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

Area of Science:

• Health Services Research
• Healthcare Management
• Digital Health

Background:

• Accountable Care Organizations (ACOs) manage significant medical expenditures, including specialty care.
• ACOs explore virtual visits as a cost-saving alternative to in-person consultations.
• The impact of virtual visits on in-person visit frequency within ACOs remains unclear.

Purpose of the Study:

• To investigate whether virtual visits reduce in-person visits within a Massachusetts-based ACO.
• To analyze the short-term and long-term effects of virtual visit adoption on healthcare utilization.

Main Methods:

• Analysis of data from over 35,000 patients within a Massachusetts ACO from 2014-2017.
• Comparative analysis of in-person and virtual visit frequency before and after virtual visit implementation.
• Longitudinal assessment of visit substitution effects over 1.5 years.

Main Results:

• Virtual visits led to an initial 33% reduction in in-person visits.
• Total healthcare visits (virtual and in-person) increased by 80% over 1.5 years.
• The reduction in in-person visits was not sustained beyond one year.

Conclusions:

• Virtual visits show a temporary potential to substitute for in-person care in ACOs.
• The overall increase in total visits suggests virtual care may supplement rather than replace in-person services.
• Further research is needed to understand long-term virtual visit efficacy and substitution in ACO models.