A recent study from the Perelman School of Medicine at the University of Pennsylvania has found that telemedicine visits are significantly less expensive than in-person appointments for common conditions treatable by both methods. The research, published in JAMA Network Open, revealed that on average, telemedicine visits cost $400 less per patient and resulted in fewer follow-up appointments.
“Before we did this study, there was a common concern that telemedicine might serve only as an easy source of ‘first aid,’ just delaying in-person care and increasing costs overall,” said co-senior author David Asch, MD, MBA, the John Morgan Professor and senior vice president for Strategic Initiatives at the University of Pennsylvania. “But we found that wasn’t true, and our work suggests that for many patients, telemedicine can be a complete solution, not just a temporary band-aid.”
Telemedicine usage saw a sharp increase during the COVID-19 pandemic due to regulatory changes expanding access. At the University of Pennsylvania Health System (UPHS), telemedicine visits grew from 11,000 in 2019 to one million between March 2020 and February 2021.
The use of telemedicine remains steady even after the pandemic’s peak. Researchers noted that between 2022 and 2024, four to six percent of all health care visits at five UPHS hospitals were conducted through telemedicine. The health system continues to invest in its telehealth services, such as centralizing after-hours primary care calls to Penn Medicine OnDemand.
“We know that telemedicine is not one-size-fits-all, particularly for mental and behavioral health, where thoughtful triage, follow-up, and continuity of care remain important, so we wanted to better understand whether we were truly seeing efficient diversion of care,” said senior author Yong Chen, PhD.
The study analyzed billing data from more than 160,000 visits over four months in 2024. It focused on ten common conditions—including COVID-19 symptoms and anxiety—and tracked each patient’s episode from seven days before their initial visit through thirty days after. The average charge per episode when starting with a telemedicine visit was $96 compared to $509 for those beginning with an in-person appointment.
Patients who started with telemedicine averaged just over three follow-up visits per episode versus more than four for those seen initially in person. In mental health care specifically, costs were similar regardless of visit type; however, telemedicine still led to fewer subsequent appointments.
“Many systems already deliver most psychiatric care via telemedicine since care is dominated mostly by counseling and medication management instead of through tests or procedures, like care for other conditions,” said first author Bingyu Zhang, MS. “So treatment and prescribing workflows may look similar across visit types and make episode charges comparable, even though telemedicine is still associated with fewer subsequent visits.”
For respiratory symptoms specifically, telemedicine visits cost about $800 less on average than office visits.
While some serious cases require in-person evaluation—which could influence higher costs—the researchers adjusted their analysis to compare similar patients across both types of visits.
The team believes these findings could apply beyond Philadelphia if health systems invest in expanding access to telehealth services. However, regulatory changes enacted during the pandemic are set to expire at the end of 2027 unless extended by Congress.
“If telemedicine is allowed to revert to the more limited model that existed before COVID, the cost savings we identified could disappear,” said UPHS CEO and study co-author Kevin B. Mahoney. “At a moment when hospitals and health systems face serious financial headwinds, those savings are vital. They enable us to reinvest in patient care and fuel innovation.”
