A study released in the March issue of the Journal of Health Affairs indicates that direct-to-consumer (DTC) telehealth may not be the cost-savings gold mine that employers are seeking. The study looked at claims data for upper respiratory illnesses, the most common complaint by direct-to-consumer telehealth users. Their data estimated that only about 12 percent of the DTC visits replaced in-person visits. In other words, around 88 percent of the visits represented patients who would not have otherwise sought care. This was an unexpected result given that in patient surveys about telehealth, a much higher percentage of patients say that they would have gone to the doctor in person if telehealth had not been available.
In the case of upper respiratory infections, most people tend to get better even if nothing is done and they rarely lead to more expensive health complications. However, the researchers pointed out that for chronic conditions like diabetes which can lead to a host of other medical problems if not managed well, telehealth could have a broader impact on cost savings.
Though the study may be unwelcome news for employers looking to lower costs by adding telehealth, this is a silver lining for healthcare facilities that want to grow their patient business. The fact that 88 percent of the visits in this study would not have occurred without telehealth indicates that virtual visits could increase patient load for brick-and-mortar organizations. When INTEGRIS Health of Oklahoma added virtual visits in 2015, they found that 60 to 70 percent of users did not have a current primary care physician and they were successful in helping virtual patients establish care with a primary care provider at INTEGRIS. In addition to the other incentives, improving continuity of care for consumers can provide lasting health benefits.
The study additionally dealt a blow to speculation that telehealth might actually be more expensive than in-person care when the “episode” cost is considered. For example, a telehealth visit for an infection might result in a need for an additional in-person visit or lab work, all constituting the cost of the same “episode.” However, the study found that DTC telehealth episodes cost an average of $79, while office visits averaged $146. ED visit were of course much higher at $1734.