Telehealth boosts outcomes, spending, as regulatory flexibilities are in question

The rapid adoption of telehealth services, accelerated by the COVID-19 pandemic, has had a positive result on outcomes and resulted in a boost in healthcare spending, according to a report in Health Affairs.

The researchers investigated the relationship between the adoption of telemedicine and its impact on costs and quality of care across various health systems.

Patients that fell into the higher level percentile of telehealth adoption had higher levels of medication adherence and saw a 1.6% rise in healthcare spending, while emergency department use, and hospitalization rates were lower, according to the report.

“Moving forward, it will be important to continue monitoring telemedicine’s impact on quality and spending,” the report noted. “The effects of telemedicine on quality and spending could change as technology improves, health systems optimize telemedicine services, or patient demand grows.”

WHY THIS MATTERS

The report comes as the flexibilities granted for telehealth use during the pandemic are set to expire at the end of this year without action from Congress.

Dr. Harvey Castro, a physician and healthcare consultant, said the findings underscore the necessity for policymakers to carefully consider the ramifications of allowing pandemic-era telehealth flexibilities to expire.

“These flexibilities have increased access to healthcare, especially for underserved populations, and fostered higher adherence to chronic medication due to easier follow-ups,” he said.

He recommends policymakers engage with stakeholders, including patient advocacy groups, to fully understand telehealth’s impact.

“As a practicing ER physician with an interest in telehealth innovations, I view the modest cost increases associated with telehealth, as reported in the study, as an investment rather than just an expense,” Castro said.

These costs are likely related to the infrastructure needed to support telehealth services and the training of staff to effectively manage virtual consultations. Lawmakers should aim to extend these flexibilities beyond the pandemic to maintain gains in healthcare access and quality, he said.

They should also consider integrating new telehealth policies that address and mitigate modest cost increases, ensuring telehealth remains an economically viable option.

“Creating a supportive regulatory environment that promotes telehealth benefits while addressing challenges such as privacy concerns and the digital divide is crucial,” Castro said.

Castro said healthcare organizations should focus on leveraging telehealth to reduce in-person visit dependencies, which can decrease overhead costs in the long run and improve patient throughput.

“Enhanced patient monitoring through telehealth can lead to better management of chronic diseases, potentially reducing costly complications and hospital readmissions,” he explained.

While upfront investments are required, the long-term savings and benefits to patient outcomes are substantial, making telehealth particularly crucial in rural or underserved areas.

Healthcare providers should integrate telehealth into their standard offerings, ensuring seamless coordination with in-person care to optimize patient pathways. But they also need to evaluate the adaptation of telehealth practices based on data as to the effectiveness on outcomes and the efficiency of their operations.

“Providers and policymakers must work together to ensure patients are informed about how to use telehealth technologies, aiming for maximum benefit and minimal frustration,” Castro said.

Continuous technological improvements are also necessary to ensure telehealth platforms are user-friendly, secure and capable of integrating with other technologies.

“Promoting a culture of innovation and learning within the healthcare community is vital to refining telehealth services to better serve patients and providers alike,” Castro said.

THE LARGER TREND

National telehealth utilization increased by 6.3% in November 2023, rising from 4.8% to 5.1% of medical claim lines compared to October 2023, according to a February report from FAIR Health’s Monthly Telehealth Regional Tracker.

The advancement of telehealth technology has also highlighted disparities in access and digital health literacy, underscoring the importance of implementing a digital equity strategy to ensure universal access and participation in telemedicine.

An October 2023 study indicated telehealth is effectively meeting the critical demand for pediatric mental health services, which suggests that commercial health insurers should leverage telehealth to address the shortage of mental health providers for young people.