September 2020 | Report

Telehealth Key in Redefining Future of Healthcare as Residents, Workers Leave Major American Cities

An exodus caused by the pandemic and social unrest will have a ripple effect on the healthcare industry in downtown markets. Our new survey of Chicago, Minneapolis, and Seattle residents suggests virtual healthcare is part of the solution.

Telehealth Key in Redefining Future of Healthcare as Residents, Workers Leave Major American Cities

Executive Summary

  • The top reason for switching healthcare providers, our survey respondents said, is moving geographic locations  
  • 1 in 5 Americans relocated this year due to the pandemic 
  • The vast majority of respondents (82%) said they are open to telehealth as a substitute for in-person visits, although the degree of openness varies by type of healthcare visit 
  • Respondents’ use of telehealth nearly doubled in the last six months, from 27% before the pandemic to 49%   


Healthcare locations have historically grown in tandem with workforces in large cities. As workers flocked to downtown offices and high-rise living, doctors set up shop nearby to meet their health needs. But with many suburban employees working remotely and residents fleeing downtown areas for more space, metropolitan centers are practically empty—and their healthcare tenants may be at a tipping point.  

With lockdowns in major cities shuttering offices, bars, restaurants, theaters, and more, many city residents have found themselves unable to enjoy the cultural perks that drew them to big cities in the first place. At the same time, unrest has led to increased crime rates in major cities, exacerbating the claustrophobia that comes with staying inside. A significant portion of city residents have relocated this year as a result—and for many, the move won’t be temporary. But what does all this mean for the future of healthcare? 

To better understand this unique moment and its implications for the future of healthcare, we conducted a national survey of 1,500 U.S. residents — 500 in Chicago, Seattle, and Minneapolis, respectively. Our results indicate a significant shift in healthcare consumer behavior: They are now far more open to telemedicine services as an alternative to in-person care. 

Metropolitan healthcare providers should use these insights to guide their telehealth strategies and maintain their patient bases as city dwellers and workers continue to exit cities.

Healthcare providers face patient loss as Americans vacate big cities

A recent Pew Research Center study reported that around 1 in 5 Americans either relocated or know some who has relocated this year due to COVID-19. 

When people move, they typically seek new healthcare providers in the area. In our survey, 50% of respondents chose “moving geographic locations” as a reason for seeking a different provider—the top reason across all three cities surveyed. 


Healthcare providers aren’t just struggling with short-term obstacles including an uncertain economy and hits to their bottom lines from decreased elective procedures and visits; they’re also facing the long-term financial risk of permanent patient loss due to relocation.

Telemedicine is poised to fill the gaps 

While the majority of Americans are compelled to seek a different healthcare provider after moving, COVID-19 has led many to realize medical treatment doesn’t always need to be bound by location. What’s more, less populated areas don’t have the capacity to meet new patient demand. In our survey conducted at the end of July, 82% of respondents indicated they are at least somewhat open to using telemedicine as an alternative to in-person appointments. 


Openness to telemedicine is rising along with its use. About 1 in 4 respondents said they had used telemedicine in the year leading up to the pandemic. That number doubled, with 49% of respondents saying they’ve used telemedicine during the pandemic.

Many Americans relied more heavily on telehealth — or used it for the first time — during quarantine, and their mainly positive experiences likely piqued their interest in continued telehealth usage. In fact, 26% of respondents said they expect to use telehealth services in lieu of in-person visits for as many appointments as possible after COVID-19. Another 39% said they would use telehealth services in lieu of basic in-person visits such as follow-ups, but that they will still see an in-person provider for more involved visits, even if they could be done remotely. 

The future of telehealth will be different by specialty 

While patients are willing to use telemedicine for certain services, they aren’t willing to substitute virtual care for everything. Of course, some areas of care require a more intensive touch, which respondents stated were better served by in-person providers. 

These results indicate healthcare companies must find a way to delicately balance new technology with human elements. For example, a patient with heart disease will likely want to seek in-person treatment related to their chronic care but would prefer a telehealth appointment to seek treatment for a common cold. Healthcare providers, therefore, need strategies and solutions that enable them to pull a variety of levers across treatment and technology types — all while offering a seamless patient experience. 


What about those who aren’t as open to telehealth? While the vast majority were open to using telemedicine as an alternative to in-person appointments, about 1 in 5, 18%, indicated they are not open to it—mostly because they don’t trust that it delivers the same quality of care. Other concerns include: security of personal health information, not wanting to change their habits, or uncertainty of how to access a telehealth provider. 


As relocation trends continue to reshape the healthcare landscape, providing the right mix of services supported by digital tools and human expertise will only become more important. Delivering a strong healthcare experience now is critical to meeting shifting consumer demand and preserving long-term patient relationships.

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