Do virtual doctor visits save you money?
Virtual doctor visits conducted from the living room couch or other convenient locations might lead to needless overuse, thereby driving up health care costs, according to a new study.
The study says patients could be video chatting with doctors and incurring costs for ailments that otherwise would not have led them to seek treatment.
“Increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending,” study authors from RAND Corp., a nonprofit research organization, wrote in their report published last week in the medical journal Health Affairs.
The results drew skepticism from local health systems and telemedicine vendors and manufacturers who say the medium is revolutionizing doctor care.
Parties on both sides of the debate agree that telemedicine, also known as telehealth, is here to stay. The study's figures bear that out: more than 1 million Americans in 2015 used phones or video conferencing for medical consultations.
“I think we have to look at the demographic shift that is occurring,” Kim Jacobs, vice president of consumer innovation for UPMC Health Plan, told the Tribune-Review. “Millennials who are surpassing the baby boomers are much more comfortable using this type of technology, particularly for low level acute cases.”
In the RAND study, researchers analyzed data from 300,000 people enrolled in the Blue Shield of California Public Employees' Retirement System between 2011-13 to deduce telemedicine costs. The HMO began offering telemedicine to enrollees in 2012, covering current and former state employees.
A virtual medical visit costs about $79, compared to about $146 for an office visit, according to the study. Study authors focused on treatment for acute respiratory infections such as bronchitis, sinusitis and tonsillitis. But the video or phone doctor visits often spur follow-up appointments, lab tests and prescriptions, eventually increasing spending.
“For example, given liability concerns, direct-to-consumer telehealth physicians may be more likely to recommend that patients have a subsequent in-person visit with a provider,” the study said.
Researchers found that 88 percent of telemedicine visits represented new utilization and that yearly spending on acute respiratory illness grew by $45 per telemedicine user.
Jason Gorevic is CEO of Teladoc, the company providing telephone and videoconferencing technology for patients involved in the study. He said the findings are at odds with other results showing the efficiency of telemedicine.
“In fact, other more comprehensive studies – using six times the amount of claims data including the same population as the study – have found tremendous value of telehealth, with consistently repeatable results,” he said in a statement. “We rigorously conduct studies, review shared data with our clients and are gathering information from our members at the point of care. There is clear evidence that telehealth decreases overall health care spending.”
From a consumer perspective, a trip to the doctor can result in a loss of a half- or full day's work.
“The patient population is looking for convenience in their health care at every turn,” Dr. Phil Majewski, senior medical director at Highmark Inc. in Pittsburgh. “How about the half-day of work you would have been able to put in if you conducted a telemedicine visit on your lunch break?”
Officials at UPMC, the region's largest hospital network, cite an internal study as proof that virtual consultations are effective.
A financial analysis of 542 UPMC patients found insurers saved $86.60 per visit when patients used virtual care visits instead of a traditional visit to a primary care physician, emergency room, urgent care facility or retail clinic, according to Natasa Sokolovich, executive director of telehealth at UPMC. She said the care is integrated into the health system's electronic medical records.
“I believe what virtual care is going to eventually be another extension of in-person care,” Sokolovich told the Tribune-Review. “There are cases where it makes more sense to offer virtual visits.”
Demand for telemedicine solutions has impacted the region's economy. Compunetix, headquartered in Monroeville, manufactures audio and video conference systems for worldwide use. As a salesperson focused on videoconferencing, account manager Alvaro Cruz said 80 percent of his current business at Compunetix is telemedicine-related.
“It's incredible how much the market has shifted in the last couple of months,” he said. “Nobody wants to fall behind.”
Antonio Capodieci, sales manager of video solutions, said Compunetix designs everything from stationary telemedicine kiosks to software programs for various health systems.
“Most of our clients want something customized, and we're very flexible in what we provide,” he said.
Cruz and Capodieci read the RAND study and pointed out that researchers mentioned telemedicine's growing popularity.
Specifically, the researchers concluded: “As direct-to-consumer telehealth services grow in popularity and become a standards offering, employees may expect the services to be part of their benefits package. If this becomes the case, the strategy of cost-conscious employers and health plans should be to offer the services while simultaneously attempting to limit overuse.”
Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or firstname.lastname@example.org.