Telemedicine might have exploded during the COVID era, but according to a new UCLA-led analysis, it did not blow up America’s health care bills. Researchers report that the rapid shift to virtual visits did not lead to big jumps in outpatient appointments or total medical spending nationwide, a timely finding as officials debate what to do with pandemic-era telehealth rules.
The study and what it measured
The team examined insurance claims from January 2019 through October 2023 for 3.04 million adults covered by Medicare, Medicaid and commercial plans. Using a difference-in-differences design, they compared regions that embraced telemedicine heavily with those that lagged behind.
On paper, high-adopting areas actually appeared to have about 2.4% fewer visits and 0.5% lower spending. Statistically, though, those differences did not clear the bar for significance, since the 95% confidence intervals crossed the null. The full results and methods are laid out in JAMA Network Open.
What the authors said
Lead author John N. Mafi said the findings cut against two big pandemic-era fears: that telemedicine would either unleash a flood of unnecessary visits or send spending into overdrive. "Our findings suggest neither prediction came true on a national scale," he said, as reported by MyNewsLA.
Senior author Katherine Kahn told the outlet that policymakers should keep a close eye on how telehealth policy evolves, emphasizing the need to track new evidence as it emerges.
Why the policy context matters
The Centers for Medicare & Medicaid Services loosened telemedicine rules in 2020, broadening reimbursement, waiving geographic restrictions and easing some out-of-pocket barriers, moves that helped fuel the surge in virtual care, according to CMS. Those temporary flexibilities are now under the microscope as lawmakers and regulators consider which COVID-era changes should stay and which should sunset.
Local implications for Los Angeles
The analysis was led by UCLA investigators and builds on prior university work that uses large claims databases to examine how telemedicine shapes care patterns, according to a UCLA news release. For Los Angeles health systems that leaned heavily on video and phone visits to keep patients connected during the pandemic, the study’s finding of no clear spending spike may take some steam out of arguments against keeping certain telehealth flexibilities in place.
Bottom line and caveats
The authors stress that the study does not assess care quality or patient health outcomes and is limited to insured claims, which means uninsured patients are not captured. They call for continued research on longer-term effects and how telemedicine is affecting equity.
Overall, the paper offers timely evidence that expanded telemedicine access has not, at least so far, led to large increases in health care spending, while still leaving open key questions about where virtual care is most effective and for whom, per JAMA Network Open.
