Virtual doctor visits may be beneficial for fighting climate change. (Ground Picture/Shutterstock)
Carbon Emissions Saved Akin to Output of 130,000 Cars Every Month
In a nutshell
- Telemedicine saved millions of pounds of CO₂ each month in 2023—enough to match the emissions of up to 130,000 gas-powered cars, according to a UCLA-led study.
- The biggest environmental impact came from avoided travel, especially for rural patients who typically drive farther for care.
- While modest on a national scale, these emissions savings offer a new reason for policymakers to support expanded access to virtual healthcare.
LOS ANGELES — When you click “join appointment” for a virtual doctor visit, you’re not just saving yourself a drive to the clinic, you’re helping cut greenhouse gas emissions. According to new research from UCLA and other universities, telemedicine appointments prevented the release of up to 47.6 million kilograms of carbon dioxide monthly in 2023. That’s roughly equivalent to the emissions from 130,000 gas-powered vehicles.
The COVID-19 pandemic normalized virtual healthcare practically overnight, but researchers hadn’t quantified the environmental impact of this massive shift until now. The healthcare sector contributes a whopping 9% of all U.S. greenhouse gas emissions, more than the entire aviation industry, making it a significant but often overlooked contributor to climate change.
The study, published in The American Journal of Managed Care, found that 2023 telemedicine usage levels modestly decreased the carbon footprint of American healthcare delivery. Researchers examined data from 44.7 million American adults with various insurance types—Medicare, Medicaid, and commercial plans—representing about 19% of all insured U.S. adults. Researchers counted a monthly average of nearly 1.5 million telemedicine visits between April and June 2023, with about 66,000 of those occurring in rural areas.
Not every virtual visit truly replaces an in-person appointment. Some might represent additional care that wouldn’t have happened otherwise. Accounting for this, researchers calculated two scenarios: one where 91% of telemedicine visits substituted for in-person care (their base estimate) and a more conservative scenario where only half of virtual visits truly replaced physical appointments.
Carbon Savings from Skipped Commutes
(© fizkes – stock.adobe.com)
Even using the most conservative assumptions, telemedicine prevented the emission of at least 4 million kilograms of CO₂ monthly within the study population. When extrapolated to the entire U.S. adult population and factoring in variables like electric vehicle usage and public transportation, the monthly emissions savings ranged from 21.4 to 47.6 million kilograms.
Transportation sits at the heart of these savings. With rural patients driving an average of 17.8 miles to their usual care provider and urban patients averaging 8.1 miles per trip, those avoided car journeys add up quickly. Researchers factored in regional differences and various types of vehicles on the road to calculate the emissions impact.
The researchers pointed out that reducing healthcare’s carbon footprint produces positive downstream effects on human health. A separate modeling study cited in the paper suggests that adding 4.4 million kilograms of CO₂ annually causes one temperature-related excess death globally, not including deaths from other climate impacts like increased pollution or infectious disease spread.
Healthcare Policy
For perspective, while these savings sound impressive, they represent a drop in the carbon bucket when compared to total U.S. emissions. Despite averting emissions equivalent to as many as 130,076 passenger vehicles, this impact is modest considering there were over 98 million automobiles registered in the U.S. in 2022.
This transportation-focused approach to measuring telemedicine’s environmental impact might just be the beginning. Future research could explore whether certain medical specialties or health systems see greater or fewer emissions benefits from virtual care. Researchers also suggest investigating how renewable energy policies might further reduce healthcare’s carbon footprint.
“As Congress debates whether to extend or modify pandemic-era telehealth flexibilities, our results provide important evidence for policymakers to consider, namely that telemedicine has the potential to reduce the carbon footprint of US health care delivery.” says study author Dr. John N. Mafi from UCLA, in a statement.
While discussions about telemedicine typically center on access, reimbursement, and quality of care, this study adds environmental impact as another important consideration for policy decisions. Every virtual appointment represents both a convenience for patients and a small but measurable win for the planet. These environmental benefits offer yet another reason for lawmakers to maintain expanded access to virtual care options.
Paper Summary
Methodology
Researchers analyzed data from the Milliman MedInsight Emerging Experience deidentified research database, which included 44.7 million U.S. adults with insurance coverage through Medicare, Medicaid, or commercial plans across all 50 states. They calculated the average monthly telemedicine visits between April and June 2023, categorized by rural and urban locations. To estimate emissions savings, they multiplied the number of avoided in-person visits by the average distance patients would have driven to their usual care location and the carbon dioxide emissions per mile from typical passenger vehicles. They created multiple scenarios with different assumptions about substitution rates (what percentage of telemedicine visits truly replaced in-person care), vehicle types, electric vehicle usage, and public transportation utilization to generate both conservative and optimistic estimates.
Results
The study found a monthly average of 1,481,530 telemedicine visits during the study period, with 65,733 occurring in rural areas. Using their base assumption that 91% of telemedicine visits substituted for in-person care, researchers estimated between 4,075,065 and 7,489,486 kg of CO₂ emissions were averted monthly in their sample population. When accounting for different variables like electric vehicle and public transportation usage, estimates ranged from 4 million (most conservative) to 8.9 million (least conservative) kg of CO₂ per month. Extrapolated to the entire U.S. insured adult population, monthly emissions savings were estimated between 21.4 and 47.6 million kg of CO₂—equivalent to removing 61,255 to 130,076 gasoline-powered vehicles from the road or recycling 1.8 to 4 million trash bags monthly.
Limitations
The researchers acknowledged several limitations to their work. They used a cross-sectional convenience sample, which might limit representativeness despite efforts to match U.S. Census demographics. They relied on pre-2023 data for driving distances and vehicle market share, though they note that average driving distances to care remained relatively stable between 2001 and 2017. The researchers also recognized that their findings represent averages that might not account for regional variations beyond rural/urban distinctions, such as seasonal trends or differences based on broadband access or age. Finally, they noted that recent decreases in telemedicine use from pandemic-era highs might mean their estimates overstate future emissions savings.
Funding/Disclosures
The study was funded by the National Institutes of Health/National Institute on Aging. Several researchers disclosed various financial relationships. Three researchers were financially supported by the NIH/NIA. Three others were employees of Milliman. One researcher reported consulting relationships with numerous healthcare organizations including AbbVie, CareFirst BlueCross BlueShield, Centivo, and others. Another researcher reported grants from Arnold Ventures and Commonwealth Fund and unpaid consulting to Milliman MedInsight and the Agency for Healthcare Research and Quality.
Publication Information
The paper titled “Impact of Telemedicine Use on Outpatient-Related CO₂ Emissions: Estimate From a National Cohort” was published in The American Journal of Managed Care (AJMC) in September 2025 (Volume 31, No. 9, pages 294-298). The authors were Benjo Delarmente and colleagues from UCLA’s David Geffen School of Medicine, along with researchers from Milliman, RAND, and the University of Michigan.
