Telehealth: A Look Ahead (Part Three)

Telehealth is a cost-effective, convenient alternative to the traditional face-to-face practice of medical care and services. It allows providers to deliver care to patients when they need it, where they need it, and with less disruption to a patient’s life. Although not a new concept, telehealth has surged in popularity during the COVID-19 pandemic, accelerated by the federal government’s $200 million in funding via the Coronavirus Aid, Relief, and Economic Security (CARES) Act. In fact, since the start of the pandemic, the Centers for Medicare and Medicaid Services (CMS) has added over 250 services to the list of telehealth services that Medicare Fee-for-Service will cover.

As both patients and providers become more comfortable with telehealth—including the required technology and quality of care to execute it effectively—it is likely to change the landscape of healthcare for the long haul. In the final installment of this three-part blog series, we’ll explore the future of the telehealth market and key catalysts that are likely to continue fueling its growth.

Telehealth has been around for decades, but thanks to the ubiquity of smartphones and advances in digital technology, it's now reaching new peaks. The American Hospital Association (AHA) reports that:  

  • More than half of U.S. hospitals have implemented remote monitoring capabilities.
  • Seventy-six percent of U.S. hospitals connect with patients and consulting practitioners remotely through the use of video and other telehealth technology.
  • Almost every state Medicaid program currently has some form of coverage for telehealth services.

Telehealth is clearly a trend with staying power, and several forces have converged to support its growth. Below, we explore five of these factors:  

Rapid advances in and reliance upon technology. New technologies are making it easier for telehealth to reach more people every day. The rapid innovation of mobile application software and related devices—such as wearables—has made it possible to easily connect patients with their entire healthcare team and track their health more regularly. Wearables include wireless communication devices that continuously monitor a patient's biological data and deliver it to medical professionals in real-time, facilitating timely intervention and remote delivery of care via telehealth. In combination with technologies like wearables and AI, telehealth can make healthcare more accessible, provide timely interventions, and keep patients out of the hospital while sustaining quality-of-care.

Consumers’ desire for convenience without a premium. In today’s fast-paced digital era, consumers are seeking convenience. And healthcare is no exception. In fact, convenience is one of the most cited praises for telehealth. With it, patients are able to receive treatment without the need to travel long distances, and doctors can deliver healthcare remotely from their offices or homes. There is no need for waiting rooms or commutes, which is particularly beneficial for patients managing chronic conditions. In addition to the convenience of telehealth, today’s consumers are embracing new care models that reduce costs. Telehealth has proven effective in this category, too. It can help patients avoid secondary expenses, such as those related to travel, taking time off work, and obtaining childcare. Telehealth also frequently diverts patients away from costly care settings, including emergency rooms and urgent care facilities. It can also help providers save dollars on resources required to hold in-person visits.

The rise in value-based care. Many healthcare leaders view telehealth as a viable strategy for improving patient access, reducing costs, raising patient and provider satisfaction, and improving patient outcomes—all of which are critical to implementing value-based care. Leveraging telehealth to embrace value-based care and improve the quality-of-care presents a significant opportunity for healthcare providers and state Medicaid agencies. Telehealth can serve as a tool to mitigate the increased risk that providers assume in value-based arrangements by extending the care experience beyond the brick-and-mortar environment. Riding the recent wave of expanded services and increased adoption of telehealth over the last year, health systems can transform the healthcare experience with a virtual-first approach that will continue to modernize and optimize the delivery of care beyond the COVID-19 crisis. These realities support the notion that telehealth adoption is helping providers achieve a variety of value-based care’s benefits. If your organization is investing in telehealth to align with value-based care, consider conducting a full review of your current capabilities to determine where you can use existing resources to grow your program. We recently helped a state agency assess its state asset inventory—including technology, business process, spend and funding, procurement and contract management capacity, and governance structure and processes. Our work resulted in a high-level gap analysis of the current technology and organizational capabilities, and what is needed to achieve the desired future vision. Keeping a focus on technology redundancies and consolidating vendor contracts where possible can minimize costs—a key to success in a value-based care environment.

Support for telehealth services at the state level. The pandemic prompted states to adapt healthcare regulations to meet new demands. In fact, nearly every state has taken steps to advance their telehealth services through gubernatorial executive orders, insurance regulation, and directives. Since March 2020, over 40 states have amended existing telehealth and telemedicine regulations, or passed new guidelines to expand services or coverage and better regulate the delivery of these services (learn more in Part One). More than 200 telehealth-related bills were introduced in the 2020 legislative session. New legislation addressed reimbursement in Medicaid programs and/or among private payors, COVID-19- specific expansions in telehealth policy, the creation of telehealth professional board standards, and cross-state licensing. Some legislation also sought to establish telehealth pilot programs to test the efficacy and/or cost effectiveness of telehealth in public programs. States have also facilitated the use of telehealth by expanding Medicaid and state-regulated health-plan requirements to provide coverage parity with in-person services and eliminate geographic or originating site limitations. Even today, state governments continue to evolve existing policies and propose new policies to support the expansion of telehealth services. Going forward, telehealth initiatives must be grounded in an understanding of this changing regulatory landscape and designed to satisfy the latest compliance requirements (see Part Two for more about our work with states to navigate this environment).

Support for telehealth services at the federal level. Telehealth policies are also evolving at the federal level. Since the start of the pandemic, CMS has added over 250 services to the list of telehealth services that Medicare Fee-for-Service will cover, and they recently announced that many of these expanded services will be permanently covered after the pandemic. This includes the lift on patient location restrictions, meaning that providers will continue to be able to offer telehealth services to patients located outside of designated rural areas. CMS has also lifted Medicare restrictions on a wide range of services and delivery technologies. For example, telehealth services are now covered for new and existing patients. In addition, smartphones and audio-only communication are now approved for use in care. All these actions support the notion that telehealth is entering into a standard-of-care stage of adoption.

As we look ahead to a post-pandemic world, we believe telehealth is here to stay. It’s already moving into the mainstream as an integral part of modern healthcare. With tens of thousands of clinical professionals across the country already using telehealth technologies, the demand for this mode of healthcare is unlikely to subside anytime soon.