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Healthcare Providers Moving Forward with Telehealth, Despite Reimbursement, Cost Concerns

October 10, 2017
by Heather Landi
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Almost 60 percent of healthcare provider organizations with telehealth programs plan to expand the number of service lines or specialties served through telehealth systems and report patient convenience among the top benefits of telehealth, according to a study released by KLAS Research and the College of Healthcare Information Management Executives (CHIME).

Orem, Utah-based KLAS, a market research firm, and CHIME surveyed 104 healthcare organizations with telehealth programs to assess how healthcare organizations currently use telehealth solutions and identify barriers to its adoption. Overall, 59 percent of respondents cited improved patient access as one benefit of telehealth services, followed by improved clinical outcomes (35 percent) and lower costs (29 percent).

The study found healthcare organizations used their virtual care platform vendor in one or more of three primary visit types. More than half (56 percent) of respondents report using virtual care platforms for tele-specialty consultations to improve the clinical outcomes of patients by increasing their access to needed specialists. Thirty-eight percent of respondents are using their virtual care platform for scheduled/patient-focused visits to increase patient access by allowing patients to schedule and conduct a clinical visit virtually. And, 36 percent are using telehealth for on-demand/consumer-focused visits to decrease the costs for patients and providers by dealing with urgent/nonemergency medical needs of patients on-demand.

With the continued adoption of these technologies, organizations are now beginning to realize some of the long-expected benefits. Increased access for patients, improved clinical outcomes, and a reduction in costs were all cited by multiple respondents as benefits that have been attained from their telehealth solution, the report authors wrote.

What’s more, the survey findings indicate that healthcare organizations using telehealth have realized unique benefits to each of the specific visit types. For instance, with scheduled/patient-focused visits, 68 percent of respondents reported increased overall patient satisfaction. Close to one-third of respondents reported improved clinical outcomes and one-third reported lower costs. With on-demand/consumer-focused visits, respondents cited augmented brand awareness leading to increases in market share as one benefit. And, with tele-specialty consultations, survey respondents reported better clinical outcomes driven primarily by telestroke technology. 

As mentioned above, 58 percent of survey respondents plan to expand the service lines or specialties served through telehealth solutions and 26 percent plan to increase patient access to telehealth services.

However, the study found that telehealth is still in the early stages of adoption and many of the healthcare organizations with telehealth programs that participated in the study raised questions about cost, reimbursement, available technology, value, the patient experience and integration. In addition, promises of integration from telehealth vendors have not been realized. When integration is achieved by providers, it is most often unidirectional, the report authors wrote.

About half of the study respondents listed reimbursement as a limitation, noting that some payers have been slow to reimburse telehealth visits and/or reimburse at rates that are lower than face-to-face care. Most said integration between their electronic medical record and virtual care platform vendor was nonexistent or unidirectional.

Reimbursements are the biggest constraint on the successful expansion of telehealth technologies, and insurance companies, Medicare/Medicaid, and accountable care organizations (ACOs) have been slow to reimburse virtual visits. Though some provider organizations have received reimbursements, these often amount to less than is needed to cover the cost of the services provided. Unincentivized providers are a natural consequence of this since providers can earn more for in-person visits. The lack of reimbursement has made it difficult for organizations to make a business case for expanding telehealth solutions,” the report authors.

The report authors note that almost all states have legislation pending that would help alleviate some of the reimbursement challenges faced today. As legislation improves, difficulties surrounding reimbursement will likely fade, leading to increased adoption of telehealth solutions.

“Telehealth offers a great opportunity to enhance the lives of patients by making healthcare accessible to them wherever they may be,” Russell P. Branzell, CEO and president of CHIME, said in a statement. “Our members are advocates for improving patients’ lives through innovations like telehealth. But it needs to be carefully implemented to meet its potential and we still face headwinds with reimbursement and integration issues.”

“Telehealth holds enormous promise,” Adam Gale, president of KLAS, said in a prepared statement. “However, the underlying technology needs to evolve faster. In particular, integration of telehealth with provider EMR’s is still at a primitive level. Vendors need to step up in terms of technology and improved support.”

 

 

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