Article Impact Level: HIGH Data Quality: STRONG Summary of: medRxiv, https://www.medrxiv.org/content/10.1101/2025.01.31.25321423v2 Dr. Chad Ellimoottil et al. medRxiv, https://www.medrxiv.org/content/10.1101/2025.03.05.25323449v1 Dr. James D Lee et al.
Points
- Telehealth-initiated visits resulted in lower total Medicare spending ($260 vs. $342), with reduced use of laboratory tests and imaging procedures compared to in-person visits.
- While telehealth reduced costs, it was associated with slightly higher return visit rates (16.1% vs. 14.1%), indicating potential follow-up needs.
- Telehealth usage peaked at 41% of outpatient visits in April 2020 during the pandemic but later stabilized at 5.7%–7.0% in 2023-2024.
- Increased telehealth adoption did not lead to a rise in outpatient visits, with high- and medium-use specialties experiencing a decline in E&M visits post-pandemic.
- The findings suggest that broader telehealth adoption can improve efficiency, reducing costs without significantly increasing healthcare utilization.
Summary
In two studies examining the impact of telehealth on Medicare spending and healthcare utilization, distinct findings were observed regarding its role in outpatient visits. The first study analyzed data from 100% of Medicare fee-for-service (FFS) beneficiaries, comparing 30-day spending, return visits, laboratory tests, and imaging procedures between telehealth-initiated and in-person visits from July 2020 to December 2022. The study found that telehealth-initiated visits resulted in lower total spending ($260 vs. $342, net reduction of $82) despite higher rates of return visits (16.1% vs. 14.1%). Additionally, telehealth visits showed a lower utilization of laboratory tests (7.8% vs. 24.2%) and imaging procedures (3.5% vs. 7.8%). These results suggest that telehealth may offer a cost-saving alternative to in-person visits, potentially reducing healthcare spending and resource utilization.
The second study examined the broader impact of telehealth adoption on outpatient evaluation and management (E&M) visits, comparing visit rates before and after the pandemic using Medicare FFS claims data. The study focused on specialties with varying levels of telehealth use, including high-use specialties like behavioral health, medium-use specialties like primary care, and low-use specialties like orthopedic surgery. It found that telehealth surged during the pandemic, reaching 41.0% of monthly E&M visits in April 2020 before stabilizing at 5.7% to 7.0% in 2023-2024. Notably, the post-pandemic period showed a relative decline in E&M visits in high-use and medium-use specialties by 4.1% and 7.2%, respectively, compared to low-use specialties, suggesting that increased telehealth adoption did not lead to an overall rise in outpatient E&M visits.
Together, these studies highlight the potential for telehealth to reduce healthcare costs and utilization, with stable outpatient visit rates and reduced spending observed across specialties. These findings suggest that broader telehealth adoption can help improve healthcare delivery efficiency without escalating overall utilization.
Links to the preprints:
- https://www.medrxiv.org/content/10.1101/2025.01.31.25321423v2
- https://www.medrxiv.org/content/10.1101/2025.03.05.25323449v1
References Ellimoottil, C., Kulkarni, A. J., Zhu, Z., Dunn, R. L., Chang, C.-H., Chun, E., Hou, H., Lee, J. D., McCullough, J. S., & Thompson, M. P. (2025). Association between telehealth use and downstream 30-day medicare spending. https://doi.org/10.1101/2025.01.31.25321423 Lee, J. D., Chun, E., Chang, C.-H., Liu, T., Dunn, R. L., McCullough, J. S., Thompson, M. P., & Ellimoottil, C. (2025). Telehealth and outpatient utilization: Trends in evaluation and management visits among medicare fee-for-service beneficiaries, 2019-2024. https://doi.org/10.1101/2025.03.05.25323449
