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As Congress considers the future of telehealth regulations, a new University of Michigan study offers promising insights that virtual care does not inherently lead to an increase in low-value healthcare services. Policymakers have worried that broader access to telehealth might spur unnecessary tests and procedures, leading to wasted resources. However, this study, published in JAMA Network Open, suggests that primary care practices using telehealth frequently do not have higher rates of low-value care than those using it minimally. In fact, in some instances, high telehealth usage correlated with a decrease in such low-value services.
The research analyzed data from nearly 578,000 Medicare beneficiaries in Michigan, who received care at over 2,550 clinics between 2019 and 2022. Low-value services—such as blood tests for prostate cancer in men over 75, CT scans for uncomplicated sinus infections, and Pap smears for cervical cancer in women over 65—were specifically monitored due to their high costs and minimal clinical benefits in certain cases.
Researchers divided the clinics into groups based on their telehealth usage rates and adjusted for differences in patient volume. Overall, there was no evidence that increased telehealth led to higher low-value care rates. In six of the eight low-value care types studied, the rates either decreased or remained consistent regardless of telehealth usage. Notably, high telehealth clinics saw faster declines in cervical cancer screening for women over 65 and thyroid hormone blood tests for hypothyroidism patients compared to clinics with lower telehealth use.
Dr. Terrence Liu, the study’s lead author and a primary care physician, stated that these findings provide reassurance for telehealth policy. “Our findings are reassuring in the context of current telehealth policy decisions,” Liu said. The study also aligns with earlier University of Michigan research indicating that telehealth does not increase in-person follow-ups for conditions detected during virtual visits.
The study’s senior author, Dr. Chad Ellimoottil, heads virtual care at the University of Michigan Medical School and noted that telehealth could be a valuable supplement to traditional care. However, he echoed that it should be integrated thoughtfully. Dr. A. Mark Fendrick, director of the U-M Center for Value-Based Insurance Design and a co-author, highlighted that factors like accessibility, cost, and patient effort play a significant role in the utilization of both high- and low-value services, whether virtual or in-person.
Looking ahead, Liu and his colleagues plan to expand their research to a national level to further validate the results.
