March 11, 2025

Telehealth in California: Progress, Challenges, and the Road Ahead

The COVID-19 pandemic rapidly transformed health care delivery, making telehealth a core component of care. In California, health centers quickly adapted, offering both telephone and video visits to maintain access to care during a time of crisis. Since then, telehealth has persisted as a vital tool for care delivery (see Figure 1). Patients report satisfaction with their telehealth experiences, and evidence shows that telehealth is a particularly promising modality to increase access to behavioral health, chronic condition management, and specialty care.

Since 2020, CCHE has been partnered with the California Health Care Foundation (CHCF) to evaluate telehealth initiatives aimed at ensuring equitable and effective care delivery in the safety net. CHCF funded several learning collaboratives focused on telehealth, and our evaluations have provided insights into what makes telehealth work in the safety net – such as dedicated resources to make operational changes, adoption of patient-friendly technology, and support for patients who experience digital barriers.

In our latest report, we took a broader perspective, analyzing California’s decades-long journey with telehealth. Our evaluation included an extensive review of policy documents, peer-reviewed literature, and interviews with 27 key informants who have played leading roles in telehealth’s expansion. This comprehensive assessment highlights both the significant progress made and the opportunities ahead.
Figure 1. Average Monthly Telehealth Visits per Year, 2020–2022
Figure 1. Average Monthly Telehealth Visits per Year, 2020–2022
Source: California Department of Health Care Services, 2024.

California has made notable strides in telehealth policy, implementation, research, and consumer engagement: patients can now access telehealth visits from home or other locations of their choice; providers receive the same payment for telehealth and in-person visits; and telehealth is widely available throughout the clinical safety net. At the same time, we know that there are still disparities in how telehealth is accessed. Patients who use Medicaid, patients who speak languages other than English, and patients who live in rural areas are less likely to use telehealth.

To support ongoing progress in making access to telehealth more equitable, our report offers tailored roadmaps for key partners, including policymakers, health plans, health system leaders, providers, and researchers. These roadmaps outline actionable steps that partners can take to ensure that telehealth works for everyone, especially those who face the greatest barriers to care. By continuing to invest in telehealth infrastructure and policies that promote equitable access, California is well-positioned to lead the way in making telehealth a lasting and inclusive component of the health care system.

Read the Telehealth Evolution in California final report:

CHCF Telehealth Evaluation in California Full report_Page_1_outline.jpg

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