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1、LORI USCHER-PINES,JESSICA L.SOUSA,COLLEEN M.MCCULLOUGH,SHIRLEY DONG,KANDICE A.KAPINOSTelehealth Visits in Health Centers Serving Low-Income Patients in CaliforniaFinal Results from the Connected Care Accelerator Initiative(20222024)Federally Qualified Health Centers(FQHCs)are outpatient health cente

2、rs that provide pri-mary care and limited specialty-care services to nearly 30 million low-income patients(Farb,2023).Prior to the coronavirus disease 2019(COVID-19)pandemic,FQHCs rarely deliv-ered audio-only or video telehealth visits(Uscher-Pines et al.,2021).However,with both temporary and perman

3、ent policy changes to facilitate telehealth use at the state and federal levels,telehealth has become an important modality of care(Uscher-Pines et al.,2022;Uscher-Pines et al.,2021;Uscher-Pines et al.,2023).In 2023,approximately 9 percent of FQHC visits in the United States and 20 percent of FQHC v

4、isits in California occurred via video or audio-only visits delivered into patients homes(Health Resources and Services Administration,undated-b).Recognizing that the pandemic had rapidly accelerated the adoption of telehealth in safety net settings,including FQHCs,the California Health Care Foundat

5、ion(CHCF)first launched the Con-nected Care Accelerator(CCA)program in July 2020.This program provided funding from 2020 to 2024 for dozens of large,multisite health centers in California.Participating health centers received funding,tools,and,in some cases,hands-on technical assistance to enhance t

6、heir virtual care offer-ings.To facilitate an evaluation of the impact of CHCFs investment in capacity building,health centers committed to submitting data on an annual basis.Using a standardized reporting tool,they reported on the video,audio-only,and in-person visits delivered to patients receivin

7、g primary care and behavioral health services(Uscher-Pines et al.,2022).RAND and other evaluation teams have published numerous reports on trends in telehealth visits at CCA health centers to inform evolving telehealth policy in California and nationally(Uscher-Pines et al.,2022;Uscher-Pines et al.,

8、2023;Research Report2Uscher-Pines et al.,2021;Center for Community Health and Evaluation,2021;Center for Commu-nity Health and Evaluation,2023).This unique data source had several advantages.First,in contrast to medical claims data,CCA data were available with-out a significant time lag.Second,the C

9、CA reporting tool that health centers populated based on electronic medical record data distinguished between audio-only and video visits at a time when few other data sources could do so(Hailu et al.,2022).In this brief report,we provide updated results based on the analytic methods that RAND resea

10、rch-ers applied in prior publications(Center for Commu-nity Health and Evaluation,2023;Center for Com-munity Health and Evaluation,2021;Uscher-Pines et al.,2022;Uscher-Pines et al.,2023;Uscher-Pines et al.,2021).Specifically,we describe how telehealth use by CCA health centers changed(in terms of vo

11、lume,modality,and differences in patients served)between September 2022 and August 2024,a period that included the end of the U.S.COVID-19 public health emergency(in May 2023)and beyond.During this time frame,there was less of an urgent need to conduct telehealth visits for public health reasons.Fur

12、thermore,during this time,the California Medic-aid program preserved the broad flexibilities granted to FQHCs during the pandemic,which permanently allowed them to receive the same reimbursement for audio-only,video,and in-person visits.Payment parity for these services eliminated long-standing(pre-

13、pandemic)barriers to the use of telehealth in safety net settings(Uscher-Pines et al.,2020).MethodsThe methods employed in our study have been pub-lished in prior publications(Center for Community Health and Evaluation,2021;Center for Community Health and Evaluation,2023;Uscher-Pines et al.,2021;Usc

14、her-Pines et al.,2022;Uscher-Pines et al.,2023).In summary,participating health centers provided data for evaluation through a reporting tool that is aligned with the Health Resources and Services Administrations Uniform Data System(Uscher-Pines et al.,2021).FQHCs submitted aggre-gated data on billa

15、ble outpatient primary care and behavioral health visits,reporting monthly visit-level data on in-person,audio-only,and video visits,as well as 12-month,person-level data by modality and patient demographics from September 2022 to August 2024.1 We focused on primary care and behavioral health servic

16、es because these are among the highest volume services delivered by FQHCs in which telehealth is feasible and clinically appropri-ate.For this study,we defined telehealth as synchro-KEY FINDINGS Telehealth,which includes video and audio-only visits,continued to play a prominent role in primary care

