Study weighs telemedicine’s impact on Medicare use, spending, and quality

By Jarrod Fowler, MHA, FMA Director of Health Care Policy and Innovation

A recent study published in Health Affairs compared traditional Medicare patients who were part of health systems that used more telemedicine services relative to those that used fewer. The study compared changes between 2019 and 2021-2022 between these groups in terms of utilization, cost, and quality between 2019 and 2021-22. The study found:

• Patients with high telemedicine use had increases for drug adherence for metformin and statins. There were no differences in the pap tests, colonoscopies, or mammograms. 
• No significant changes in imaging services or laboratory tests were observed.
• Patients in high-telemedicine health systems exhibited increased spending with respect to inpatient admissions and pharmaceuticals. This was partially offset by decreases in outpatient hospital spending, particularly facility fees and outpatient hospital visits.

The authors concluded by noting, “Given the small improvements in access and quality (in particular for chronic disease medications), combined with modest increases in spending along with patients’ and clinicians’ preferences, we believe that it will be difficult to justify a return to restricting telemedicine payment in Medicare.”

Indeed, this seems to be the prevailing view everywhere: Now that telemedicine has taken off, substantially reducing or eliminating it will be all but impossible.