The Cleveland Clinic recently called increased access to telemedicine one of the top 10 medical innovations for 2021. The Centers for Medicare and Medicaid Services (CMS) report that telehealth visits from March through June 2020 were up 2,532 percent over the same period a year earlier. With the COVID-19 pandemic forcing a fundamental restructure to the delivery of healthcare, telehealth has grown from a limited-use technology to an integral component of the American healthcare system.
Before the U.S. government lifted most telemedicine restrictions and expanded access to care, notable telehealth success stories usually came from health systems, hospitals, and large-scale insurance programs. Cost savings, easier care follow-up, patient satisfaction and adherence have all been listed as benefits for groups that integrate telehealth into their care delivery.
One such initiative emerged at Kaiser Permanente. From 2016 to 2017, they experienced a 235 percent increase in video visits; in 2017, with a concerted push toward virtual care, online connections accounted for 59 percent of all Kaiser patient interactions. Video visit patient satisfaction was 93 percent.
Surgeons at Dartmouth-Hitchcock Medical Center launched a telehealth program to help deliver follow-up care to plastic surgery patients. In advance, about three-quarters of participants said they prefer an in-person visit; after, 96 percent said they would opt for telehealth.
The positive effects of telemedicine on quality of care, workflow, and business aren’t exclusive to hospitals and insurance initiatives. Small and midsize independent practices can reap the rewards of a telehealth platform and strategy — no large-scale program or multitude of resources required.
A schedule that may have been in-office appointments nearly 100 percent of the time can now work as a blend of in-office and telehealth. Your practice should determine that mix based on business goals, needs of your patient population, and the type of care you deliver.
The benefits to private practices are many:
According to PatientPop research, three of four patients with a telehealth visit in 2020 expressed satisfaction with their appointment. About the same number (76.2%) said they would prefer telehealth in the future.
Check-in and wait times for patients are minimal, and the workflow process for practice staff is streamlined.
Greater scheduling flexibility
Telehealth visits allow for more and later appointments without the work and stress associated with in-office visits. In the survey cited above, when asked what they want most from their providers, 46 percent of patients listed more flexible and later hours as a priority.
Reduced no-shows and late cancellations
The ease and convenience of virtual care (“a new spin on the old-fashioned house call,” as Cleveland Clinic says on its medical innovations list) is a welcome opportunity for patients who a) have physical limitations for which staying home is safer than coming into the office, or b) have social conditions that make it difficult to carve out time or find transportation for an appointment. Telehealth removes those hurdles, giving more patients greater opportunities to receive care.
When should your practice offer telehealth visits? The answer comes down to the situations that work best for your specialty, staffing, and the kind of practice you want to manage.
For instance, counseling specialties can rely greatly on telehealth. Not only does the care lend itself to an easier telehealth transition, but CMS has expanded the list of telehealth services to include more behavioral and psychological care.
If you’ve used telehealth sparingly, consider the value of virtual care with established patients who don’t require a physical exam. You can diagnose and treat them by reviewing their health history, and looking and listening during the encounter.
Other telemedicine opportunities include traditionally short visits — the 5-10-minute follow-up can be completed in 5-10 minutes — as well as check-ins to maintain an ongoing care plan, or types of visits (or patients) that tend to no-show more than others.
If you’re unsure about times of day, try your virtual visits early in the morning, after usual office hours, and before and after office lunch breaks. In those instances, you’re offering greater flexibility to patients without having to fully staff your front office, or hustle patients in and out of exam rooms. If you’re a solo practitioner, depending on your specialty, you could consider reserving a half-day to conduct virtual visits without having to go into the office.
Beginning when the pandemic pushed telehealth into the forefront of care delivery, PatientPop has created and collected a series of resources to help practices with telehealth strategy and execution. The following is a select list that covers everything from the initial basics to technology tips.
List of covered telehealth services and codes from CMS
7 steps to build your telehealth strategy
AMA telehealth quick guide
Getting reimbursed for telehealth services
How to bring telehealth marketing to your practice business strategy
Unless you practice in a rural area (where telehealth was already allowed and reimbursed before 2020), you may have concerns about the status of telemedicine after the national health emergency. Ideally, regulations would offer parity between in-person and virtual care, especially in how providers are paid.
Are the actions of large companies a sign of what’s to come? Google recently invested $100 million with telehealth network AmWell. Can we tell from the ways insurance companies have approached patient obligation for telehealth visits?
One recent analysis shared that requirements for site origination (location of the visit) and geographic limitations will go away, and that CMS will continue widespread telehealth reimbursement for Medicare. A senior executive at a major healthcare organization told PatientPop the waivers and expansions wouldn’t all remain, but wouldn’t all be rolled back either. The reality for the future of telehealth likely exists somewhere in the middle.
With 90 percent of healthcare providers having access to a telehealth platform (according to Cleveland Clinic), private practices can benefit from telehealth today. Offer it to patients who are rescheduling missed appointments due to COVID-19. See if telehealth can make your practice more competitive, with later hours. Use it to try increasing your visit volume or decreasing your no-shows.
Whatever your approach, establishing a strategy now allows your practice to find the right path for later months of the pandemic, and be prepared for the updated regulations beyond.
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