17、and behavioral health care delivery in California health centers,accounting for about one-fourth and one-half of all visits,respectively,from September 2022 to August 2024.Telehealth visitsand video visits in particularcomprised an incrementally smaller proportion of overall primary care and behavio

18、ral health visits over time.For primary care,the share of video visits decreased from 8.9 percent in September 2022 to 5.4 percent in August 2024.Over the same period,audio-only primary care visits declined from 19.5 percent to 17.3 percent.Most health centers in California continued to offer all th

19、ree visit modalities(in-person,video,audio-only)for primary care(n=20;83 percent)and behavioral health care(n=17;70.8 percent)during the final year of the study period(September 2023August 2024).There were persistent disparities in telehealth use according to patient language preference.Patients who

20、se preferred language was English were overrepresented among primary care and behavioral health patients with video visits.For example,in the case of behavioral health,patients who preferred English represented 80.1 percent of patients with video visits but 66.6 percent of unique patients with any v

21、isits in the final year of the study period(September 2023August 2024).3nous audio-only or video visits that connect patients and health care providers.We calculated descriptive statistics on visit modality(video,audio-only,in-person)and charac-teristics of patients served by different visit modali-

22、ties.We used chi-squared tests to compare propor-tions across modalities.We applied the Bonferroni correction to adjust for multiple comparisons,result-ing in statistical significance being defined as a two-sided p 0.002(0.05/27 comparisons).2 We were well powered to detect statistical differences i

23、n the frac-tion of visits in each modality over time.Across the three modalities(in-person,video,and audio-only)with approximately 200,000 primary care visits each month,we could detect differences of 0.5 percent or larger with 80 percent power(alpha=0.001)in the percentage of visits in each modalit

24、y from month to month.Because there were fewer behavioral health visits each month(approximately 20,000),we were able to detect differences of 1.5 percent or larger in the percentage of visits in each modality.We were statistically powered at 80 percent or better(alpha=0.001)to detect demographic di

25、fferences by modal-ity of approximately 1 percentage point or larger across all primary care visits and 5 percentage points or larger across all behavioral health visits from September 2023 to August 2024.The analyses were conducted using Stata version 18(StataCorp,2023).The RAND Institutional Revie

26、w Board declared the study exempt.ResultsFrom 2022 to 2024,24 health centers participated in the evaluation.Most health centers in the sample were large organizations with multiple clinic sites.The majority(n=22;92 percent)were FQHCs.The health centers were distributed across the state of California

27、(Table 1).During the full study period from September 2022 to August 2024,there were 5,321,876 primary care visits,including 4,037,416(75.9 percent)in-person visits,945,335(17.8 percent)audio-only visits,and 339,125(6.4 percent)video visits.Telehealth visits in generaland video visits in particularm

28、ade up an incrementally smaller proportion of overall visits TABLE 1Characteristics of Participating Health Centers(N=24)CharacteristicnPercentageOrganization typeaFQHC2292FQHC look-alike14Public hospital FQHC14Region in CaliforniabNorthern521Central521Southern1458Total unique primary care patients(

29、20232024)9,99952110,00049,999135450,00099,999417100,000+28SOURCE:Visit data submitted by participating health centers.a See Health Resources and Services Administration,undated-b.b California is divided into Northern,Central,and Southern regions(Study California,undated).4as time progressed.In Septe

30、mber 2022,8.9 percent of visits were via video and 19.5 percent were audio-only,while 71.9 percent were conducted in person.By August 2024,in-person visits had increased by 5.5 percentage points(p 0.001)to 77.4 percent,while the percentage of visits via telephone and video had fallen by 2.2(p 0.001)

31、and 3.3(p 0.001)percentage points,respectively(Figure 1).Among individual health centers in the sample,three(12.5 percent)delivered no video visits and one(4 percent)delivered no audio-only visits for primary care in the final year of the study period(September 2023August 2024).Most health centers(n

32、=20;83 percent)offered all three visit modalities.In contrast,telehealth use was significantly more prominent for behavioral health visits than for primary care,comprising 49.3 percent of all visits(difference with primary care visits=0.26,p 0.001).From September 2022 to August 2024,there were a tot

33、al of 575,396 behavioral health visits,including 283,610(49.3 percent)in-person visits,145,852(25.3 percent)audio-only visits,and 145,934(25.4 percent)video visits.In-person visits increased by 3.5 percentage points(p 0.001),from 46.4 per-cent of all behavioral health visits to 49.9 percent over the

