The Pulse

The Future of Telehealth in the US

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When the coronavirus hit the United States, there were two situations – the COVID hospitals were overwhelmed by the number of cases whereas the non-COVID hospitals either saw a significant drop in the number of office visits or a complete cease. With the lockdown encouraging people to stay at home and feat patients who weren’t willing to risk exposing themselves to the virus, the healthcare sector of the country was definitely threatened. But, with telehealth, the industry took a turn for the better. Now, the industry is growing at an accelerated rate all over the country.

According to a report published by Fortune Business Insights, over the years of 2019 to 2026, the market of telehealth is expected to grow at a 14.9% CAGR. More and more healthcare facilities and hospitals are bringing in the technology to set up telehealth services. The telehealth industry has the potential to improve patient outreach, reduce healthcare costs, and change the way doctors treat patients. Over the next few years, the technology is going to get more advanced which will accelerate the influence it has on the healthcare sector. There will be new programs and devices created to help the doctor better treat their patient. In fact, in the coming months, several states are set to vote on impactful telehealth legislation.

Increasing demand for telehealth services

As more and more people are suffering from long-term chronic diseases, the telehealth industry has increased in popularity not only in the US but all over the world. According to the US National Center for Health Statistics, about 40 million Americans have to limit their usual activities because they are suffering from one or more chronic diseases. In 2019, about 133 million Americans were affected by chronic diseases that represented about 40% of the total population. In the coming years, this number is only going to increase.

Since such individuals have to limit their daily activities, visiting the doctor for an in-person appointment can be troublesome. Care providers will be able to monitor the patients better as their condition changes while making sure that they are comfortable at their homes. Also, with the increase in the number of patients suffering from chronic diseases, the demand for healthcare providers has increased as well. Thanks to the telehealth industry, healthcare professionals can manage their patients better, reduce last-minute cancellations and no-shows, reduce costs, and improve efficiency.

But, the significant increase in the use of telehealth services is because of the coronavirus pandemic. Because of the virus, Centers for Medicare & Medicaid Services changed their Medicare payment policies for reimbursing the telehealth appointments for a wide range of care. Some restrictions on the Health Insurance Portability and Accountability Act (HIPAA) were loosed temporarily so that doctors were able to communicate easily with the patients through the device of their choosing. Before the pandemic, telehealth visits were reimbursed by Medicare only for limited circumstances like if the patient lived in a rural area with little to no access to care. As per the changes, the patients didn’t have to use the clunky HIPAA-compliant platforms for the telehealth appointments. Instead, they could use their smartphones which increased consumer convenience. Many private payers followed the lead of Medicare and altered their reimbursement policies.

The future of telehealth

Telehealth is a disruptive healthcare innovation. Because of the pandemic, it is o at the forefront of the healthcare landscape transformation. According to the United States Department of Health and Human Services, from February 2020 to April 2020, telehealth grew from about 1% of primary care visits to 43.5%. Thanks to the current trajectory of the industry and the rapid adoption rate, this industry has the potential to completely redefine the way healthcare systems operate, manage costs, and deliver care. Here are a few possible ways in which the telehealth industry can change the future of healthcare.

  • Telehealth offered as a standard service across all settings

Now that patients have grown accustomed to the level of ease and accessibility offered by telehealth, there is no way to go back. Over the past decade, telehealth saw steady growth. But, because of the pandemic, its adoption skyrocketed. This continued growth of the telehealth industry will be sustained in the future. The common thread for this sustainability is the easier access to healthcare that will drive growth and generate confidence.

  • Patients will use telehealth access for choosing hospitals, health systems, and providers

If a patient feels that the medical care that they are receiving through telehealth is good, if not better than an in-person, routine visit, they won’t endure those long wait times at the hospitals. After all, if they can get the same care from the safety and comfort of their home, why wouldn’t they avoid an in-person visit. The telehealth industry has the potential of redefining the expectations of the patients in all facets of healthcare.

Now that patients have grown accustomed to online healthcare, hospitals and health systems that don’t offer telehealth access will see a decrease in patient volumes as they will choose providers offering telehealth. Even if the system has been a naysayer to the disruptive technology, they will be forced to add telehealth services to their offerings. Telehealth provides a high level of access to healthcare and hospitals that don’t embrace this change will see a decline.

  • Medical facilities that offer telehealth services will see an increase in their revenue and growth

Patients will now request telehealth. During the pandemic, there was a significant increase in business for hospitals that offered the service because a lot of hospitals didn’t offer telehealth services or were slower to adopt. Because of the COVID-19, people were avoiding regular healthcare visits which resulted in hospitals experiencing a major drop in their patient volumes and revenue. According to AHA, US hospitals suffered a loss of about $404.6 billion from March 2020 to June 2020 alone. In the future, telehealth will be a major revenue source that will safeguard hospitals against future troughs.

