- When U.S. patients envision their future medical care, the majority see telehealth playing a role. But when presented with the choice between an in-person or video visit for nonemergent care, most prefer a traditional in-office visit, according to new research analyzing consumer telehealth preferences.
- The survey conducted by the nonprofit Rand Corporation published in JAMA on Wednesday found those who leaned toward in-person care were more willing to pay for their preferred visit modality, while those who preferred video visits were more sensitive to out-of-pocket costs.
- Of the respondents who had used telehealth at least once since last March, only 2.3% said they were unwilling to use telehealth in the future, suggesting the method's continued importance in hybrid models of care even after the pandemic — though it's unlikely to be most patients' first choice, researchers said.
Telehealth use skyrocketed starting last year as patients sought out digital avenues to medical care, put off from doctor's offices and other care sites over state-mandated lockdowns and fears of coronavirus transmission.
But virtual care's long-term role in U.S. healthcare post-COVID-19 is still being defined. Most experts agree it will hang around in some form or another after being normalized over the past year-and-a-half, though it is unclear what modalities will be permitted by Washington, how much it will be reimbursed and how much patient demand will remain.
The new study conducted in March suggests it's important to be aware of patient preferences in answering these questions that could determine the future of the $145 billion industry.
The survey of more than 2,000 U.S. adults found almost 67% of participants preferred at least some video visits in the future. That jibes with previous research finding generally high levels of satisfaction with telehealth encounters — even as some early evidence suggests telehealth use is decreasing as COVID-19 cases fall. Telehealth use is stabilizing at about 38 times higher than before the pandemic, according to McKinsey.
However, when faced with a choice between an in-person or video visit when the appointment could be conducted either way, more than half of respondents (53%) preferred an in-person encounter.
Researchers then asked people with a preference for either modality which option they preferred if their preferred option had an out-of-pocket cost of $30 or the other modality had an out-of-pocket cost of $10.
Among those who preferred an in-person visit when out-of-pocket costs were not a factor, almost half still preferred in-person care and 24% switched to a video visit when told the in-person visit would be more expensive.
Among those who initially preferred a video visit, only 19% still preferred a video visit and 62% switched to an in-person visit when told the video visit would be more expensive.
Researchers said that difference in perceived value could have many potential explanations. Patients may prefer telehealth for certain circumstances, like to receive care for minor acute conditions, but may not think video visits have the same value as in-person care overall. Patients might think that in-person visits allow for easier referrals for diagnostic testing or other needed followup care.
Alternatively, some patients might think in-person care has benefits that even the highest quality virtual care visits can't match, such as rapport with a clinician or the ritual of attending a doctor's office, that outweigh the additional travel and time costs associated with in-person care.
A little over 33% of participants didn't see any role for video visits in their medical care. Those respondents tended to be older, lower income, in rural areas and have lower levels of education.
Though much has been said about telehealth's ability to expand access to care for underserved populations and HHS has made expanding virtual care a key prong of its health equity strategy, the findings suggest these populations may be the least likely to demand virtual care. Such efforts may not be taking the preferences of these populations into account, researchers said.