34、 full study period.Audio visits decreased by 1.1 percentage points(p=0.008),and video visits decreased by 2.3 percentage points(p 0.001).These patterns are similar to those observed among pri-FIGURE 1Total Primary Care Visits,by Modality(September 2022August 2024)NOTE:This graph uses data reported b

35、y 23 out of 24 participating health centers.One health centers data were excluded because of data quality issues.September 2022October 2022November 2022December 2022January 2023February 2023March 2023April 2023May 2023June 2023July 2023August 2023September 2023October 2023November 2023December 2023J

36、anuary 2024February 2024March 2024April 2024May 2024June 2024Number of visits250,000200,000150,000100,00050,0000VideoAudio-onlyIn-personCare modality77.4%17.3%5.4%71.9%19.5%8.9%July 20245mary care visits,though the changes were smaller in magnitude(Figure 2).Among individual health centers in the sa

37、mple,four(16.7 percent)delivered no video visits and three(12.4 percent)delivered no audio-only visits for behavioral health in the final year of the study period(September 2023August 2024).The majority of health centers(n=17;70.8 percent)offered all three visit modalities.Health centers reported on

38、 the characteristics of patients who participated in different visit types in the final year of the study period(September 2023August 2024).Table 2 shows differences by modality,but comparisons for some measures are problematic because of missing data.Therefore,we highlight dif-ferences by English p

39、roficiency,which had the small-est fraction of patients for whom the visit type was unknown or unreported.For primary care,patients who were proficient in English represented 57.8 per-cent of patients who participated in video visits com-pared with 54.0 percent of patients who received any visits(in

40、clusive of all modalities)(difference signifi-cant at p 0.001).For behavioral health,patients who were proficient in English represented 80.1 percent of patients who participated in video visits compared with 66.6 percent of patients who received any visits(Table 3)(difference significant at p 0.001

41、).FIGURE 2Total Behavioral Health Visits,by Modality(September 2022August 2024)NOTE:This graph uses data reported by 23 out of 24 participating health centers.One health centers data were excluded because of data quality issues.September 2022October 2022November 2022December 2022January 2023February

42、 2023March 2023April 2023May 2023June 2023July 2023August 2023September 2023October 2023November 2023December 2023January 2024February 2024March 2024April 2024May 2024June 2024Number of visits30,00025,00020,00015,00010,0005,0000VideoAudio-onlyIn-personCare modality49.9%27.2%23.0%46.4%28.3%25.3%July

43、20246TABLE 2Primary Care Patient Characteristics:Unique Patients with Primary Care Visits in September 2023August 2024Patients with One or More Primary Care VisitVideo(N=71,651)Audio-Only(N=196,018)In-Person(N=686,509)All Patients(N=774,524)Characteristicn%n%n%n%RaceWhite32,66545.6104,01353.1371,474

44、54.1415,75153.7Black4,8936.812,3096.332,9774.840,3075.2Asian18,41025.736,41518.6102,44214.9104,95113.6Other4,0115.69,2914.731,6374.650,6806.5More than one2,6533.74,6032.320,1652.924,5483.2Unreported9,01912.629,38715.0127,81418.6138,28717.9EthnicityHispanic33,36346.695,67048.8316,70246.1366,20047.3No

45、t Hispanic33,37346.680,74941.2234,63634.2264,45034.1Unreported4,9156.919,59910.0135,17119.7143,87118.6Age in years17 and younger20,31528.430,12615.4207,15730.2222,28128.7184423,94333.469,05835.2216,59631.6255,32033.0456417,89225.064,82333.1174,97625.5198,44525.665 and older9,50113.332,01116.387,7801

46、2.898,47812.7LanguageEnglish41,40557.896,70549.3342,29949.9418,13354.0Other than English29,96441.899,25650.6339,92149.5352,05945.5Unreported2820.4570.04,2890.64,3320.6NOTE:N=19 health centers contributed data.7TABLE 3Behavioral Health Patient Characteristics:Unique Patients with Behavioral Health Vi

47、sits in September 2023August 2024Patients with One or More Behavioral Health VisitVideo(N=13,258)Audio-Only(N=25,440)In-Person(N=53,046)All Patients(N=74,660)Characteristicn%n%n%n%RaceWhite7,95960.013,76154.127,44451.740,73054.6Black9837.42,0648.14,1897.95,7987.8Asian9537.22,5269.93,6897.05,5037.4Ot

