Despite widespread adoption during COVID‐19, there is limited evidence supporting the quality of telemedicine care in managing patients with abnormal BMI.

To evaluate the comparability of telemedicine and in‐person (office) quality performance for abnormal body mass index (BMI kg/m2) screening and management in primary care.

This retrospective cohort study measured Healthcare Effectiveness Data and Information Set (HEDIS) quality performance for abnormal BMI screening (patients with BMIs <18.5 or >25 kg/m2 and a qualifying documented follow up plan) across an 8‐hospital integrated health system seen via primary care from 4/1/20 ‐ 9/30/21. Encounters were divided into three exposure groups: office (excluding telemedicine), telemedicine (excluding office), and blended telemedicine (office + telemedicine). Demographic stratification compared group composition. Chi squared tests determined statistical differences in quality performance (p = <0.05).

Demographics of sub‐groups for the 287,387 patients (office: 222,333; telemedicine: 1,556; blended‐telemedicine: 63,489) revealed a modest female predominance, majority ages 26–70, mostly White non‐Hispanics of low health risk, and the majority BMI representation was overweight, followed closely by class 1 obesity. In both HEDIS specified and HEDIS modified performance, blended‐telemedicine performed better than office (12.56%, 95% CI 12.29%–13.01%; 11.16%, 95% CI: 10.85%–11.48%; p < 0.0001); office performed better than telemedicine (4.29%, 95% CI 2.84%–5.54%; 4.79%, 95% CI 3.99%–5.35%; p < 0.0001).

Quality performance was highest for blended‐telemedicine, followed by office‐only, then telemedicine‐only. Given the known cost savings, adding telemedicine as a care venue might promote value within health systems without negatively impacting HEDIS performance.