We’ve been talking about creating a more integrated healthcare delivery system for years. We now understand that achieving positive outcomes—and top reimbursement—requires ongoing care management outside of the exam room. Telehealth is gaining momentum as a way to accommodate that need, although a 2018 survey by Deloitte discovered just 14% of physicians had implemented telehealth. Of those, only 18% said they had plans to do so within two years. Then came COVID-19, which has driven telehealth to the forefront. An estimated 97% of providers have expanded the use of telehealth since the pandemic began.
While some providers may see telehealth as a bridge that helps us care for patients until the pandemic is over, industry leaders see it as a valuable opportunity to continue evolving a new patient-centric care model. Debora Fisher, COO, at NavCare, a leading provider of care management services, says, “As an industry, we need to consider the ramifications of losing the momentum we’ve built for telehealth in the past few months.” Fisher believes it would be to our detriment if we were to let the progress, we’ve made slip away. “Instead, we need to look for ways to leverage the tools, processes, and resources we’ve put into place since the pandemic began as a way to expedite our journey toward enhanced patient satisfaction, improved outcomes, and lower costs.”
The virtual care model centers around the needs of the patient while reducing stressors on providers and lowering costs for all.
At the heart of virtual care is remote patient monitoring (RPM) and chronic care management (CCM). In a time when providers are being asked to do more with less, this dynamic duo, combined with telehealth technology, has significant benefits for providers, payers, and patients.
Benefits to Providers
- Increases revenues through new RPM and CCM codes without adding more resources
- Increases reimbursement through better outcomes
- Improves care plan and medication adherence
- Allows for quick assessments and triage to ensure patients get the most appropriate care
- Reduces no-shows
- Allows for more effective remote monitoring through the use of digital devices
- Enables clinicians to quickly address urgent issues instead of waiting for an in-person appointment
- Reduces clinician drive time so they can see more patients
Benefits to Payers
- Reduces expenditures on chronic conditions, now responsible for 80% of all healthcare costs
- Lowers the number of hospitalizations and ED visits, 80% of which are related to chronic conditions
- Drives utilization
- Increases member satisfaction
- Improves payer quality scores
Benefits to Patients
- Increases access to care, especially for those in rural areas or who have mobility issues
- Reduces social isolation and loneliness and improves conditions like high blood pressure, heart disease, anxiety, and depression
- Lowers stress on family members
- Creates a more intimate relationship with their provider
- Allows them to get the care they need faster
- Reduces the cost of travel and, often, co-payments
- Reduces the need to wait for appointments
The Cost of Going Backward
As a nation, our population is getting sicker. Eighty percent of those aged 65 and over have at least one chronic condition , and 77% have at least two chronic conditions. Caring for our elderly population alone takes up between 40% to 50% of all healthcare resources. This is simply not sustainable, and we already see the impact. Rural hospitals are closing at record rates, leaving many communities without access to care. Even urban medical facilities struggle with decreasing reimbursements and increasing patient financial responsibility. This comes at a time when our provider base is shrinking. This puts us at a pivotal moment in healthcare. Which direction are we going to go: forward or backward?
Telehealth is here now, queued up, and in use at most provider organizations. Now is the time to hone in on its benefits, create strategic plans to fully implement it into ongoing workflows, and to increase national efforts to make it economically feasible for providers, payers, and patients alike. Debora Fisher, COO of NavCare says, “If we were to let this opportunity slip away, we will have wasted all our hard work and resources of the past three months. We must continue building for the healthcare system of the future, not the past.”
 Clinical Health Coach 2018