A analysis–and challenging takedown–of the RAND telehealth cost study (updated)

A must read on telemedicine and telehealth cost. One of our Readers, Bruce Judson, commented on our earlier coverage of RAND Health’s new study published in Health Affairs [TTA 8 Mar] finding that telemedicine virtual visits (here called telehealth) drove up utilization of care by 88 percent and cost by $45 per year for respiratory illnesses that typically resolved on their own.

He has written his own analysis based on the full study. Telehealth Costs: RAND’s Questionable Rant (Huffington Post), considers the full study and compares it to a 2014 RAND study by the same authors. Mr Judson notes inconsistencies in sampling and definitions; the illogical attachment of a waiting period cost (77 minutes=$30) to a telehealth visit (perhaps to level it with an office visit?); the misinterpretation of results; small sample size; and the fact that the CalPERS sample is ancient (2011-13), representative of a time when telemedicine (here provided by Teladoc) was a new notion. There are inconsistencies with an earlier RAND study based on the same data! (He does not count in costs outside the study such as lost time at work or the cost of spreading infection to co-workers.)

Mr Judson, after many years in publishing, digital marketing and strategy (from when it was called ‘new media’), and currently an advisor to a UK firm investing in IoT, has cast his lot with us in health tech, heading a firm in the Hudson Valley of NY, Telehealthworks, which markets an employer telemedicine and wellness program called freshbenies. While he discloses that he’s not a disinterested observer or researcher, he has that in common with most of our Readers, who are very interested in determining the truth about costs and savings. He gives many reasons to be skeptical of the RAND findings.

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