While payers should cover telehealth, where these services are the most valuable still requires investigation, according to a study in Information Systems Research.
The Centers for Medicare & Medicaid Services made the rules about telehealth usage more flexible during the COVID-19 pandemic, and some lawmakers want to make those changes permanent. But that should not mean giving providers carte blanche approval in using the new technology, nor should payers cover all uses of telehealth, suggests a study by researchers with the University of Texas.
“Telehealth should not be regarded as a one-size-fits-all solution to virtualize healthcare,” the study said.
Despite that, however, the study also states that “insurance plans should expand their telehealth coverage to include more providers and close the healthcare access divide in rural locations, which can reduce subsequent hospitalizations and unnecessary costs.”
The authors argue that telehealth’s benefits can be seen in treating conditions and diseases with “high virtualization potential” such as mental health, skin problems, metabolic conditions and musculoskeletal diseases. However, telehealth did not significantly reduce visits to specialists or emergency departments for circulatory, respiratory or infectious diseases.
Indranil Bardhan, Ph.D., one of the authors of the study, said in a press release that “people believed that telehealth would be the next big thing, the future of healthcare. But our research shows that its impact is not as straightforward as people might think. It’s more nuanced.”
The data come from a review of all hospital-based outpatient clinics in Maryland from 2012 to 2021. Researchers did a literature search that identified 16 diseases and asked providers to score them on a scale of low, medium or high in terms of their ability to go virtual.
While researchers argue that telehealth should be used judiciously, they did find solid evidence of its cost-saving potential in monitoring disease progression, thereby lowering utilization costs.
Telehealth use resulted in a 13.6% reduction in the number of outpatient visits, or $239 in total savings per patient within 30 days of a telehealth visit. Spending for patients with high virtualization potential saw a 12.2% decrease in outpatient visits within 30 days of a telehealth visit, equaling a reduction of $179.50 per patient. In addition, the study states that telehealth can save money by monitoring disease progression over time. The researchers gauged utilization by tracking the number of outpatient visits and the total costs of those visits.
Telehealth can also function as a gateway to healthcare for individuals who live in rural areas, the researchers said.
“We observe that rural patients undergoing telehealth for high virtualizability diseases exhibit a higher incidence of PCP and non-PCP visits but incur lower costs, within 30 days after a telehealth visit,” the study said.
Bardhan hopes the study will contribute to the discussion about how to more efficiently utilize healthcare resources by encouraging providers to focus telehealth on treating specific diseases and conditions where it can do the most good and not using the technology where its effects will be negligible.
"Our findings are critical for policymakers to develop new reimbursement models and promote telehealth adoption for specific diseases and conditions, as a way to bend the cost curve and support the shift toward outpatient and home-based care services," the study said.