By Tom Toperczer, director of product management for OmniJoin, Brother International Corporation’s web conferencing service

Telehealth appears to be at a tipping point, both from a patient demand and reimbursement perspective. A great example of this trend is survey results released in June that show 77 percent of survey participants would consider a virtual visit, while nearly 19 percent have already done so.[1]

In addition, reimbursement changes at the federal and state level may make telehealth more financially viable for providers, particularly for those in rural areas who want to expand access. Offering telehealth services, however, needs to be strategic. Providers must consider patient demand, workflow impact and selecting the telehealth platform that meets provider and patient needs.

Growing government acceptance

Even amidst healthcare reform uncertainty, telehealth adoption is growing. Apart from the interest from consumers, a key accelerator for telehealth centers on how the federal government’s healthcare leaders seem to be advocates of the care-delivery method.

For example, during his Senate confirmation hearing, U.S. Department of Health and Human Services Secretary Tom Price, M.D., said: “Telemedicine is an exciting innovation that will allow for individuals to access resources that are otherwise not available.”[2] He then described a program in his home state of Georgia where a neurologist in real time diagnoses patients exhibiting stroke symptoms and recommends care interventions.

Similarly, Centers for Medicare and Medicaid Services (CMS’s) Administrator Seema Verna, in written confirmation responses to senators, stated: “Telehealth can provide innovative means of making healthcare more flexible and patient-centric.” Verna added that she was particularly intrigued by telehealth’s potential to expand access in rural and underserved areas.[3]

Reimbursement improving

In the legislative branch, a major telehealth-related bill received a positive rating in May from the influential Congressional Budget Office (CBO). The CBO concluded that the CHRONIC Care Act (S. 870), which expands Medicare coverage for telehealth, would not increase or decrease Medicare spending. The bill would improve reimbursement policies for telestroke, home remote patient monitoring for dialysis therapy, enhanced telehealth coverage for ACOs, and more flexibility for telehealth coverage under Medicare Advantage plans.[4]

Another positive financial indicator for telehealth is that during his confirmation hearing, Price said: “I would also consider how we can allow for reimbursement of telehealth in general and to further help address provider shortages.”[5] Commercial health insurers often follow CMS’s example, which could mean additional revenue streams for telehealth services.

At the state level, reimbursement is also improving. For example, as of the end of July, 34 states and the District of Columbia have telehealth reimbursement parity laws for commercial insurers and eight states have similar laws in the works.[6] These state laws can vary widely in restrictions and covered services—and payers are not always compliant—so it is important to inquire with top payers to determine reimbursement rates.

Seeking the right workflow and technology fit

For organizations that haven’t began offering telehealth services, there are five main considerations—other than determining that the combined potential reimbursement from payers and co-payment from patients will be adequate compensation:

1. Measuring demand. If the organization has not considered offering telehealth, gauging patient demand is your first and most important step. This can be accomplished through an online or paper survey. These results, along with reimbursement estimates, should offer insight into whether to move forward.
2. Workflow. How will telehealth services be delivered and for what conditions? This is highly dependent on the size and resources of the organization. Some organizations will be able to dedicate staff to telehealth, others will need to shift between online and in-person appointments.
3. Technology. There are numerous telehealth platforms organizations can choose from to begin delivering virtual visits. Ease of use is perhaps the most important consideration because it has the most direct impact on provider productivity and efficiency. It also affects the patient experience and may influence their decision to seek care through telehealth again. Such streamlined features would include controls that only need a one-time configuration based on physician preferences, as well as a streamlined sign-on and authentication process.
4. Security. A private cloud-based implementation behind a hospital network firewall can offer security, while alleviating the hospital from purchasing additional server hardware. Security would be further enhanced with data encryption capabilities that support HIPAA compliance and patient privacy protection.
5. Patient experience. High-definition video and audio is crucial to more closely simulate the in-person experience for the patient and provider. Enhanced video and audio clarity can also help providers to detect nuanced body language essential to successfully perform psychiatric evaluations, medical checks and other procedures conducted remotely.

The future is bright for telehealth

Judging from the widespread usage of live, web video-based communication among all age groups, local demand for telehealth is likely match the national trends. Given this high-growth outlook, providers need to investigate potential reimbursement for telehealth among its payers as well has how to configure clinical staff duties and workflows to accommodate this new care delivery method. In short, expanding care access through telehealth will be a win for patients, but make sure it will be a win for your organization, too.

[1] Advisory Board. “Virtual Visits with Medical Specialists Draw Strong Consumer Demand, Survey Shows,” June 19, 2017. Accessible at: http://www.prnewswire.com/news-releases/virtual-visits-with-medical-specialists-draw-strong-consumer-demand-survey-shows-300475757.html

[2] U.S. Senate Finance Committee. “Questions for the Record: ‘The Honorable Thomas E. Price Nomination Hearing for HHS Secretary.’” Transcript. January 24, 2017. Accessible at: http://static.politico.com/b8/dd/542cf7084be185c759497c910b93/rep-tom-prices-questions-for-the-record-to-senate-finance-committee.pdf

[3] Politico. “Verma Gets Senate Finance Vote.” February 28, 2017. Accessible at: http://www.politico.com/tipsheets/morning-ehealth/2017/02/ama-other-doctor-groups-call-for-delay-in-2015-certified-ehrs-218967

[4] American Telemedicine Association. “CBO Greenlights Expanded Medicare Coverage of Telehealth.” May 18, 2017.  Accessible at: https://thesource.americantelemed.org/blogs/jessica-washington/2017/05/18/cbo-greenlights-expanded-medicare-coverage-of-telehealth

[5] U.S. Senate Finance Committee. “Questions for the Record: ‘The Honorable Thomas E. Price Nomination Hearing for HHS Secretary.’” Transcript. January 24, 2017. Accessible at: http://static.politico.com/b8/dd/542cf7084be185c759497c910b93/rep-tom-prices-questions-for-the-record-to-senate-finance-committee.pdf

[6] American Telemedicine Association. “2017 State Telemedicine Legislation Tracking (as of 5/31/2017)” Accessible at: https://higherlogicdownload.s3.amazonaws.com/AMERICANTELEMED/3c09839a-fffd-46f7-916c-692c11d78933/UploadedImages/Policy/State%20Policy%20Resource%20Center/State%20Legislation%20Matrix_2017.pdf