Consumer Preferences for Care Delivery Modality, Timely Care Access, and Time Costs: Insights from Discrete Choice...

Background. Policies on telehealth coverage and reimbursement have been evolving. To support national decisions on telehealth use and delivery, this study assessed patient preferences on care delivery modalities and value of time for primary care in outpatient settings. Design. Discrete choice experiments were designed to calibrate care visits by 1 price attribute and 3 nonprice attributes: delivery mode (phone, video, in-person), time costs, and waiting time. Mixed logistic regression models were used to estimate patient preferences and willingness to pay (WTP). Sample. A total of 110 respondents were recruited from a state representative cohort in the Midwestern United States with oversampling of Black and Hispanic minorities. Results. Patients were willing to pay $23.2 (95% confidence interval [CI] 13.3, 37.9) for a primary care visit and $30.3 extra (95% CI 21.1, 44.0) for in-person care but discounted the value of care by $8.7 for a video visit and $21.6 for a phone visit. Reducing time costs from 45 to 30 min increased patients' WTP by $4.0 (1.8, 7.3). Patients' WTP was $4.1 higher (or $2.2) if care visits were scheduled on the same day (or within 3 d) rather than in 7 d. Patients who were non-White minorities, older than 65 y, did not own a property, or were Medicaid beneficiaries valued care visits lower than the average ($11-$18 v. $23) but valued same-day visits more ($6.2-$6.3 v. $4.1). Conclusions. Patients discounted care delivered by phone or video visits but preferred to have such options for flexibility and timely access. The benefits of telehealth such as reducing time costs and providing timely care access increased its desirability and the potential to avoid missed or delayed care for preventive and care maintenance purposes.

Patients are willing to pay about $23 for a typical primary care visit on prevention and maintenance.Patients discount video or phone visits by $8 to $20 but prefer to have such options for flexibility and timely access.Patients are willing to pay $4 to $6 for shorter time cost obtaining care or same-day timely access to care.Non-White minorities and older and low-income patients have lower valuation for a care visit but a higher price premium for same-day visits than the general population, suggesting high potential of telehealth to help avoid missed or delayed care for these subpopulations.