The growth in telehealth service — long anticipated as part of the shift to value-based care – has been catapulted to unprecedented levels since the coronavirus pandemic took hold in the U.S. early this year.
Experts agree its use is unlikely to return to pre-Covid-19 levels, as provider organizations have widely adopted it and more consumers feel comfortable using it.
“There are a number of indicators that suggest virtual health consultations will continue to remain in vogue during the remainder of the pandemic and even after,” notes Kate Palazzolo, vice president at Allscripts.
Research published earlier this summer by the Commonwealth Fund showed that telemedicine visits, as a percentage of all health care encounters, rose from 1 percent in mid-March to 14 percent of all encounters by April 19. That percentage declined only slightly to 12 percent of all visits by mid-May.
That matches the explosive growth that Palazzolo saw among Allscripts clients. “We saw relatively low adoption of telehealth solutions prior to the onset of Covid-19,” she said. “When the pandemic hit, the company saw more than 200 organizations using its telemedicine solution, involving more than 4,500 providers conducting visits with patients. They’ve used it for nearly 260,000 video visits with patients since mid-March.”
Other researchers have verified the growth of telemedicine services. For example, a report by McKinsey and Company in late May estimates that 76 percent of consumers now are interested in using telehealth for services, compared to about 11 percent of consumers who expressed willingness to consider telehealth only a year earlier. McKinsey also reported that 57 percent of providers view telehealth more favorably than they did before Covid-19, and 64 percent say they are more comfortable using it. That rapid shift prompted the consulting firm to estimate that as much as $250 billion of current U.S. health care spending could potentially come from virtualized services.
The pandemic also has caused a shift among payers, which are more willing to pay for services provided via telemedicine. Leading that charge has been the federal government, which through the Centers for Medicare & Medicaid Services temporarily approved Medicare coverage of more than 80 new services for beneficiaries. That initial endorsement for telehealth was bolstered in early August, when President Donald Trump signed an executive order to make permanent the temporary flexibility for telehealth related to the Covid-19 pandemic.
Under the executive order, Medicare will cover telehealth visits at no additional cost, and copayments can be waived for telehealth services. The order will allow Medicare to cover more than 135 services through telehealth, including physical therapy, emergency care, home care, behavioral and substance abuse counseling, and more.
States have followed the federal lead. After the decision by CMS to expand access to telehealth services, some states introduced waivers to telehealth laws. Several states, including Colorado, Idaho, and Massachusetts, have taken steps to ensure that recent changes to their telehealth laws will remain in effect after the Covid-19 public health emergency ends, according to a report in mid-July in the HIPAA Journal.
Other national organizations are stepping up support for the burgeoning business line. For example, the Alliance for Connected Care, the National Committee for Quality Assurance (NCQA), and the American Telemedicine Association have convened the Taskforce on Telehealth Policy, which is working to develop consensus recommendations for policymakers on how to maximize the benefits of telehealth services while maintaining quality and efficacy of its services within the health care ecosystem.
As health care organizations and payers have accepted the logic of virtual care, consumers are increasingly gravitating toward the use of telemedicine. That is borne out in the results of a study by Accenture, which surveyed patients in several countries, including the U.S., for using telehealth services. The Accenture study found that at least 60 percent of patients who used virtual care tools during the pandemic said they want to use technology more for communicating with health care providers and managing their conditions. Patients said they believed the virtual care was more personal, convenient, and timely, with 90 percent saying the quality of care was as good or better than the in-person care they experienced before the pandemic.
Providers will continue to reap the benefits of telehealth, as the return on investment can help address some of the financial burdens of 2020. Clinicians and front office staff can work more efficiently, guard against appointment no-shows, seize revenue opportunities, and respond faster to patient care needs.
Palazzolo says, “You will see a lot of solutions out there that offer a completely separate patient experience that’s not well-aligned with a long-term engagement strategy.” By contrast, Allscripts offers an integrated patient engagement platform, with a mobile-first telehealth solution that’s built for medical usage and is EHR- and patient portal-agnostic. There’s also a mobile app for providers to connect with patients, making telehealth easily accessible for everyone.
Post-pandemic, it’s not clear whether patients and providers will maintain the current level of virtual visits. However, Palazzolo believes that the demand for telehealth capabilities will make it an essential offering for health care organizations that want to remain competitive. Patients have seen the convenience of a remote visit, which in turn opens multiple doors of engagement for patients as remote interaction will be the norm. Providers can follow up, offer surveys, provide education, and promote wellness programs through additional modalities — meeting patients where they are.
Furthermore, patients expect providers to offer virtual visits as part of a continuum of services. “If you don’t have a solution and your competitors do, you are at a competitive disadvantage,” Palazzolo says. “If you show [consumers] that you’re removing as many barriers as possible, it makes them look at you differently. Patients will share that experience with others about how you’re providing quality, easy-to-use service. This in turn can lead to additional business, higher patient satisfaction, and even better outcomes and increased revenue for your organization.”