BackgroundExpansion of telehealth insurance coverage is hampered by concerns that such coverage may encourage excessive use and spending. ObjectiveThe aim of this paper is to examine whether users of telehealth services rely more on other forms of outpatient care than nonusers, and to estimate the differences in payment rates. MethodsWe examined claims data from a large national insurer in 2017. We limited our analysis to patients with visits for 3 common diagnoses (N=660,546). We calculated the total number of visits per patient, overall, and by setting, and adjusted for patient- and county-level factors. ResultsAfter multivariable adjustment, telehealth-visit users, compared to nonusers, had 0.44 fewer visits to primary care, 0.11 fewer visits to emergency departments, and 0.17 fewer visits to retail and urgent care. All estimates are statistically significant at P