By Chris Sullivan, Vice President, Commercial Segment for Clinical Effectiveness, Wolters Kluwer Health
LinkedIn: Chris Sullivan
LinkedIn: Wolters Kluwer Health
Virtual care’s rise to status quo during the pandemic had many thinking that doctor visits by video or phone was going to become the norm. But four years later, telehealth still isn’t as large a part of our “new normal” as many thought it would be. In recent months, we have seen vendors retire their virtual care programs and realign their businesses to other parts of healthcare as the once seemingly limitless funding now dwindles.
While there are still concerns around the telehealth industry, the benefits of the medium can’t be ignored: improved outcomes, timely care, and cost-effective and scalable delivery of services.
While “telehealth 1.0” might be over, virtual care is here to stay, partly because there is a significant care void that needs to be filled in the healthcare community. In fact, the Association of American Medical Colleges (AAMC) predicts that by 2036, we could face a physician shortage of up to 86,000. This shortage will exacerbate the difficulties of accessing appropriate or timely in-person care for many patients, as 100 million Americans already face barriers to accessing primary care.
Virtual care has the potential to bridge these gaps. However, in order to do so, it needs to continue to evolve from a new technology to a permanent and fully integrated healthcare delivery system that provides value to both patients and busy providers.
So, what is needed to see telehealth as a vital part of the healthcare ecosystem? A critical issue is played by healthcare payers who can support the evolution through continued adoption and investment in reimbursement models. We’re faced with three key challenges/opportunities: reimbursement, accessibility, and patient engagement.
- Reimbursement. The uncertainty that services will be reimbursed and at one level can hinder the full integration of virtual care. Coverage and reimbursement for some telehealth services vary, and this can create disruptions for patients, providers, and telehealth developers alike. Although more than 40 U.S. states have implemented coverage parity, only 21 have fully implemented policies requiring payment parity. The Centers for Medicare and Medicaid Services (CMS) recently proposed 2025 Medicare physician fee is encouraging as it promises to bring back telehealth flexibilities during the Covid-19 public health emergency. It’s important that industry stakeholders from providers, technology developers, and regulators come together to improve healthcare access across different demographics and regions.
- Accessibility. Virtual care breaks down barriers that might restrict patients from accessing in-person care. With the adoption of telehealth, patients can access providers from a space they’re comfortable in and at a time that suits their schedule. This convenience could lead to better compliance with treatment recommendations. Additionally, it addresses a pressing issue in healthcare: care deserts. Access to virtual care helps extend the reach of specialists so patients can continue seeking non-emergent and follow up care in the comfort of their own home or local healthcare facility.
- Patient/Member Engagement. Providing patients with results-driven engagement is critical to the success of virtual health. While some skepticism may still exist about the quality of care, integrated digital health content and virtual care technology can engage both patients and providers, and deliver a more enriching, patient-centric experience. Recent research suggests 80% of patients are likely to have follow up questions after appointments and virtual care offers a convenient solution to help patients get answers faster for not only a better experience but better outcomes. It also aligns with the need to not just deliver care but deliver value-based care. However, there is more work to be done regarding the implementation of patient engagement tools in virtual care that address the needs of all patients such as tailoring educational content based on their race, gender, or abilities.
It’s our responsibility throughout the healthcare community to embrace virtual care and support its evolution. By addressing these key challenges, we can ensure we’re doing what’s best for all stakeholders – from payer to providers to patients.