Primary Care Practice Telehealth Use and Low-Value Care Services.

Area of Science:

• Health Services Research
• Primary Care Medicine
• Digital Health

Background:

• The widespread adoption of telehealth has altered primary care delivery, but its impact on care quality, specifically concerning low-value services, remains unclear.
• Concerns exist that increased telehealth utilization might lead to unnecessary healthcare spending.

Purpose of the Study:

• To investigate the association between the extent of telehealth use in primary care practices and the rates of low-value care delivery.

Main Methods:

• A retrospective cohort study analyzed Medicare fee-for-service claims data from January 2019 to December 2022.
• The study included Medicare beneficiaries attributed to primary care practices in Michigan, categorizing practices by telehealth use (low, medium, high tertiles).
• Low-value care was measured using 8 claims-based indicators across office-based, laboratory, imaging, and mixed-modality services, analyzed via Poisson regression.

Main Results:

• The study included 577,928 beneficiaries across 2552 primary care practices.
• High telehealth use was associated with significantly lower rates of low-value cervical cancer screening and thyroid testing compared to low telehealth use.
• No significant association was found between telehealth use and rates of other examined low-value care services.

Conclusions:

• Practices with higher telehealth adoption demonstrated reduced rates of specific low-value services, including cervical cancer screening in older women and unnecessary thyroid testing.
• These findings suggest telehealth can play a role in mitigating certain types of low-value care.
• Further evaluation of telehealth's influence on low-value services is crucial for understanding its overall impact on healthcare quality.