Telehealth is gaining ground as a more convenient and less costly option than a trip to the emergency room or the walk-in clinic for patients with minor conditions, multiple surveys now say.

Traditional visits to the doctor or a walk-in clinic for a minor condition such as a cold or a sprained ankle can average $136 and $176 and way over $1,000 for a trip to the emergency room, says health industry trade group the Alliance for Connected Health. In comparison the average cost of a telehealth visit is between $40 and $80, says the Alliance for Connected Health.

But while telehealth offers patients more convenient and economical ways to consult with doctors for an office visit, a new study from The Rand Corp. suggests that digital doctor visits in many instances can raise overall healthcare costs because of more patients seeking more care for illnesses that would not have received care if telehealth was not available.

Rand researchers examined claims information from 2011 to 2013 for 300,000 beneficiaries enrolled in a health plan through CalPERS, a large California public employee benefit organization that began offering direct-to-consumer telehealth services to members in 2012.

Researchers focused on acute respiratory infections, a group of ailments that include sinus infections and bronchitis and are the most common reasons people seek care from a direct-to-consumer telehealth provider. Rand says it examined the records of enrollees who sought care for an acute respiratory infection from telehealth providers, as well those who sought care for the same conditions from a physician’s office or a hospital emergency department. A total of 981 enrollees received care from a telehealth provider for acute respiratory infection during the study period, Rand says.


The study found that for each episode of acute respiratory infection, the cost of telehealth services were about 50% lower than a physician office visit and less than 5% the cost of a visit to an emergency department. But the Rand study estimates that net annual spending on acute respiratory illness increased by $45 per telehealth user, says Rand policy researcher Lori Uscher-Pines.

“While we found that per-episode spending was lower if the patient had a direct-to-consumer telehealth visit compared to an in-person visit the convenience of telehealth led to greater use of care and therefore increased healthcare spending,” she says.

Rand says its study of respiratory problem claims data shows costs averaged $79 for a telehealth visit versus $146 for a traditional visit to the doctor and $1,734 for a trip to the emergency room. But the higher costs for the telehealth visit were higher over time because 88% of telehealth visitors needed additional care, such as for a prescription, lab test or imaging, Rand says.

“Given that direct-to-consumer telehealth is even more convenient than traveling to retail clinics, it may not be surprising that an even greater share of telehealth services represent new medical use,” Uscher-Pines says. “There may be a dose response with respect to convenience and use—the more convenient the location, the lower the threshold for seeking care and the greater the use of medical services.”