How Coronavirus Will Impact Telehealth & the Future of Value Based Payment

By Raj Lakhanpal
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As COVID-19 has spread across the globe, the U.S. has become the country with the highest number of confirmed cases. As Americans attempt to do their part and “flatten the curve” through self-isolation and social distancing, healthcare providers are trying to remain disease-free while delivering important care to vulnerable patients. In a time like this, a virtual intervention is able to overcome barriers in non-acute healthcare delivery caused by COVID-19.

Before now, the vast majority of American consumers—82%—did not use telehealth. The pandemic has brought telehealth into a new light and the adoption and demand for telehealth has skyrocketed. Both the American Medical Association (AMA) and the Academy of Family Physicians (AAFP) have now released guidelines surrounding telemedicine and the CDC and WHO are now advocating for its use. The Centers for Medicare and Medicaid Services (CMS) has also taken a step to loosen its regulations to allow for the use of FaceTime and Skype, to enable providers order to carry out detailed patient evaluations that require audio and video and also suspended its originating site geographic limitation.

Telehealth is a vital tool in protecting at-risk patients from exposure while providing routine care. It isn’t just a tool for observing patients who are positive for COVID-19, but acts as an alternative for in-person clinical services for elderly and other high-risk patients, like those with diabetes, asthma, and heart disease.

Adding to all the positives, every time telehealth is utilized marks a preservation of personal protection equipment and ancillary staff. Unnecessary uses of resources allow them to be better allocated for patients who require in-person care.

While telehealth has proven itself as a successful tool and method for delivering healthcare services during COVID-19, it has big implications on how care could be delivered in the future outside of COVID-19 care.  

 

A Silver Lining

The increased use, speedy utilization, and development of telehealth initiatives could be a silver lining during this pandemic. The infrastructure of telehealth, which has been considered the largest barrier to largescale implementation, is quickly being overcome as COVID-19 has necessitated its use. COVID-19 has exposed hundreds of thousands of people to telehealth who may not have been interested in it or otherwise suspicious.

Rural communities can especially benefit from telehealth, in particular when it comes to specialty care. Telehealth can increase volume, increase quality, and reduce overall costs by reducing readmission and avoidable ED visits.

As patients would no longer have to travel long distances to access specialty care or be transferred to other facilities, smaller hospitals in rural areas would be able to provide quality healthcare services at lower costs in the local hospital with specialists virtually visiting their patients.

 

Benefits for All

While discussions of telehealth typically focus on rural communities, many urban and suburban areas could benefit from a strengthened telehealth infrastructure as well.

In 2017, the average wait time to schedule a physician appointment in fifteen of the largest cities in America was 24 days—almost a month. The long wait times are due to an ongoing physician shortage. Americans of all sorts are having trouble accessing care and could benefit from the increasing use of telehealth for primary care appointments and follow-ups.

Convenient appointments are also a very important void telehealth could fill for those with hourly-wage jobs where patients, particularly parents, may be faced with the decision to miss out on work for a primary care appointment or pay more for a more convenient, but also more costly, emergency department visit.

Those living in less central urban communities could benefit from telehealth that transcends inconsistent public transportation, like buses, that may cause them to miss their appointments. In the same vein, suburban areas can also see a benefit. Suburban poverty is growing, which means a growing class of people who have no cars while also having little to no public transportation infrastructure to get them to their appointments or which takes hours of bus hopping to get them there.   

While COVID-19 has created many new challenges, it has also sparked innovation which addresses old challenges. Physicians will have the flexibility and convenience of seeing patients remotely when necessary while continuing to care for patients in-person. They will also be able to better serve the underserved across the United States—urban, suburban, and remote alike.

Tags: Value Based Payments, Health Plans, COVID 19

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