48、her7015.31,4345.63,9547.54,9196.6More than one5143.97252.81,9843.72,8923.9Unreported2,14816.24,93019.411,78622.214,81819.8EthnicityHispanic4,85136.612,20348.024,19145.634,05545.6Not Hispanic6,00345.311,22544.119,74337.228,45838.1Unreported2,40418.12,0127.99,11217.212,14716.3Age in years17 and younge

49、r2,36517.83,96315.614,20426.818,95425.418446,75751.011,41344.920,14738.030,37540.745643,33525.27,40629.113,12524.717,49323.465 and older8016.02,65810.45,57010.57,83810.5LanguageEnglish10,62280.117,00966.933,97564.049,71666.6Other than English2,55119.28,42033.115,83329.821,69529.1Unreported850.6110.0

50、3,2386.13,2494.4NOTE:N=19 health centers contributed data.8DiscussionMore than four years have elapsed since COVID-19 was first declared a public health emergency in the United States in January 2020.Although the urgent need to conduct telehealth visits to protect patients and health center staff ha

51、s subsided,telehealth con-tinues to play a prominent role in the delivery of primary care and behavioral health services in safety net settings in California.From 2023 to 2024,tele-health represented approximately one-fourth and one-half of all primary care and behavioral health visits,respectively.

52、Furthermore,although audio-only visits continued to dominate in primary care(representing 74 percent of all telehealth visits),both audio-only and video visits played a prominent role in behavioral health services.What is especially note-worthy is that health centers seem to have entered a steady st

53、ate with their telehealth use;we observe only modest declines over the past two years with respect to total telehealth use and little change in the balance of the different visit modalities.Video visits have not substituted for audio-only visits despite addi-tional implementation time.In fact,video

54、visits have slightly declined along with telehealth more broadly.Despite efforts to identify and address disparities in use across the health system,patients with limited English proficiency continued to be underrepre-sented in the population of patients who accessed video visits in 2023 to 2024.Tel

55、ehealth use and reliance on audio-only visits are unlikely to change substantially in Californias health centers in the short term.Telehealth reim-bursement policy in Californias Medicaid program is permanent(Center for Connected Health Policy,2023),and given payment parity for all three visit types

56、,health centers have little incentive to transi-tion away from telehealth or from audio-only visits,particularly when such visits are used to overcome access barriers for patients.Nonetheless,it is unclear whether the Medicare program will continue to reimburse FQHCs for primary care telehealth and

57、at what level after 2024.Although Medicare is not a leading payer for Californias FQHCs,Medicare policy is highly influential in shaping the decisions of payers across the health care system.Given that telehealth use may remain fairly stable in California health centers in coming years,it is importa

58、nt to reflect on whether the observed level of telehealth is an intended consequence of policy changes.Is this level of use ideal from the perspective of patients,providers,and policymakers?On the one hand,it is important that telehealth enables access to a variety of convenient options for care and

59、 that health centers have new strategies to address access barriers and workforce shortages(e.g.,by recruit-ing remote behavioral health clinicians to provide telehealth visits)(Finocchio et al.,2021).On the other hand,it is important to consider care quality.Although health centers in California ar

60、e still recov-ering from a particularly challenging period in 2020,their performance on multiple quality measures(e.g.,colorectal cancer screening,diabetes and blood pres-sure control)in 2023 still lagged behind 2019(Health Resources and Services Administration,undated-a).Many factors can influence

61、performance on clinical quality measures,including staffing(Sun et al.,2024),payment models(Markowski et al.,2024),and the availability of resources to support patient outreach(Cole et al.,2023).It is important to assess whether high telehealth use is influencing performance on key quality measures

62、and the potential impacts of reliance on audio-only visits.Although the urgent need to conduct telehealth visits has subsided,telehealth continues to play a prominent role in the delivery of primary care and behavioral health services.9More work is needed to support FQHCs in over-coming the digital

63、divide to ensure that patients have equal access to video visits regardless of English proficiency,rurality,race,ethnicity,income or insur-ance type,and other factors.Disparities in access to telehealthand video visits in particularare well established and have important implications for health equi

64、ty(Rodriguez et al.,2021;Chang et al.,2021;Hsueh et al.,2021;Weber et al.,2023;Gallegos-Rejas et al.,2023).Low digital literacy,the lack of a reliable broadband connection or video-enabled device,and the use of telehealth workflows that are incompatible with third-party translation services are just

