The Impact of Video Visits on Measures of Clinical Efficiency and Reimbursement

Introduction: Telehealth is gaining more attention in multiple specialties including urology. Video visits in particular have shown high satisfaction and cost-saving for patients. However, there has been little investigation into how video visits compare to traditional clinic visits on measures of clinical efficiency and reimbursement. Methods: Our data set included 250 video visits of established patients at Michigan Medicine Department of Urology and 250 in-person clinic visits with the same providers completed between July 2016 and July 2017. Information on visit completion and cancellation rates, cycle time (time from check-in to check-out), reimbursement; and patient out-of-pocket expenses was collected using the electronic medical record and billing data. Results: Completion rates were similar between video and clinic visits (58% vs 61%, respectively, p=0.24). Average cycle time for video visits was significantly shorter compared to clinic visits (24 minutes vs 80 minutes, respectively, p <0.01). Neither average commercial payer reimbursement (p=0.21) nor average out-of-pocket expense (p=0.22) was statistically different between video and traditional visits. More video visits than clinic visits were billed as level 3 encounters (85% and 63%, respectively, p=0.002). Conclusions: Our study demonstrates that video visits have the potential to reduce the time patients spend on followup care without negatively impacting reimbursement rates. However, these visits could reduce average billing levels. These findings suggest that the incorporation of video visits into practice may be more efficient for patients but may also reduce billing levels.

Automated summary

Telehealth, particularly through video visits, has shown high patient satisfaction and cost-saving benefits. This study found that video visits had similar completion rates as traditional clinic visits, but significantly shorter cycle times. While video visits may reduce patient follow-up time without affecting reimbursement rates, they may also lower billing levels.