The rapid expansion of telemedicine during the COVID-19 pandemic did not lead to major increases in health care use or spending in Southern California or nationwide, according to a UCLA study released Monday.
The study, published in the journal JAMA Network Open, examined medical claims data for more than 3 million adults enrolled in Medicare, Medicaid and commercial insurance plans between 2019 and 2023.
Researchers found telemedicine visits declined 2.4% during the study period, while health care spending dropped 0.5%, though neither change was considered statistically significant.
“Our findings suggest neither prediction came true on a national scale,” lead author Dr. John N. Mafi, an associate professor-in-residence of medicine at the David Geffen School of Medicine at UCLA, said in a statement.
“As telemedicine use grew, visits and spending in heavy users tracked closely with patterns in lighter users. That is reassuring for anyone worried about ballooning costs, but more sobering for anyone hoping telemedicine would close longstanding gaps in access. At least so far, it looks more like a substitute for in-person care than a true expansion of it.”
Researchers said the findings could ease concerns among lawmakers that expanded telemedicine access would sharply increase medical costs following policy changes adopted during the pandemic.
The Centers for Medicare & Medicaid Services loosened telemedicine restrictions in 2020 by allowing broader reimbursement, waiving geographic limitations and eliminating some out-of-pocket costs.
According to the study, researchers also found no statistically significant increases or decreases in spending among urban, rural, Medicaid or Medicare populations examined during the analysis.
Senior author Dr. Katherine Kahn of UCLA and RAND said telemedicine policy should continue to be monitored as usage patterns evolve.
“Much more work is needed to understand telemedicine’s longer-term effects on quality of care, health outcomes, and spending, and whether those effects differ across the diverse populations who depend on it. Policymakers should keep monitoring closely as the evidence base matures,” Kahn said.
