The American Telemedicine Association just teamed up with nine major U.S. health systems to deliver one of the most comprehensive looks at Medicare telehealth utilization to date, and the numbers look good for virtual care.
The analysis of 1.67M Medicare beneficiaries from 2019 to 2023 found that telehealth is primarily a substitute for in-person care, replacing office visits rather than adding new ones.
- Despite the pandemic fueling a 31x increase in telehealth use at the health systems, Medicare patients averaged just 0.25 additional visits per year.
- The real-world operational data shows that 74% of those telehealth visits were a substitute for in-person care.
- Not too surprising, except that the CBO has that substitution rate pegged at 30%.
Real-world evidence beats theoretical models. The findings offer a window into how telehealth is embedded in everyday care – with real workflows and patients – suggesting that actual substitution patterns might be a ways away from current budget modeling assumptions.
- The analysis spanned academic medical centers, integrated pay-viders, and rural hospitals – all showing that telehealth was a substitute during both the pandemic and “steady-state operations” in 2023.
- Each of the systems also saw costs remain stable or decrease with telehealth adoption, with one of the rural systems avoiding 2,551 patient transfers and saving $8.1M from sidestepping referrals and transportation costs
- That not only suggests that virtual care is still beneficial post-pandemic, but it might also have lower federal costs than currently forecasted.
The clock is ticking. Medicare telehealth reimbursement flexibilities are set to expire January 30th, and the ATA hopes that these results will inform policy discussions ahead of the deadline.
- “This data represents the current state under a patchwork policy environment. We’re just scratching the surface of what health systems could achieve with predictable legislative frameworks that let us build infrastructure to serve patients regardless of who’s paying the bills.”
The Takeaway
Most qualitative evidence already told us that telehealth is convenient for patients and clearly a substitute for in-person care. The ATA just provided the quantitative data to back that up.
