The Top Five Reasons Health Systems Want Telehealth - and the One Hurdle

03:00 AM

By Danielle Russella, President, Customer Solutions, American Well

You may have seen that Community Health Systems (CHS), one of the largest health systems in the U.S., is making telehealth available to their patients for primary care video visits. CHS is the most recent system to join a growing list of hospital networks offering online doctor visits – others include St. Luke’s University Health Network, Intermountain Healthcare, Avera Health, Nemours Children’s Hospital, and Cleveland Clinic.

Following health plans, health systems are the fastest growing sector of the telehealth adoption market. You may be wondering – why? Having partnered with leaders at these organizations to implement telehealth, below are the top reasons they are embracing this new model of care.

  1. It delivers a better experience that will retain and attract patients

Patients consistently report high satisfaction with telehealth encounters (97% of patients report satisfaction with an online telehealth encounter) because it provides convenient after-hours care options and reduces wait times, travel time and costs associated with accessing care at traditional care settings. This high satisfaction leads to a better overall experience and a greater affinity for the health system. Naturally telehealth can be a draw for an existing patient to stay with their doctor if they can see them more regularly over video – and may attract new patients beyond the immediate vicinity of that hospital or system.

  1. It reduces hospital admission rates

Hospital readmission rates are a big issue today, and with huge associated costs. Telehealth can help reduce admission rates by enabling doctors, care managers or pharmacists to see patients over video for follow-up care and care management for chronically ill and post-surgical patients.  

  1. Systems can enhance the depth, breadth and distribution of medical providers and specialists

CHS, like other large, health systems, has multiple campuses and hospitals with specialists and other allied health providers distributed throughout these locations or regions. Telehealth enables hospitals to distribute staff and expertise throughout the system and provide access to more specialists, ensuring that patients have timely access to the doctors they need to see – without appointment scheduling, waiting and longer-term coordination. Telehealth also greatly improves provider-to-provider communication so doctors can easily share information, resulting in care that is more coordinated and cost effective. Finally, with telehealth, multi-disciplinary teams can more easily be assembled to care for a patient or a panel of patients.

  1. Systems can cut costs through more preventative outreach

As more patients are covered under alternative or value-based reimbursement arrangements, hospital systems need to find ways to engage and manage chronically ill patients.  By reducing the number of preventable admissions, from complications like diabetes, dehydration and heart conditions, hospitals can greatly reduce their costs. In fact, a decrease in the number of potentially avoidable hospital admissions from 2005 to 2010 saved nearly $1 billion in hospital costs. Just as important – telehealth facilitates consistent, convenient ongoing monitoring for those at-risk for hospitalization, ensuring patients are as healthy as possible.

  1. The ability to help improve clinical outcomes

Patients who participate in their care have significantly better outcomes. Telehealth is a powerful tool to drive patient compliance with medication and post-discharge instructions and connect them more easily with physicians and caregivers.

However there is one challenge to health systems that we as an industry will need to overcome in 2016: the reimbursement puzzle.

There is a lack of understanding and consistency about how each of the three major payer types—Medicare, Medicaid, and commercial payers—reimburse for telemedicine visits. This has understandably prevented delivery systems from making informed decisions about adopting telehealth. 

Currently, 29 states and the District of Columbia have mandates for commercial reimbursement of care provided through telehealth, with several states considering such legislation in the coming year.  Nearly every state has a policy for telehealth reimbursement for its Medicaid population, with significant variation from state-to-state.

The largest barrier that remains is the environment for Medicare reimbursement. Medicare requires that the patient setting be a rural clinical location such as a doctor’s office or hospital – no homes or cities count. Naturally this limits widespread telehealth reimbursement.

The good news – multiple congressional efforts are focused on expanding Medicare payment and demonstrating the clinical and financial value of serving this population through telehealth technologies. As part of its Next Generation ACO initiative, CMS will remove this restriction for participating ACOs, arguably the first step toward lifting this restriction for its entire population.

Just as promising – and in spite of Medicare patient setting restrictions – many Medicare Advantage enrollees do currently have access to telehealth, regardless of location. For one, commercial plans recognize the value and benefit of telemedicine and have added it as a supplemental benefit.

2016 is poised to be the year that many more health systems adopt telehealth services, and many more patients have the option of seeing their primary care physician from the comforts of home – a great indicator for the power of mobile health technology to actually foster the doctor-patient relationship, not disrupt it.

If you’re interested in learning more about telehealth, please visit us at Booth #2154 at HIMSS 2016.

Danielle Russella is the president of customer solutions at American Well, a top national telehealth services provider delivering online doctor visits to health plans, health systems and employers, in addition to its direct-to-consumer service, Amwell.

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