  • Telemedicine will be an efficient way for preventative care

As per the CDC, about 75% of the United States healthcare spending is from chronic diseases that can be avoided through preventative care. By providing convenient access to specialists for faster diagnosis, follow-up care, and telehealth treatment, hospitals will be able to demonstrate fewer complications, readmissions, inpatient stays, and reduced higher-cost services and treatments. The aim of future healthcare is to encourage preventative care so that adjustments can be made early on. Telehealth can happen to implement this in a time-effective and cost-effective manner.

  • Easy access to specialists that reduced the wait times at a hospital

As the telehealth industry continues to grow, specialty centers will be created where hospitals can call in and access a network of physicians 24/7 who are experts in their fields. With such a level of access to physician specialties, the hospitals will offer expanded access to focused care to their patients. This will improve the patient experience and decrease the cost of hiring staff full-time. Currently, doctors have to tell a patient to contact a neurologist. But, with telehealth, the doctor will be able to connect to a neurologist immediately and discuss the case.

As technological innovations continue to evolve the expectations of the patients and the healthcare industry, preparation is becoming more critical. Telehealth is easier to adopt and will be staying for a long time.

Congress and telehealth

Even though telehealth has been the perfect solution for some of the challenges created by the pandemic, there is a lot that Congress will have to discuss before making permanent changes to telehealth reimbursement. Congress might not offer full, permanent coverage for telehealth services, but trying to cover it beyond the PHE (public health emergency) and studying the impact it has on quality, cost, and utilization will go a long way. There is no concrete evidence supporting the fact that telehealth offers the same level of quality service as the hands-on approach. In areas like behavioral health that do not require a physical examination and the patients might be comfortable not being in the hospital, it will be easier to sell to Congress for more telehealth. This also works for chronic care management that requires only a simple check-in.

So, what will happen to the telehealth industry once the PHE is over in all the states? Will telehealth have the same appeal?

Some experts suggest that instead of dialing up your physician on your smartphone or making a Zoom call, patients will have to use HIPAA-compliant platforms. This will affect the degree of convenience offered to the customers by the telehealth industry. Another issue is the Medicare population that prefers to get a hands-on examination from their doctor.

Congressional leaders who already spoke about the concerns they have regarding the increasing healthcare costs might argue that setting up a convenience telehealth service is unaffordable. One of the main reasons why Medicare hadn’t included telehealth in the past is the concern that with broad coverage and the increased level of convenience, there will be an increase in the volume of unnecessary care. The Congressional Budget Office thinks that telehealth will drive up the costs of the Medicare program to the government. However, the other side of this is that if preventative care becomes more convenient, it will help patients stay out of the hospital and save money in the long run.

Even if the telehealth policy changes are made permanent by Congress, the reimbursement rates will be most likely less for virtual visits. The pandemic boosted the use of telehealth services by patients as well as physicians. However, the unknowns regarding the long-term patient enthusiasm and reimbursement can make telehealth a challenging endeavor for practices, especially the cash-strapped ones.

Once the pandemic is over the situation goes back to normal, it is possible that there will be a decline in the use of telehealth services. Patients will be willing to go back to the clinic. However, things will never be the same. There are a lot of younger patients who want virtual care. In the past year, all generations used telehealth to avail healthcare services. And even though they connect to their doctors through video, they are connected to them. There is no denying that the future of telehealth services is dependent on the reimbursement for general acceptance.

Physicians cannot ignore the telehealth services as they will play a crucial role in offering value-based care. In the coming years, telehealth will become an integral part of the healthcare industry. Primary care physicians who want their patients to have better access to healthcare and who are willing to invest in value-based initiatives, need to take a chance at telehealth services.

Because of the pandemic fear and the changes in the payment policies, there was a significant increase in the demand for telehealth services. Practices that already had telehealth capabilities ramped up their capacity quickly and practices that didn’t have it, installed the technology for conducting remote visits. As per the 2020 Telehealth-EHR survey conducted by Medical Economics, over 77% of doctors used telehealth for the first time after the pandemic hit the country. It became the lifeline for medical practices. Doctors and patients embraced the technology as well as the convenience it offered. The pandemic proved that telehealth is capable of becoming an integral part of practices that can increase patient volumes. In fact, the advances made in the field of telehealth can be considered as the silver lining to the pandemic.

But, now that the intensity of the pandemic has reduced and the lockdown has been lifted, many are questioning the future of telehealth. The number of telehealth visits has come down significantly, even though the Medicare payment policies are still in place. Patients are shifting back to the in-office visits. When the PHE (public health emergency) ends, the changes that made telehealth such a viable option will end as well. In order to ensure the future of the telehealth industry, it is crucial to have a workable reimbursement structure supporting it. Congress will have to take steps at the federal level to ensure the growth of the field.

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