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Health Policy

Changes in Virtual and In-Person Health Care Utilization in a Large Health System During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Network Open

Published Online: October 27, 2021

Research Letter

Article Information and Disclosures

Kori S. Zachrison, MD, MSc^1,2;

Zhiyu Yan, MS³;

Lee H. Schwamm, MD^2,3

Author Affiliations

¹Department of Emergency Medicine, Massachusetts General Hospital, Boston
²Harvard Medical School, Boston, Massachusetts
³Department of Neurology, Boston, Massachusetts

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Virtual care has quickly become an integral component of care delivery.¹ However, some have expressed legitimate concern that this may increase health care spending by leading to churn and increase total medical expense.²^,3 As the pandemic and associated regulatory relief led to more permissive use of virtual care, we sought to evaluate the association between the growth of virtual care and health care utilization in an integrated delivery network.

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Article Information

Accepted for Publication: August 15, 2021.

Published: October 27, 2021. doi:10.1001/jamanetworkopen.2021.29973

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Zachrison KS et al. JAMA Network Open.

Corresponding Author: Kori S. Zachrison, MD, MSc, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 (kzachrison@mgh.harvard.edu).

Author Contributions: Dr Zachrison had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Zachrison, Schwamm.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Zachrison.

Critical revision of the manuscript for important intellectual content: Yan. Schwamm.

Statistical analysis: Zachrison, Yan.

Obtained funding: Zachrison.

Administrative, technical, or material support: Schwamm.

Supervision: Schwamm.

Conflict of Interest Disclosures: Dr Zachrison reported receiving grants from National Institute of Neurological Disorders and Stroke, CRICO, and the American College of Emergency Physicians outside the submitted work. Dr Schwamm reported receiving personal fees from LifeImage and grants from the National Institute of Neurological Disorders and Stroke and the Patient Centered Outcomes Research Institute outside the submitted work. No other disclosures were reported.

Funding/Support: Dr Yan and Zachrison were funded by grant K08 HS024561 from the Agency for Healthcare Research and Quality.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References

Schwamm LH , Estrada J , Erskine A , Licurse A . Virtual care: new models of caring for our patients and workforce. Lancet Digit Health. 2020;2(6):e282-e285. doi:10.1016/S2589-7500(20)30104-7 PubMed Google Scholar Crossref

Telemedicine: what should the regulatory and payment landscape look like post-pandemic? Accessed May 31, 2021. https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/telemedicine-post-pandemic-regulation

Mehrotra A , Bhatia RS , Snoswell CL . Paying for telemedicine after the pandemic. JAMA. 2021;325(5):431-432. doi:10.1001/jama.2020.25706 PubMed Google Scholar Crossref

Pfefferbaum B , North CS . Mental health and the COVID-19 pandemic. N Engl J Med. 2020;383(6):510-512. doi:10.1056/NEJMp2008017 PubMed Google Scholar Crossref

The doctor is out: continuing disparities in access to mental and physical health care. National Alliance on Mental Illness. Accessed June 3, 2021. https://www.nami.org/Support-Education/Publications-Reports/Public-Policy-Reports/The-Doctor-is-Out

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.