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What’s on the Horizon for Telehealth? Growth, Change and a Hard Look at Efficiency


In our recent Healthcare Consumer Engagement Forecast, we predicted that telehealth is absolutely here to stay, but considerable transitions lie ahead in terms of growth, infrastructure and scope.

Out of pandemic necessity, the adoption of all types of telehealth has already increased dramatically. Around-the-clock telephonic nurse advice has become invaluable. Many individuals are trying on-demand virtual physician consults for the first time. Provider practices are embracing telemedicine.

Will this mean a slow and steady continued growth of telehealth? Let’s break down our thoughts about telehealth and its emerging role as an integral part of healthcare delivery strategies.

Consumer use of on-demand, 24/7 telehealth in particular will continue to increase—and expand to other areas of on-demand care.

Once consumers experience the convenience of telehealth for appropriate kinds of care, there’s little impetus to go back to the way things were. All signs point to increased adoption—but not at the rate experienced in March through May 2020. After the initial spring surge, utilization of on-demand Virtual Clinics has continued to see spikes; some of our clients at Carenet Health have experienced double-digit percentage growth in use over last year.

However, an August 2020 report found the acceleration of telehealth adoption, including on-demand urgent care, could mean that $250 billion of current U.S. healthcare spending will soon be virtualized. Plus, we already know that 24/7 telehealth can deliver cost-savings for both the patient and the payer due to unnecessary care avoidance— offering further incentive.

That’s why we expect to see further expansion and healthcare consumer interest in areas like:

To support further growth, the industry will need to make some changes, though—including moving away from a one-size-fits-all mindset. Not everyone will want to see their dermatologist via telehealth about an uncomfortable skin infection, for instance, but are fine interacting about a simple rash via virtual care. Not all telehealth will need to be video-based, which will solve for connectivity and user technical limitations; in fact, audio, email/portal exchanges and other channel options may be adequate.

Different needs and likes among populations and healthcare needs will need to help drive the patient-centric options and changes needed.

Consumer education, encouragement and assistance will be needed to sustain telehealth growth.

A recent poll showed that 80% of consumers who have had a telehealth visit would choose to have another. Generation Z and millennials in particular are eager to continue with virtual care at 86% and 83% respectively. A large portion (88%) of those with chronic disease plan to continue, as well.

On the other hand, baby boomers may need more support to reach that level of optimism. The 2020 National Poll on Healthy Aging found that not all seniors view virtual care as an adequate substitute for in-office care. Gender also plays a role; men are more likely to use telehealth today than women.

Research from J.D. Power released in October 2020 found high consumer awareness of telehealth (75%), but more than half (54%) of consumers citing a lack of understanding whether their health plan covers telehealth services.

Payers, providers and telehealth partners will need to work together to keep the momentum going, and to educate and support consumers.

In particular, the industry will need to consider response strategies that help bridge the gap between interest and successful use of telehealth by seniors. A recent study by Harvard Business School found that seniors who have impairments related to vision or hearing can struggle with telehealth and may benefit from devices provided by their providers or payers. Others may need one-on-one training.  (Some great ideas are covered in this Harvard Business Review article.)

Costs—who pays for what kinds of telehealth and how much—will need attention.

The recent news from CMS about the finalization of the Physician Fee Schedule, which includes an addition of 144 telehealth services covered by Medicare, marks a pivotal moment for virtual care. Many states are also working toward improving telehealth reimbursement policies. A report from the Center for Connected Health Policy shows that all 50 states and the District of Columbia have some form of Medicaid reimbursement for telehealth in their public program. However, most industry associations agree more action is needed.

In addition, commercial and Medicare Advantage plans in particular, will need to consider lowering some telehealth copays or even eliminating them for consumers. Traditional healthcare organizations will soon encounter rising competition from new and non-traditional players that will offer free or low-cost virtual care opportunities.

Healthcare consumers will have their say, too. A study published in July found that 50% of patients surveyed said they would consider changing providers if affordable and convenient telehealth wasn’t offered. More than 20 percent said they would access telehealth on a limited basis even if their insurance didn’t cover it. Medicare Advantage plan purchasers have also indicated telehealth coverage was important to them during enrollment this fall.

Telehealth—when smartly integrated with other services—will continue to reduce overall costs for the healthcare system.

Any time a patient can use on-demand telehealth versus in-person care (emergency, urgent, primary office care) for an appropriate health need, payers, risk-based providers and their members save money. Placing a registered nurse in front of on-demand physician consults—the Carenet model—can save additional money, as treatment guidance by an RN costs less than care from a licensed physician.

Nurses can triage nearly 700 adult and pediatric conditions, and our estimates show that a “nurse first” approach can save healthcare organizations up to 67% over a direct-to-econsult infrastructure. This type of approach may also serve as a gatekeeper for appropriate use of telehealth and fraud prevention.

Telehealth will be especially important for organizations interested in unnecessary emergency care visit avoidance. Each time a patient enters the emergency department (ED) with a condition that can be treated in a primary care setting, it comes at an average cost of $2,032 to the healthcare system, according to an analysis published by UnitedHealth Group.

Taking it a step further, inpatient admissions that often result from an ED visit—up to 18% often do, says the Emergency Department Benchmarking Alliance—could also be avoided with a more robust telehealth infrastructure. (The average cost of an inpatient admission now exceeds $22,000, according to this study.)

Progress will ultimately come down to the patient experience.

Yes, the pandemic pretty much forced telehealth into the spotlight. And yes, the future seems bright—with innovations, investments and improvements on the horizon. But like any other service in the modern world, user experience will eventually determine how the future of virtual care plays out.

Will healthcare disruptors like Amazon, which understand consumerism better than most, set the bar? Will payers and providers partner in new ways that benefit the virtual experience for their patients and members?

As your healthcare organization plans for the future amidst continued uncertainty, it will be critical to focus on that patient experience. Those who do, and who can differentiate their services, will be in the best position a year from now.

To read more predictions from Carenet Health engagement experts, download our complete forecast. To learn why Carenet is considered among the best nurse triage and Virtual Clinic telehealth vendors, contact us today.


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