As the popularity of telehealth visits increases rapidly (see: Telehealth use surged in 2017), better data is being acquired about the advantages of this approach to healthcare, particularly the cost savings. A recent article addressed this issue with an excerpt below (see: Telehealth eliminates time and distance to save money):
In the argument of whether telehealth increases or decreases utilization, Anthem is squarely on the side of the latter and has been ramping up its efforts to expand virtual services to members. Employers want it because it saves money and telehealth can keep employees on the job rather than leaving work to see their primary care doctor or go to urgent care or the emergency room....Anthem has decreased the copay for these visits to $5, compared to a $25 to $35 copay if a member visits their primary care doctor. An Anthem HealthCore study of claims analysis for utilization of acute, non-urgent care found telehealth saved 6% in episode of care costs by diverting members who would otherwise have gone to the emergency room. The savings were $201 per episode of care in 2014 and 2015 dollars, which would be about $242 today, for 11 conditions....The follow-up rate suggests adequate clinical resolution and that patients are not using virtual visits as a first step before seeking in-person care....Data released last year by the Advisory Board, citing Health Care Cost Institute analysis, found office visits to primary care doctors decreased by 18% from 2012 to 2016, even as specialist visits increased.
The advantage of telehealth for employers who are seeking to address the minor health problems of employees is obvious. Providing a telehealth kiosk in a factory or office setting "can keep employees on the job rather than leaving work to see their primary care doctor or go to urgent care or the emergency room." Regarding virtual care cost savings, I suspect that some of them cited in the excerpt above may be related to the fact that emergency room physicians order more lab tests and imaging studies in order to rule out rare conditions as a defensive medicine strategy. By way of contrast, a virtual interaction with a physician will probably more closely mimic a PCP office visit with less use of lab testing and imaging. I don't know if this question has been studied but it would be interesting to pursue.
All of this leads to the premise, mentioned above, that telemedicine may be now contributing in a minor way to the observed decrease in office visits to PCPs and even perhaps emergency room visits. If this is the case, these effects will only increase in the near future as the number of televisits increases. A critical factor for the growth of telemedicine has been the support of telehealth by heath insurance companies like Anthem. This is surely driven, in part, by the demonstrated lower costs. However, the study cited above suggests that "clinical resolution" is generally being achieved and that virtual care is not a prelude to a later in-person office visit unless it is clearly indicated.
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