As millions of Americans seek health services under the Affordable Care Act (ACA), patient demand for these services is expected to exceed medical provider supply. This realization has increased the use of telehealth services as an avenue for providers to offer health education and treatment to their patients outside the traditional office visit. Now telehealth services are expanding further, specifically into care management for complex conditions, such as heart failure, COPD and diabetes.
The appeal of telehealth
Why are telehealth services growing in appeal? For one, telehealth is a convenient and a cost-effective option for payers, employers and members as the focus on improving quality and outcomes continues to increase. These services can deliver additional revenue, reduce costs, enhance the consumer experience and improve outcomes.
More than 10 million consumers have directly benefitted from telehealth services.1 Patients value the convenience and low cost associated with monitoring chronic conditions in the convenience of their home. Providers appreciate the ability of telehealth services to enable continuous outreach with patients managing chronic conditions.
In 2015, the Centers for Medicare and Medicaid Services (CMS) began reimbursing physicians for non-face-to-face complex condition management, at an average rate of $42 per patient per month. With approximately 36 million Medicare patients diagnosed with multiple chronic conditions, billions of dollars in revenue could be generated each year.
Opportunity for health plans
As telehealth continues to grow in popularity with providers and patients, payers should consider offering these services and technology in plan benefits. In doing so, plans can:
- Reduce administrative costs and provide plan members an alternative to costly and unnecessary urgent care and ER visits.
- Improve access to care
- Increase member engagement
- Gain competitive advantage
To review additional resources on the future of telehealth services, along with tips for payers, visit optum.com/ontrend.
1. American Telemedicine Association: Harris Poll on behalf of American Well Corporation from December 1-3, 2014
About the author:
VP Digital Services, Population Health Management
An UHG Innovation Council member, Imad Ahmed leads a product management and development team charged with delivering digital care and coaching platforms to market. This end-to-end remote care management platform utilizes consumer electronics, wireless health devices and the Optum Telehealth Cloud to enable population health to over 20,000 consumers. Optum has been able to deploy regional telehealth systems to help promote continuity of care within provider practices, as well as enable consumers to get healthy, stay healthy and live with an illness.