I have spent my entire career in Healthcare IT, much of it trying to get new technology into medical practices to increase efficiencies and help them succeed in value-based payment models. As I think back to various infusions of technology, there was always a catalyst. For telehealth, it was the COVID-19 pandemic and the industry accomplished more in five weeks than it did in the last 10 years. Claims data has allowed us to see that there was a staggering increase in telehealth use as compared to the same time period in 2019; in fact, the AMA reports on its website on June 18, 2020 that “Physicians and other health professionals are now seeing 50 to 175 times the number of patients via telehealth than they did before the pandemic.”
COVID-19 forced clinicians who were hesitant to use telehealth to dive in. Many small practices closed for a few days or weeks and worked from home as they compiled a plan to reopen safely. The CDC and other organizations published daily safety briefs for these groups to follow. The government stepped in with money earmarked for telehealth adoption. CMS and commercial payers then passed waivers to make it more convenient and economical to provide telehealth services. But many of these acts and waivers are not permanent and although recently extended, are set to expire in October 2020.
Prior to COVID-19, US healthcare was rapidly adopting value-based arrangements with many physician groups and accountable care organizations taking on risk, betting on their ability to keep patients healthy and lower costs. With the massive change in care delivery from in-person to primarily remote, many clinicians focused on meeting their patients’ needs for acute issues and put preventative measures on the back burner. However, for many of these waivers to stick, we must prove that telehealth is an effective care delivery channel.
As convenient and accessible as telehealth is, we must prove that we can manage patient care and lower costs. The Medical Group Management Association (MGMA) published a statistic in a June 10, 2020 report that 87% of healthcare leaders cited “patient safety” as the reason patients are missing visits at an alarming rate. The mortality rate has increased, even among younger populations, as patients allow symptoms to persist in fear of going to the doctor. We must re-engage with our patients and make them feel comfortable with a hybrid care model so they can get the medical treatment they need in the safest way possible. The data is there, and the payers are combing through it to set future reimbursement models. They will be looking to see if the virtual visits accomplish what in-person visits historically have, and if not, reimbursement likely won’t be at the same rate.
We expect there to be a blend of in-person and remotely delivered care moving forward. Consumers (patients, in this case) drive the market and the expectation is there, and many are beginning to prefer telehealth options both for their convenience and safety. Clinicians and patients are becoming more comfortable with the nuances of remote patient care. We are at a point where we need to ensure that quality is on the forefront, so that reimbursement models will be set fairly, and we can continue moving forward.
Medical Advantage can help you figure out the proper balance of in-person and telehealth services while injecting a quality-focused approach to care. To learn more, contact Medical Advantage today.