A new study from Rand Corp. found that because direct-to-consumer telehealth services often initiate new use of medical services, they could drive up medical spending instead of decreasing it.
As part of Rand Corp.'s study, which is published in the March edition of Health Affairs, researchers analyzed 2011 to 2013 claims information for 300,000 beneficiaries enrolled in a health plan through CalPERS, a California public employee benefit organization. CalPERS began offering direct-to-consumer telehealth services in 2012.
Specifically, the researchers analyzed enrollees who sought care for an acute respiratory infection from telehealth providers and enrollees who sought care for the same condition from an emergency department or a physician's office. In sum, 981 enrollees got care via a direct-to-consumer telehealth provider.
Here are three findings from the study.
1. For every episode of infection, the cost of telehealth visits were approximately 50 percent lower than a visit to a physician's office and less than 5 percent of the cost of an ED visit.
2. Although there were cost savings, the study found net annual spending on acute respiratory infection increased by $45 for every telehealth patient due to new use of medical services.
3. Researchers estimate approximately 12 percent of the telehealth visits replaced visits to an ED or physician's office, but 88 percent included new use of medical services.
"Given that direct-to-consumer telehealth is even more convenient than traveling to retail clinics, it may not be surprising that an even greater share of telehealth services represent new medical use," said Lori Uscher-Pines, PhD, a coauthor of the study and a policy researcher at Rand Corp. "There may be a dose response with respect to convenience and use — the more convenient the location, the lower the threshold for seeking care and the greater the use of medical services."
Researchers advised insurers wanting to increase direct-to-consumer telehealth services to consider raising copays for telehealth. In addition, researchers suggested creating new tools to encourage frequent ED users to utilize telehealth services instead.
Click here for more information on the study, titled Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending.