Telemedicine Expansion Not Associated With Higher Health Care Utilization or Costs

Key Takeaways:

• The approaching expiration of telemedicine policies that were established during the COVID-19 pandemic has sparked debate among law and policymakers about the future of telemedicine. Many are looking to extend current policies but worry about the impact of telemedicine on health care utilization and spending.
• Researchers found slight changes in visit rates and care costs in areas with a high adoption of telemedicine, but these percentages are not statistically significant.
• The study’s findings show that expanding telemedicine is not likely to increase health care utilization or spending.

The COVID-19 pandemic led to the rise of telemedicine in US health care. However, the expiration of key telemedicine policies in 2027 has generated debate among politicians and policymakers, with many concerned that expanding telemedicine will have a negative impact on health care utilization and spending.

A study sought to examine the association between telemedicine adoption and care visits and spending. Using data from Milliman MedInsight Emerging Experience Research Database from 2019 to 2023, the study quantified the number of ambulatory visits and care costs in areas with high and low adoption of telemedicine.

Links Between Telemedicine and Care Utilization and Costs

The study analyzed data from 3.04 million US adults, which included 120 million visits (9.8% of which were telemedicine visits) and $178.44 billion in spending between 2019 and 2023. The average visit rate was 0.66, and the average spending rate was $774.69 per-member-per-month.

The findings indicated that areas with a high adoption of telemedicine had 2.4% fewer visits and 0.5% lower spending than areas with low adoption rates.

Urban areas with higher rates of telemedicine adoption had 4.4% fewer visits and 2.3% lower spending than urban areas with lower rates of adoption. Conversely, rural areas with high adoption had 3.4% greater visits and 3.8% higher spending.

Health care costs were 2.5% lower for patients with Medicare, 5.3% lower spending for dual-eligible individuals, 3.0% lower spending for patients with Medicare Advantage, and 1.5% lower among socially vulnerable populations.

By contrast, care costs were 1.1% higher for patients with commercial insurance, 1.0% higher for patients with Medicare fee-for-service, and 4.5% higher among less socially vulnerable groups.

Overall, the researchers found these estimates to be null and not statistically significant. No noteworthy association was observed between telemedicine adoption and changes in care utilization and costs, which means extending telemedicine policies may not increase health care utilization or spending.

According to the researchers, “Null findings across all subgroups, combined with our injury-related negative control analysis, provide reassurance that telemedicine expansion has not produced large spending increases or exacerbated disparities across these dimensions.”

Reference

Mafi JN, Vangala S, Cantor J, et al. Telemedicine adoption, US ambulatory visits, and total medical spending, 2019-2023. JAMA Netw Open. 2026;9(5):e2611835. doi:10.1001/jamanetworkopen.2026.11835