Acceleration of Telehealth Adoption May Help Drive Transition to Value-Based Healthcare

| URAC Staff
nurse or doctor is using innovative technologies in order to manage work in the hospit

With the rapid growth in telehealth technologies and surge in consumer demand, it seems that telehealth adoption is accelerating. And the U.S. healthcare industry seems to have no choice but to embrace the innovations that are inevitably coming.

URAC’s new Industry Insight Report, Accelerating Telehealth Adoption: Telemedicine’s Role in the Volume to Value Journey, takes a deep dive into how the value of telehealth could tip the scale for healthcare organizations that are transitioning to new payment models.

Although there is growing evidence of telehealth’s benefits, there remains concern that telehealth may only supplement in-person services, not replace them, resulting in higher utilization and spending for payers and patients, according to the Industry Insight Report. This concern is a hurdle telehealth advocates must overcome because paying for service volume rather than outcomes is the dominant model in today’s landscape.

 The healthcare industry can look to payer-providers, such as Kaiser Permanente and University of Pittsburgh Medical Center, for evidence of the value of telehealth in cost savings, improved health outcomes, quality of care, and patient satisfaction, according to the Insight Report.

For Kaiser, telehealth has proven itself by raising quality in the telestroke program. One example: Medical guidelines recommend “door-to-needle” time of 60 minutes or less for intravenous alteplase to thin blood and restore blood flow to the brain. However, studies show that less than 30 percent of acute ischemic patients are being treated within this window. Kaiser reported that its telestroke program achieved an 87 percent success rate in meeting that time standard across its 21 Northern California hospitals.

The UPMC AnywhereCare app, which offers 24/7 video visits to all UPMC patients within the state, showed a potential savings of $86.64 per episode of care when utilizing an on-line, virtual visit versus an Emergency Department, urgent care, retail clinic, or primary care physician. Further, as the cost of “brick and mortar” options continue to climb, a recent economic analysis showed potential cost savings of $131.71 per episode of care when using telehealth.

The report highlights one model that may be the key to a successful transition to value-based healthcare may be Project ECHO® -- a telehealth distance-learning model that helps rural physicians acquire new expertise and provide evidence-based healthcare to underserved patients by drawing on the knowledge of experts in urban areas with larger hospitals.

Under the Project Echo® umbrella, the University of Rochester Medical Center (URMC), Rochester, NY, launched a geriatric mental health (GEMH) program in 2014, and has seen emergency department visits drop 20 percent while cutting costs by 24 percent.

Large systems, such as Northwell Health, are transitioning to direct-to-consumer (DTC) telehealth models, including remote patient monitoring programs, mHealth devices and video portals. Moving to a consumer-centric model, according to Martin Doerfler, M.D., associate chief medical officer, has opened the door to many new uses of telehealth.  

But some providers and consumers aren’t convinced that telehealth convinced telehealth service can be superior or even equal to in-office care. “I don’t think everybody’s bought in,” said Rene Quashie, a former attorney specializing in telehealth, now vice president of policy and regulatory affairs of digital health, Consumer Technology Association.

Standards and accreditation might help by offering a “baseline set of requirements that telemedicine practitioners must meet,” Quashie said. Accreditation could also serve as something of a “comfort factor” to patients and the healthcare community at large by helping to “identify telehealth providers that have those standards of excellence for telehealth,” he added.

Download the complete Industry Insight Report here.

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