Has increased telehealth access during COVID-19 led to over-utilization of primary care?

Abstract

Telehealth use for primary care has skyrocketed since the onset of the COVID-19 pandemic. Enthusiasts have praised this new medium of delivery as a way to increase access to care while potentially reducing spending. Over two years into the pandemic, the question of whether telehealth will lead to an increase in primary care utilization and spending has been met with contradictory answers. Some evidence suggests that telehealth may be used as an addition to in-person visits. Others like Dixit et al. have found that telehealth can actually substitute for in-person care rather than contribute to overutilization. As telehealth continues to evolve, outcomes, utilization, and quality of care should be closely monitored.

Telehealth Expansion and Medicare Beneficiaries’ Care Quality and Access

“…Another study documented a largely favorable association between telehealth exposure and the quality of primary care using electronic medical record data of commercial, Medicare, and Medicaid beneficiaries from more than 200 outpatient care sites in Pennsylvania and Maryland. Differences in telehealth protocols across health care systems may have contributed to the inconclusive findings . In addition, most published studies compare telehealth users with nonusers, attempting to control for confounders but acknowledging the inherent bias.…”

“…Differences in telehealth protocols across health care systems may have contributed to the inconclusive findings. 13 In addition, most published studies compare telehealth users with nonusers, attempting to control for confounders but acknowledging the inherent bias. As an exception, Li et al 14 categorized practice-level telehealth into terciles using Michigan commercial payer data; they found that patients from practices with higher telehealth use had a higher rate of ambulatory care–sensitive (ACS) hospitalizations and ED visits.…”