Dive Brief:
- Most patients who had a telehealth visit didn’t need an in-person follow-up appointment in the next three months, according to new research from Epic. The trend was reflected in almost every specialty included in the study.
- For specialties that required follow-ups, the additional visits were likely due to patients needing additional, not duplicative, care, Epic researchers said. That’s because high follow-up rates were only present in specialties that require regular hands-on care, such as obstetrics and surgery.
- The study is the latest addressing whether telehealth results in duplicative care, instead of replacing an in-person encounter. The question is being debated by lawmakers as they consider how much telehealth flexibility should be allowed once the COVID-19 public health emergency expires.
Dive Insight:
For the study, Epic researchers examined more than 35 million telehealth visits conducted between March 2020 and May 2022 using data from the EHR vendor’s Cosmos dataset.
The findings suggest that telehealth isn’t driving more in-person care encounters — a result that has significant implications for policy, especially as telehealth use remains high compared to pre-pandemic levels.
Researchers said that telehealth visits might even be replacing in-person visits entirely in specialties like genetics and nutrition. Genetics telehealth visits, for example, only required follow-ups 4% of the time.
Mental health and psychiatry, which had the highest volume of telehealth utilization, also had some of the lowest rates of required in-person follow-up visits, at 15%.
Other specialties that had heavy use of telehealth had slightly higher rates of in-person follow-up visits. However, many follow-ups might be additional appointments that are part of regular care, such as monthly mental health visits, researchers said.
Most telehealth visits didn’t result in an additional in-person visit
The data suggests that telehealth visits are an alternative, rather than additional medical encounter. As a result, payers should extend coverage to telehealth visits after the COVID-19 public health emergency to increase healthcare access, researchers argued.
However, research is mixed on whether telemedicine cuts down on care and saves money overall. Some previous studies conducted prior to the pandemic conflict with Tuesday’s findings, including a 2017 study from the Rand Corporation that found virtual care increased healthcare utilization and spending in California.
Additionally, a study published earlier this year suggested telehealth could be driving duplicative care for patients with acute conditions, but not for patients with chronic conditions.
Regulations allowing for broader telehealth payment and access are set to wind down when the COVID-19 public health emergency expires, expected sometime next year. Congress has enacted a temporary grace period for telehealth flexibilities after the end of the emergency, so regulators have more time to analyze telehealth’s impact before lawmakers permanently enshrine new legislation.
Expanding telemedicine access has broad bipartisan support in Congress. A number of bills have been introduced to codify more telehealth protections after COVID-19, including the industry-supported Connect for Health Act, which would loosen geographic and originating site restrictions. Connect for Health has more than 60 Senate sponsors but has yet to come up for a vote.
