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Are We Really Turning a Corner When It Comes to Telehealth?

June 16, 2015
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Developments are taking place along numerous dimensions with regard to telehealth—offering a positive outlook for that important phenomenon

A new report on healthcare costs and trends, researchers from PriceWaterhouseCoopers (PwC) have referenced telehealth and remote patient monitoring as phenomena positively impacting healthcare cost trendlines.

Indeed, in a report that looks broadly at cost drivers, its authors cited those two phenomena, together as one of three cost “deflators,” along with the looming “Cadillac tax”—an insurance excise tax under the Affordable Care Act that will become effective in 2018, and emergence of “new health advisers” who “are helping to steer consumers to more efficient healthcare with more experience in consumer retail services.”

Here’s what the authors wrote: “Virtual care—new technology increasingly renders virtual visits more efficient and convenient than traditional medical care. Hospitals are already using remote monitoring to improve outcomes and bring down treatment costs. Large companies now see telehealth as a valuable tool for primary care.”

It is interesting that telehealth and remote patient monitoring were the two elements within one of only three phenomena cited as cost “deflators” in the coming few years in healthcare.

Meanwhile, telehealth is receiving attention at the federal level, including inside the Centers for Medicare & Medicaid Services (CMS), whose final rule for accountable care organizations (ACOs), released earlier this month, makes mention of telehealth. As a summary of the rule on iHealthBeat notes:

“The final rule also calls on ACOs to describe in their applications their plans for promoting the use of health IT to improve care coordination. The final rule notes that such tools could include:

  • Electronic health records;
  • Data aggregation and analytics tools;
  • Telehealth services, including remote patient monitoring; and
  • Electronic health information exchange.

However, the rule does not require ACOs to use a certain tool. The rule states, "We are not finalizing additional specific requirements because we agree with commenters that ACOs should have the flexibility to define their care coordination process and use of enabling technologies. We believe this flexibility can encourage innovative methods of engaging both beneficiaries and providers in the coordination of a patient's care."

CMS has also recently amplified its rules for telehealth reimbursement for calendar year 2015, as noted here.

All of these developments speak to the sense that telehealth, as a broad phenomenon, may soon be entering a true golden age in healthcare. The technology facilitating telehealth has improved dramatically along several dimensions; reimbursement is advancing along diverse dimensions; and most of all, the shift to risk-based reimbursement, via ACOs, population health-based contracts, and other forms of partial capitation, really is shifting everything.

At Healthcare Informatics, we’ve had the privilege of interviewing many leaders in this arena, and of attending numerous presentations and discussions at recent conferences around the topic. Here’s my not-so-astonishing prediction: in the next few years, we’ll see an absolute explosion in telehealth-facilitated care delivery. What’s incredibly heartening right now is that all of the stakeholders around healthcare support this change—the public and private purchasers and payers of healthcare, hospitals, physicians, and other providers, and very importantly also the patients/consumers of healthcare. And the consensus on the need to move forward in this area really will now, indeed, move things forward.

Are conditions “perfect” yet? Of course not. And to be honest, a lot of process elements are still not in place, most particularly within patient care organizations themselves. Telehealth programs remain fragmented, sometimes-under-managed, and are definitely still largely underfunded and lacking in the c-suite-level support needed to grow into full robustness.

But I believe that many of those elements will change in the next couple of years, particularly as reimbursement finally catches up with the reality of what is possible telemedically.

So stay tuned, and watch for leaders of pioneering healthcare organizations lay the groundwork and provide the practical templates in this area going forward. It’s bound to be an exciting and satisfying time for all those who want to increase the availability patient-centeredness, and cost-effectiveness of healthcare going forward.