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Health Aff (Millwood). 2017 Mar 1;36(3):485-491. doi: 10.1377/hlthaff.2016.1130.

Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending.

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J. Scott Ashwood ( is an associate policy researcher at the RAND Corporation in Santa Monica, California.
Ateev Mehrotra is an associate professor of health care policy at Harvard Medical School, in Boston, Massachusetts.
David Cowling is a research scientist at the California Public Employees' Retirement System, in Sacramento.
Lori Uscher-Pines is a policy researcher at the RAND Corporation in Arlington, Virginia.


The use of direct-to-consumer telehealth, in which a patient has access to a physician via telephone or videoconferencing, is growing rapidly. A key attraction of this type of telehealth for health plans and employers is the potential savings involved in replacing physician office and emergency department visits with less expensive virtual visits. However, increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending. We used commercial claims data on over 300,000 patients from three years (2011-13) to explore patterns of utilization and spending for acute respiratory illnesses. We estimated that 12 percent of direct-to-consumer telehealth visits replaced visits to other providers, and 88 percent represented new utilization. Net annual spending on acute respiratory illness increased $45 per telehealth user. Direct-to-consumer telehealth may increase access by making care more convenient for certain patients, but it may also increase utilization and health care spending.


Access To Care; Cost of Health Care; Health Spending; Organization and Delivery of Care

[Indexed for MEDLINE]

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