023, “telehealth has remained an important element of the health care delivery system.”  

While the rise of telehealth in the early 2020s “did improve access to care,” an HPC spokesperson said this month, not everyone is able to use the new virtual hospital landscape. “Specific actions could be taken to further enhance access for more rural and vulnerable populations,” the spokesperson said.  

According to new polling data from the MassINC Polling Group for CommonWealth Beacon, many Massachusetts residents aren’t leaning heavily into the digital health care transformation. The survey found that 37 percent had no telehealth appointments in the past year, while another 25 percent said less than half of their appointments were conducted virtually. (MassINC Polling Group is partially owned by Commonwealth Beacon’s publisher, MassINC.) 

The poll surveyed 1,000 Massachusetts residents from August 11 to 18 and has a credibility interval of plus or minus 3.5 percentage points. (Topline | Crosstabs)   

Those who make under $75,000 a year were significantly more likely to report no medical appointments in the last year (10 percent) than those making over $75,000 (3 percent). For those who did report medical appointments, higher income brackets were more likely to report fewer telehealth visits, though a majority of respondents of all income levels said they had no telehealth appointments or less than half of their appointments were telehealth over the past year. 

For those who want and can access telehealth, options abound. 

The Bay State has the third highest rate of hospital telehealth adoption in the country – 93.8 percent of its hospitals had installed some sort of telemedicine solution by early 2024.  

Mass General Brigham, the state’s largest health system and private employer, launched a new virtual and artificial intelligence-based primary care platform this month. For now, the program covers MGB patients who are between providers and those in risk-based contracts who haven’t come in for a visit in the past year.  

A spokesperson said the health system plans to expand the program this winter to reach new patients who prefer a virtual primary care physician experience. 

“Mass General Brigham always strives to provide the best quality, personalized care for our patients and give options as to how patients access care,” the hospital said in a statement. “Telehealth is a vital tool to expand access to care and lower barriers for patients.” 

Digital tools can ease some of the workforce strain, hospitals and insurers say. Facing weeks, months, or even more than a year of wait time for appointments, patients may opt for telehealth as an initial option if they can access it. 

“We understand how difficult it is for our members to access high-quality, affordable care,” Blue Cross Blue Shield Massachusetts spokesperson Kelsey Pearse said in a statement. “We’re focused on building a network of providers and solutions that can support our members now and navigate them to the care they need when they need it.” 

Blue Cross Blue Shield pointed to 13 percent growth in their primary care network and 48 percent growth in their mental health provider network over the past five years, including in-person and “virtual first” providers. Almost all of the system’s providers offer some sort of telemedicine these days, Pearse noted. The major remote-only vendor through BCBS is the telehealth network Well Connection. Other digital health options that have boomed during the pandemic include the physical therapy app Hinge Health and the virtual women’s health clinic Maven Clinic. 

According to Epic Research tracking, telehealth had declined from its mid-pandemic peak but remained above pre-pandemic levels, especially in behavioral health fields. About 27 percent of mental health contacts were via telehealth in June 2025, compared to less than 7 percent of primary care and 2 percent for urgent care. 

Pandemic aside, remote health care has stayed in the headlines because of its role in accessing abortion medications, something that is increasingly under attack in dozens of states.  

Since the US Supreme Court overturned Roe v. Wade in 2022, the number of people receiving abortion medication prescriptions through telehealth has surged, with a Society of Family Planning report finding that a quarter of all abortions in the United States were delivered via telehealth prescriptions of medication by the end of 2024.  

Massachusetts providers reaffirmed earlier this month that they plan to continue mailing abortion pills to Texas even after its governor, Greg Abbott, signed a first-of-its-kind law that lets anyone sue prescribers and others responsible for getting abortion pills into the state.  

But accessing virtual care requires access to technology and a strong internet connection.  

The Health Policy Commission identified low digital literacy and a lack of access to connected devices and reliable internet as the biggest barriers for patients to access telehealth services. They also found telehealth platforms, patient portals, and other patient communication materials may be challenging to use for those with lower English proficiency or vision and hearing impairments. 

For regions without many accessible care facilities, telehealth is pitched as a partial solution. It may be physically easier to access than distant in-person appointments, but the regions also need improvements to their digital infrastructure to make full use of virtual care. 

“Rural patients face unique challenges in accessing both in-person and audio-video services, creating inequities in care,” according to the National Rural Health Association. “Rural patients, on average, travel further to access health care than their non-rural counterparts. This disincentivizes rural residents from seeking care if they do not have the ability or resources for travel.”    

These areas have less broadband infrastructure and lower rates of smartphone ownership, the advocacy organization notes. Expanded telehealth and rural internet offerings during the pandemic have been a boon, it says, and rural areas “will suffer if such flexibilities are removed.” 

Residents in Southeast Massachusetts were least likely in polling to regularly use telehealth, with just 22 percent reporting that more than half of their appointments were remote and 37 percent reporting no telehealth appointments in the past year. Greater Boston residents were most likely to report more than half of appointments by telehealth (31 percent), with Western and Central Massachusetts regions reporting less regular telehealth usage but also fewer overall medical appointments in the last year. 

Massachusetts lawmakers are still refining the state’s telehealth policies.  

The initial telehealth legislation’s payment parity mandate between telehealth and in-person services expired at the end of 2022, which the Massachusetts Medical Society noted “caused some insurers to reduce reimbursement rates. This variation in payment policies creates confusion and instability for providers and limits patient access to care.” 

Rep. Marjorie Decker and Sen. Adam Gomez have introduced legislation this session to re-establish payment parity for all telehealth services and create initiatives to advance digital health equity.  

A hearing on legislation put forward by Rep. William MacGregor of Boston that would create a special commission to study the accessibility and quality of telehealth is scheduled for September 29.