As virtual care becomes increasingly embedded in healthcare delivery, policymakers and healthcare purchasers — including employers considering cost-sharing and benefit design changes — need to understand who relies most on virtual care. To answer that question, Included Health partnered with the Urban Institute to examine which patients used Included Health’s integrated virtual primary care and behavioral health practice most frequently — and how their needs and characteristics differ from less frequent users.

Researchers analyzed data from 17,941 commercially insured adults who used Included Health’s national virtual practice in 2022. Patients were grouped by visit frequency:

• Minimal use: 1 visit
• Some use: 2–4 visits
• Frequent use: 5 or more visits

The study compared demographic, clinical, and geographic characteristics across groups. Statistical models identified which factors predicted frequent use of telehealth services.

Frequent telehealth use was common and closely tied to ongoing mental health care.

• 18% of patients were frequent users, with five or more visits in 2022.
• Frequent users were more likely to be:
  
  • Female and younger
  • Living with greater clinical complexity
  • Residing in the South, often in areas with higher poverty or more racial diversity
• Their visits were largely for chronic conditions (59%), especially mental health diagnoses such as depression, anxiety, and bipolar disorder.
• Patients with only one visit were more likely to seek care for acute conditions (82%), including sinusitis and COVID-19.

Frequent users rely on virtual care as their primary source of ongoing care, particularly for mental health support.

Integrated virtual primary and behavioral health models can meet the needs of patients facing barriers such as geography, provider shortages, or cost.

The findings underscore the importance of maintaining telehealth flexibility so people who depend on virtual care can continue to access consistent, high-quality support.