Journal Article

Virtual Visits Partially Replaced In-Person Visits In An ACO-Based Medical Specialty Practice

Schwamm, Lee H., Rao, Sandhya K., Estrada, Juan, Venkataramani, Atheendar, Matiello, Marcelo, Shah, Sachin J., Simoni, Marcy R., Cohen, Adam B.

2018

Overview

Specialty care contributes significantly to total medical expenditures, for which accountable care organizations (ACOs) are responsible. AcOs have sought to replace costly in-person visits with lower-cost alternatives such as virtual visits (videoconferencing with physicians). In fee-for-service environments, virtual visits appear to add to in-person visits instead of replacing them. While this may be less of a problem within ACOs, whether virtual visits reduce in-person visits in an ACO is not known. Using data from over 35,000 patients in the period 2014-17 within a Massachusetts-based ACO, we found that the use of virtual visits reduced in-person visits by 33 percent but increased total visits (virtual plus in-person visits) by 80 percent over 1.5 years. While the use of virtual visits reduced in-person visits soon after registering with the program, the effect did not endure beyond a year. Whether and how virtual visits can substitute for in-person care in the long term are open questions.

• Publisher: The People to People Health Foundation, Inc., Project HOPE
• Subject: Accountability / Accountable care organizations / Alternative approaches / Bias / Clinics / Cost control / Expenditures / Health care expenditures / Health care policy / Monetary incentives / Patients / Physicians / Registration / Sensitivity analysis / Telemedicine / Trends / Video conferencing / Videoconferencing / Virtual environments / Visits