Virtual visits cheaper, even if other factors considered

Patients using virtual visits are largely using them to replace emergency department, urgent-care and office visits and they don't require extensive follow-up care, a new study reports.

Those findings could bolster the case of those who suggest that virtual visits can cut healthcare costs and so should be eligible for Medicaid reimbursements.

The Alliance for Connected Care, a trade group for telemedicine, released the study Friday. It argues that the estimated cost difference between a telehealth visit and a corresponding office-based visit is roughly $40, after adjusting for what happens after the visit.

But it's not feasible to simply extrapolate that into Medicare savings. Some patients might use a virtual visit when they would otherwise use the doctor. Others might require additional, follow-up care. Either scenario would drive up costs for Medicare if it were to reimburse for virtual visits.

The survey results seem to have resonated with at least one commercial player. Anthem, a company executive said during a call to discuss the results, is rolling out telehealth for many of its Medicare Advantage plans beginning Jan. 1.

Members in certain plans in 12 states—California, Connecticut, Florida, Georgia, Kentucky, Maine, New Mexico, New York, Ohio, Virginia, Washington and Wisconsin—will be able to access virtual visits without a co-pay.

Anthem has at least two networks of doctors confirmed for virtual visits and is working on adding Spanish-speaking doctors, as well as doctors who are a part of Anthem's regular provider network.

The Alliance study, undertaken by actuary and consultant Dale Yamamoto of Red Quill Consulting, surveyed a number of vendors and insurers to arrive at its estimates. Telehealth providers American Well, Doctor on Demand and Teladoc participated, as well as insurers WellPoint and Optum Health.

According to vendor data in the survey, 5.6% of patients who used the virtual visits would otherwise have gone to an emergency department; 45.8% to urgent care; and 30.9% to office visits. Roughly 12% of patients would simply have done nothing.

And 83% of conditions were resolved by a virtual visit. Of the patients who weren't resolved, 10% required an emergency department referral, and 17% went for an office visit.

But the study doesn't address whether its findings are applicable to the Medicare population. During a call presenting the study, Krista Drobac of the Alliance for Connected Care argued that extrapolating from commercial data—presumably from a younger, healthier population than Medicare's—was the best way to model the effects of reimbursing telehealth visits for the Medicare population.

Teladoc, one of the startups participating in the study, is contemplating a subsequent study to gauge the effects of virtual visits on an older population.

Follow Darius Tahir on Twitter: @dariustahir