One of the most comprehensive looks at operational Medicare telehealth utilization patterns, new analysis of Medicare data from 1.67 million beneficiaries in 25 states and Washington, D.C. found that Medicare patients averaged just 0.25 additional visits per year, despite a 31-fold increase in virtual visits. The analysis, a project of the Center of Digital Excellence at the American Telemedicine Association (ATA) shows that telehealth is overwhelmingly substitutive, not additive.
Nine health systems and Access TeleCare contributed data to the analysis.
Across 1.67 million Medicare beneficiaries:
- Virtual visits increased 31-fold, yet
- Total Medicare utilization rose by just 0.25 visits per beneficiary, on average.
In the largest Medicare population studied — more than 350,000 beneficiaries — virtual visits increased more than 200-fold while overall use increased by only 0.01 visits per patient. The analysis shows a 74 percent substitution rate, far greater than the Congressional Budget Office’s long-standing assumption of 30 percent.
“Real-world data continues to show what we see every day across the hospitals we serve: telemedicine improves access without driving unnecessary utilization,” said Joshua DeTillio, CEO, Access TeleCare. “This report confirms that virtual care is a substitutive, cost-efficient solution—and federal policy should reflect that reality.”
In other words, more telehealth does not mean runaway utilization or increased cost. It means timely access, more efficient care, and a system that better matches patient need with available expertise.
This conclusion aligns with our operational data.
From nearly 400,000 patients supported through Access TeleCare programs:
- Utilization increased only marginally (1.76 → 2.25 visits per patient),
- While the cost per encounter declined by ~36 percent over three years.
More virtual care did not dramatically increase service use — and, in fact, lowered the cost of delivering specialty care.
Access TeleCare’s data offer an additional national-scale dataset that mirrors the ATA CODE findings and provides further evidence that specialty telehealth follows the same substitutive, cost-efficient pattern observed across large health systems.
In addition to Access TeleCare, nine health systems participated, including: Advocate Health, Ballad Health, Intermountain Healthcare, Johns Hopkins Medicine, MedStar Health, OSF OnCall/OSF Healthcare, Sanford Health, UPMC, and WVU Medicine.
This new report adds authoritative, data-driven weight to the need for permanent telehealth flexibilities. The evidence is clear: virtual care improves access and efficiency without increasing overall utilization.
See the press release from ATA and full report here.
This report was authored and prepared by Elissa Baker and Samantha Guseyn-Zade in collaboration with the ATA CODE members.
