Clinical AdvisorHigh Telehealth Use Tied to Increased Health Care Utilization, Cost

High telehealth use is linked to increased healthcare utilization and costs, suggesting that, although telehealth improves access, it may also contribute to higher rates of ambulatory care-sensitive hospitalizations.

A recent study published in JAMA Network Open examines the relationship between telehealth use and healthcare outcomes for Medicare beneficiaries, revealing that higher telehealth utilization is associated with increased healthcare utilization and costs. This finding highlights the complex dynamics of telehealth’s impact on the healthcare system, particularly in the context of the COVID-19 pandemic.

Key Points:

• Study Context: Researchers from Meta Platforms Inc. evaluated the association between telehealth use and healthcare outcomes for Medicare fee-for-service beneficiaries.
• Sample Size: The study analyzed data from 3,436 hospital service areas, encompassing approximately 30 million Medicare beneficiaries.
• Increased Hospitalizations: Areas with high telehealth use experienced 1.63 additional ambulatory care-sensitive hospitalizations per 1,000 beneficiaries compared to low-use areas.
• More Clinician Encounters: Beneficiaries in high-use areas had 0.30 additional clinician encounters per semester.
• Higher Costs: Total healthcare costs were $164.99 higher per beneficiary per semester in high telehealth use areas.
• Emergency Department Visits: No significant difference was found in ambulatory care-sensitive emergency department visits between high and low telehealth use areas.
• Pandemic Influence: Data suggest that higher levels of telehealth use during the COVID-19 pandemic may be linked to increased access to care but potentially lower quality of care.
• Call for Further Research: The authors emphasize the need for replication of this analysis with post-COVID-19 data to fully understand the impacts of telehealth expansion.

HCN Medical Memo
In this cohort study of Medicare beneficiaries across all 3,436 hospital service areas (HSAs), high levels of telehealth use were linked to an increase in clinician encounters, more ambulatory care-sensitive (ACS) hospitalizations, and higher overall healthcare costs. The study period coincided with elevated COVID-19 case rates, suggesting that these findings may partly reflect a greater capacity for providing health services in HSAs with higher telehealth intensity compared to other areas.

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