65、 some of the barriers that can keep patients from accessing video visits(OShea et al.,2023).As a result of these challenges,video visits may require more time and effort on the part of providers and health center staff to troubleshoot technical issues,interface with interpreter services,and assist p

66、atients with lower digital literacy(Benjenk et al.,2021;Sharma et al.,2023).Audio-only visits are important for maintaining access to care but may not be of equivalent quality for some care needs(Chen et al.,2022).In the absence of research confirming the effectiveness of audio-only treatment models

67、,health centers should take steps to replace audio-only visits with video visits.A combination of strategies will likely yield the greatest benefit.Health centers should be provided with technical and financial assistance to support staff training and integrate third-party translation services into

68、workflows.They should also develop resources and engagement strategies for sup-porting patient digital literacy and implement other best practices that have been identified in a variety of tool kits and guidance documents that have been published since 2022(Gallegos-Rejas et al.,2023;Center for Comm

69、unity Health and Evaluation,2023;Lyles et al.,2022;Health Resources and Services Administration,2024).LimitationsThere are several limitations to note.First,health centers submitted data reports to our team using a standardized tool.Although the tool aimed to col-lect measures consistently across ce

70、nters,measure-ment error is still a potential problem because centers reported information instead of providing access to administrative records.Second,health centers sub-mitted aggregate data on visits by month.Without patient-level data,we were limited in the types of analyses that we could conduc

71、t on disparities in use.Third,we are well powered to detect monthly trends in modality by type of care and by demographics,except in examining demographic differences for behavioral health visits,for which we have smaller samples.Furthermore,missing data and differences in how clinics reported on ra

72、ce and ethnicity limited our ability to draw conclusions on disparities by race and ethnicity.Future research should explore this in-depth.Finally,our analytic sample included only FQHCs in California,and results may not generalize to other settings or to other states.ConclusionWhen the COVID-19 pan

73、demic began,many experts asserted that telehealth was here to stay(Henry,2021).Our results indicate that,in some care settings serving low-income patients,this prediction was correct.Compared with settings serving other popu-lations or similar settings in other states,telehealth use in Californias F

74、QHCs has been particularly robust in part because of supportive state policies(FAIR Health,undated).Ongoing research is needed to inform the specific role that telehealth,as well as audio-only visits,should play in the care of low-income patients.Ongoing research is needed to inform the specific rol

75、e that telehealth,as well as audio-only visits,should play in the care of low-income patients.10ReferencesBenjenk,Ivy,Luisa Franzini,Dylan Roby,and Jie Chen,“Disparities in Audio-Only Telemedicine Use Among Medicare Beneficiaries During the Coronavirus Disease 2019 Pandemic,”Medical Care,Vol.59,No.1

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86、ay,but Payment Is Key to Future Use,”American Medical Association,November 8,2021.Hsueh,Loretta,Jie Huang,Andrea K.Millman,Anjali Gopalan,Rahul K.Parikh,Silvia Teran,and Mary E.Reed,“Disparities in Use of Video Telemedicine Among Patients with Limited English Proficiency During the COVID-19 Pandemic

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92、n,Howard P.Forman,Logan Stern,and BenjaminJ.Oldfield,“Clinician Staffing and Quality of Care in US Health Centers,”JAMA Network Open,Vol.7,No.10,October 22,2024.Notes1 FQHCs provided 12-month data on the number of unique patients who completed one or more visits in-person,by audio-only,by video,and

93、by any modality,organized by race,ethnicity,age group,and language.2 There were 24 months of data and three modalities.11AcknowledgmentsWe are grateful to the California Health Care Founda-tion for sponsoring this project.We thank Diana Cama-cho,Christopher Perrone,Josephine Taylor,and Lauren Vandam

94、 of CHCF for their support.We are grateful to our external quality assurance reviewer,Maggie Jones(Center for Community Health and Evaluation).We thank Nata-sha Arora,Abbie Lee,Veenu Aulakh,Melissa Schoen,and Sofi Bergkvist for their partnership over the course of this project.Among our colleagues a

95、t RAND,we are grateful to our internal quality assurance reviewers,Jonathan Cantor,Jeanne Ringel,and Paul Koegel.We are also grateful to Lisa Turner and Amanda Wilson for their support.This report is only possible thanks to the dozens of indi-viduals who gave their time,expertise,and support in subm

96、itting data reports on behalf of their health center.Uscher-Pines,Lori,Natasha Arora,Maggie Jones,Abbie Lee,Jessica L.Sousa,Colleen M.McCullough,Sarita D.Lee,Monique Martineau,Zachary Predmore,Christopher M.Whaley,and Allison J.Ober,Experiences of Health Centers in Implementing Telehealth Visits for

97、 Underserved Patients During the COVID-19 Pandemic:Results from the Connected Care Accelerator Initiative,RAND Corporation,RR-A1840-1,2022.As of November 24,2024:https:/www.rand.org/pubs/research_reports/RRA1840-1.htmlUscher-Pines,Lori,Colleen M.McCullough,Jessica L.Sousa,Sarita D.Lee,Allison J.Ober

98、,Diana Camacho,and Kandice A.Kapinos,“Changes in In-Person,Audio-Only,and Video Visits in Californias Federally Qualified Health Centers,20192022,”Journal of the American Medical Association,Vol.329,No.14,April 11,2023.Uscher-Pines,Lori,Jessica Sousa,Maggie Jones,Christopher Whaley,Christopher Perro

99、ne,Colleen McCullough,and AllisonJ.Ober,“Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic,”Journal of the American Medical Association,Vol.325,No.11,March 16,2021.Uscher-Pines,Lori,Jessica Sousa,Alina I.Palimaru,Mark Zocchi,Kandice A.Kapinos,and Allison J.Ober

100、,Experiences of Community Health Centers in Expanding Telemedicine,RAND Corporation,RR-A100-1,2020.As of October 25,2024:https:/www.rand.org/pubs/research_reports/RRA100-1.htmlWeber,Ellerie,Sarah J.Miller,Nandini Shroff,Matt Beyrouty,and Neil Calman,“Recent Telehealth Utilization at a Large Federall

101、y Qualified Health Center System:Evidence of Disparities Even Within Telehealth Modalities,”Telemedicine and e-Health,Vol.29,No.11,November 2023.RR-A3468-1RAND is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more

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105、nsure intellectual independence.For more information,visit www.rand.org/about/research-integrity.RANDs publications do not necessarily reflect the opinions of its research clients and sponsors.is a registered trademark.Limited Print and Electronic Distribution RightsThis publication and trademark(s)

106、contained herein are protected by law.This representation of RAND intellectual property is provided for noncommercial use only.Unauthorized posting of this publication online is prohibited;linking directly to its webpage on rand.org is encouraged.Permission is required from RAND to reproduce,or reus

107、e in another form,any of its research products for commercial purposes.For information on reprint and reuse permissions,please visit www.rand.org/pubs/permissions.For more information on this publication,visit www.rand.org/t/RRA3468-1.2024 RAND CorporationAbout This ReportIn this report,we summarize

108、 data on the use of in-person,audio-only,and video health visits during September 2022 to August 2024,a period that included the end of the COVID-19 public health emergency in May 2023 and beyond.These data were collected to evaluate the impact of the Connected Care Accelerator program,which is an e

109、ffort launched by the California Health Care Foundation in July 2020 to support health centers in implementing telehealth for low-income patients in California.This report is the final in a series of reports that were published from 2021 to 2024.In some cases,we use the same or similar language(e.g.

110、,to describe methods,interpret findings)as in the following publications:Lori Uscher-Pines,Natasha Arora,Maggie Jones,Abbie Lee,Jessica L.Sousa,Colleen M.McCullough,Sarita D.Lee,Monique Martineau,Zach-ary Predmore,Christopher M.Whaley,and Allison J.Ober,Experiences of Health Centers in Implementing

111、Telehealth Visits for Underserved Patients During the COVID-19 Pandemic:Results from the Connected Care Accelera-tor Initiative,RAND Corporation,RR-A1840-1,2022 Lori Uscher-Pines,Colleen M.McCullough,Jessica L.Sousa,Sarita D.Lee,Allison J.Ober,Diana Camacho,and Kandice A.Kapinos,“Changes in In-Perso

112、n,Audio-Only,and Video Visits in Californias Federally Qualified Health Centers,20192022,”Journal of the American Medical Association,Vol.329,No.14,April 11,2023 Lori Uscher-Pines,Jessica Sousa,Maggie Jones,Christopher Whaley,Chris-topher Perrone,Colleen McCullough,and Allison J.Ober,“Telehealth Use

113、 Among Safety-Net Organizations in California During the COVID-19 Pandemic,”Journal of the American Medical Association,Vol.325,No.11,March 16,2021.This research was funded by the California Health Care Foundation and carried out within the Access and Delivery Program in RAND Health Care.RAND Health

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