That will likely depend on the parity between telehealth and in-person reimbursement as well as state and federal regulations post-pandemic, she added. (Telehealth spending)
“There could be a legislative and regulatory policy stew that’s created as a result of this that may give rise to a new terrain of telehealth,” Gelburd said.
Similar to March 2019, telehealth was most commonly used for mental health issues in March 2020. But hypertension was among the top five telehealth diagnoses in 2020, unlike February and March of last year, which may reflect COVID-19-related stress and the prevalence of remotely monitoring individuals with chronic conditions, Fair Health researchers said.
While acute respiratory conditions remained the second most common diagnosis year over year, those types of diagnoses dropped off in March 2020, which may indicate that people who feared they had the virus preferred in-person visits.
“There is a tremendous opportunity to use the data to understand how telehealth is used and the outcomes associated with it,” said Gelburd, noting that the ICD-10 codes for telehealth are becoming more refined. “We can use de-identified data to track migratory patterns of patients and related outcomes.”
The stigma of a virtual visit as a less effective intervention is one of several challenges. If telehealth services and providers are treated as an appendage of the care continuum instead of working them into the communication systems and broader network, experts worry that care would be duplicated or hindered.
Consumers may not be aware of telehealth offerings, what’s best suited for the medium and what’s covered by insurance. Providers are also concerned about data security, workflow integration and reimbursement, McKinsey surveys show.
Although, more than half of providers surveyed in May viewed telehealth more favorably than they did before, according to McKinsey. Also, more than three-fourths of consumers surveyed said they were moderately or highly likely to use telehealth going forward, with 74% reporting they were highly satisfied with telehealth.
Over a week’s time, Renton, Wash.-based Providence went from 50 physicians to 7,000 physicians using telehealth. The integrated health system performed 70,000 video visits a week, up from around 700 a month as the typically more skeptical specialists bought in, said Jennifer Schaab, chief operating officer of physician enterprises at Providence.
“Initially, a lot of providers were against telemedicine because they weren’t getting enough work (relative value units) or didn’t think it was good for patients,” she told Modern Healthcare in late April. “But telehealth is tailoring care to both patients and individual physicians. The crisis brought them together.”
The median age for a patient on a telephone visit is 10 years older than those on video consultations, which will help Providence tailor how it delivers care to specific markets and populations, Schaab said.
Similarly, providers at New Orleans-based Ochsner Health were reluctant to try telehealth. While the technology was relatively easy to navigate, many doctors preferred a more personal touch and building a rapport, said Dr. Katherine Baumgarten, medical director of infection control and prevention for Ochsner.
“The convenience of telehealth and the fact that it is readily available has gotten a lot of positive feedback,” said Baumgarten, adding that it can be particularly useful for monitoring chronic conditions. “There will be a role for in-person care too, but telehealth will continue to expand.”
Generally, reimbursement has also been an impediment. While emergency declaration waivers have expanded billable telehealth services and relaxed certain regulations, providers are unsure how much will stick.
“The lifting of telehealth restrictions for the Medicare program was the most important thing the government did to give providers the tools and flexibility to respond to the crisis,” said Dr. Eric Pifer, chief medical officer at MarinHealth in the San Francisco Bay Area. Prior to the pandemic, MarinHealth rarely performed any telehealth services because of the stark pay difference compared to in-person visits, he said.
Peter Banko, CEO of Centennial, Colo.-based Centura Health, said he would love to see payers maintain these telehealth reimbursement levels.
“Regardless of the payment mechanism, I think telehealth is the new normal and is only going to increase,” he said. “It will be hard to get people to come into hospitals and clinics, especially if they are in a vulnerable population.”