Telehealth is a rapidly growing business; in fact, the global telemedicine market is expected to reach $30 billion by 2020, with the United States accounting for nearly 40 percent of that total. According to a 2014 study, nearly 90 percent of health care CEOs were developing, planning, or implementing distance-based care programs, and 84 percent considered "meaningful telemedicine programs" to be central to their financial success.
There are several factors driving the growth in telehealth, not the least being alternate payment structures in the Affordable Care Act. For some health care systems, given the penalties for readmission under the Act, a telehealth policy is a "post-ACA imperative."
Adding a telemedicine component to your practice offers many potential advantages:
- Overall reduction in health care service costs. Remote monitoring for patients with chronic conditions, as well as those recently discharged from a hospital admission, has been shown to reduce non-emergent hospital visits and re-admissions. In fact, one study showed that telemedicine patients had 38 percent fewer hospital admissions and lower scores for depression, anxiety, and stress.
- Increased compliance and patient engagement. For patients with transportation and mobility issues, a telemedicine option encourages compliance with routine visits and care schedules. In addition, patients with access to triage via a telehealth option are more likely to seek early intervention in potential health issues and pursue appropriate, cost effective care options (urgent care center versus hospital ER, for example).
- Improved bottom line. Telehealth offers several new pathways to revenue generation, including insurance reimbursement for many telemedicine activities. In addition, offering a telehealth office has been shown to decrease no-show rates, estimated to be around 7 percent on average by the MGMA. Telehealth is also a marketing strategy in and of itself to attract new patients: Over 75 percent of consumers expressed interest in using telemedicine for minor or urgent conditions. Finally, some practices are capturing billable services using telehealth for some of their after-hours on-call encounters.
Of course, there are several potential drawbacks to implementing telehealth, as well, which should be considered before making the decision to add it to the practice offerings.
- Despite the ACA's push for telemedicine, about 40 percent of providers report some difficulty getting paid for their telehealth services, and 21 percent say that reimbursement is lower than for their in-person services.
- Providers worry that continuity of care will suffer if more patients seek telehealth consults for urgent or minor conditions as opposed to creating an ongoing patient-provider relationship.
- Building an IT infrastructure and developing policies and procedures that comply with state and federal privacy and informed consent guidelines can be an obstacle for implementing telemedicine.
Wondering if telehealth is right for your practice? Before developing a plan, it's important to answer the following questions:
- How do you see telehealth in relation to your existing practice? Which in-person activities do you plan to replace or supplement with telemedicine?
- Do you plan to expand practice hours with telehealth? Will you use non physician providers to staff your telehealth services?
- What business model will you use for your telehealth services? Will you use a small set fee for telehealth consults or seek insurance reimbursement for your services?
- Are your providers licensed or credentialed to practice telemedicine in your state?
Telehealth has the potential to provide faster access to routine care, expand access to specialty care, and improve compliance with self care routines for chronic health conditions; for these reasons alone, many practices are adding telehealth capabilities. But don't overlook the significant impact it can have on your bottom line.