Regions with higher telehealth adoption during the pandemic did not experience statistically significant increases in ambulatory visits or total medical spending compared to lower-adoption regions, according to a study published May 11 in JAMA Network Open.
The University of California Los Angeles study analyzed claims data from more than 3 million insured adults from January 2019 through October 2023 using Milliman MedInsight’s Emerging Experience Research Database, which includes patients enrolled in Medicare fee-for-service, Medicare Advantage, Medicaid, dual-eligible and commercial insurance plans across all 50 states.
The study compared regions with the highest telemedicine adoption rates against those with the lowest adoption rates after federal regulators expanded telehealth access in March 2020 by waiving geographic restrictions, granting payment parity with in-person visits and eliminating some patient cost-sharing requirements under Medicare.
Here are four key findings from the study:
- Telemedicine use increased sharply during the study period. In regions with the highest telehealth adoption, virtual visits rose from 0.26% of ambulatory visits in 2019 to 40.7% in 2020. In the lowest-adoption regions, telehealth visits increased from 0.24% to 2.5% during the same period.
- Despite those differences in adoption, researchers did not find statistically significant increases in utilization or spending tied to higher telehealth use. Overall, high-adoption regions showed 2.4% fewer visits and 0.5% lower spending compared to low-adoption regions, though confidence intervals crossed zero for both findings.
- The findings were consistent across payer groups and geographic regions, including commercial insurance, Medicare fee-for-service, Medicare Advantage, Medicaid and dual-eligible populations.
- Researchers also found no statistically significant differences when analyzing results by income level, social vulnerability or urban versus rural populations.
The study authors noted several limitations, including that the analysis did not assess quality of care or patient outcomes. They also said the claims data could not be reliably stratified by race or ethnicity and cautioned that the study’s regional-level design limits individual-level conclusions.
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