The Cost of Convenience: How Consumers Respond to Innovations in Care Delivery

Innovations in the delivery of acute care have given consumers new choices. New, low-cost providers, such as retail clinics and direct-to-consumer (DTC) telemedicine, have the potential to decrease spending if they replace more expensive providers for acute care. On the other hand, the added convenience may make these alternatives so attractive that they lead to increased visits and increased spending. We conducted studies of both retail clinics and DTC telemedicine to find out how consumers respond. In both studies, we used several years of commercial insurance claims data to compare changes over time in acute care visits and spending for consumers of these new options and a comparison sample. We found that new visits to these providers greatly exceeded replacement of visits to other providers, and that the net impact was an increase in short-term spending on acute care. These results suggest that giving consumers less expensive, convenient options does not save money. The relatively larger increase in new visits for the more convenient, DTC telemedicine, suggests that convenience is important to consumers making these choices. Employers, insurers, and health care providers should not think of these innovations in care delivery as means to save money.