Digital Health

Telehealth Linked to Quality as Extension Deadline Looms

Health Affairs

Efforts to extend regulatory flexibilities for virtual care gained some wind in their sails from a new study in Health Affairs that linked telehealth use to significant quality improvements and a relatively modest bump in spending. 

Researchers assigned Medicare patients to health systems according to care patterns in 2019, then segmented the providers based on their telehealth adoption in 2020 (5.5M patients, 576 systems). They then analyzed outcomes for 2021 and 2022.

Patients at health systems in the highest quartile of telehealth use (27% of all visits) had an increase of 0.21 outpatient visits per patient per year, a relative increase of 2.2% compared to systems in the lowest quartile of telehealth use (9.5% of all visits).

  • These patients also had 14.4 fewer non-COVID ED visits per 1,000 patients per year, a 2.7% relative decrease.
  • Further, the patients at high-telehealth systems saw improved adherence to medications like metformin and statins, although there were no clear changes in hospitalizations.

Those improvements came at the cost of an additional $248 per patient per year at high-telehealth systems, a relative increase of 1.6% above the lowest quartile.

  • The authors noted that this increase was largely driven by inpatient admissions and pharmaceuticals, but offset by decreases in outpatient spending.

Where do we go from here? With many virtual care flexibilities set to expire at the end of the year – like allowing Medicare patients to receive telehealth in their homes – regulators are on the clock to create more permanent policies.

  • Policymakers have already proposed a bevy of bills to extend the flexibilities, but the debate carries on as the deadline looms.

The Takeaway

Given the access benefits, quality improvements, and modest increase in spending, this study only makes it harder to justify rolling back telehealth coverage for Medicare patients. The evidence is mounting, and it’s not too hard to picture a world where the arguments against telehealth only grow weaker as technology improves and providers optimize their virtual care services.

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