Out-of-pocket costs may play larger role in telehealth visits than in-person care: survey

Telehealth consultation
Nearly 67% of respondents to a new survey by the RAND Corporation said they wanted at least some of their care to be conducted virtually. (Getty/AndreyPopov)

Out-of-pocket costs may play a larger role in choosing telehealth over in-person visits for those who would otherwise prefer virtual care, a new survey by the RAND Corporation suggests.

In a study conducted in March by the nonprofit research organization and published in JAMA Network Open, researchers assessed post-pandemic patient preferences for telehealth versus in-person care.

Nearly 67% of respondents said they wanted at least some of their care to be conducted virtually.

But when the hypothetical cost of the virtual visit jumped from $10 to $30, nearly 62% of respondents who initially preferred video visits said they’d rather have an in-person visit instead.

In contrast, only 24% of people who preferred in-person care said they’d switch to a video visit when presented with a higher out-of-pocket cost.

These findings, according to the authors, appear to reflect the perceived difference in value between telehealth and traditional brick-and-mortar care.

While patients may choose telehealth for certain circumstances, like treatment for minor acute conditions or mental health concerns, researchers said patients may not believe that video visits can offer equivalent care or may perceive the providers to be putting in less effort than they would in person.

RELATED: Hospital telehealth visits leveling off at 10%-20% of appointments as claims hit lowest level since pandemic

In general, 53% preferred in-person visits over video visits when given the choice, and only 21% said they preferred video visits, while 26% indicated no preference.

However, 34% of participants said they wanted all their care to be in person, a sample that skewed slightly older, had lower incomes and lower education levels and tended to live in more rural areas.

“It is not clear whether these patients do not value telehealth as much as in-person care or do not view telehealth as feasible or practical given personal circumstances, such as not having access to a broadband internet connection,” said lead author Zachary S. Predmore, a RAND associate policy researcher, in a statement about the study.

Conversely, younger patients, those with higher education levels and those with higher incomes were more likely to prefer video visits over in-person care.

While telehealth utilization shot up during the COVID-19 pandemic, recent months have seen the volume of virtual visits mostly leveling off.

Still, telehealth use overall remains far higher now than before the pandemic, and lawmakers appear poised to pass legislation to make permanent certain flexibilities that have enabled more widespread telehealth use in the past two years.

RELATED: New Cures 2.0 bill extends key telehealth flexibilities, hastens CMS approval of medical devices

Lawmakers introduced the Cures 2.0 bill mid-November, a piece of bipartisan legislation that builds on the 21st Century Cures Act of 2016.

The bill would make it easier for providers to receive reimbursement from Medicare for telehealth services and would remove Medicare’s previous rules that required patients to live in a rural area and be in a doctor’s office to qualify for telehealth services.