Practice Notes

Nine things you should know about telehealth, from American Well

by Cassie Dormond

Over the past few months, we've been inundated with member questions about telehealth. What better way to get some answers than to go straight to the source?

One of our members, American Well is a telehealth company that works with health systems, medical groups, and individual providers to offer video visits to patients. American Well has been a leaders in the space since 2006, so we hopped on the phone with their Vice President of Marketing, Chris Storer to pick his brain about the industry. Here’s what we learned.

Nine insights from American Well

1. The birth of health system-provided telehealth is a relatively new phenomenon. The initial wave of inquiries from health systems began at the end of 2012 and early 2013. Since then, the telehealth industry has experienced tremendous growth.

Chris notes that there is a significant first-mover advantage in developing telehealth capabilities. In effect, a health system can “leapfrog” retail threats by offering competitively priced, convenient telehealth care to new patients. And, the affiliation with the treating telehealth doctor is a way for health systems to establish a brand connection with a new patient.

2. Telehealth offers a multi-faceted value proposition. Chris told us that their health system partners typically use the service to target some combination of: consumer preferences, quality of patient transitions, and keeping patients out of the emergency department. The end goal of a telehealth offering depends on a health system’s strategies and reimbursement environment.

For example, Accountable Care Organizations and Patient-Centered Medical Homes are often interested in telehealth for population health management as a mechanism for surrounding patients with a suite of clinical services that prevent unnecessary emergency department admissions.

3. American patients are ready for virtual visits. Chris shared results from a nationally-projectable survey that American Well ran with Harris Poll in December 2014 showing that 64% of all consumers are willing to try a video visit in place of an in-person visit. While millennials were the most likely age group to be interested in using video visits (74%), interest remains high across age groups (35-44=70%, 45-64=64%, 65+=41%). The survey also found that geography was not an indicator of interest, with little variance across the country (63-65%).

4. As it turns out, doctors are ready for telehealth, too. American Well ran a survey of more than 2,000 physicians in May 2015 and found that most doctors are willing to see a patient via video. Coupled with patient interest, this is a welcome bellwether for health systems looking to broadly deploy telehealth system-wide. The results of the study—Telehealth Index: 2015 Physician Survey—will be published by American Well in June.

5. Telehealth is gaining significant momentum in clinical permissibility. In early 2013, telehealth consults and prescribing (with the exception of controlled substances) was permissible in only about a third of the country. This year, there are 41 states plus Washington, D.C., where telehealth can be used to establish a physician-patient relationship and consultations and prescribing can occur. In addition, only three states deny telehealth consultations without a prior in-person relationship.

6. Payer reimbursement is also on the upswing. Today, 24 states and Washington, D.C., mandate reimbursement for commercially-provided telehealth services. In 2014, Medicare telehealth reimbursements hit their highest level to date at $13.9 million. Private payers like UnitedHealthcare and Anthem are also announcing coverage of telehealth video visits for larger sectors of their self-funded employers, employer-sponsored, and individual plan participants.

The time for telehealth is now. So what's the holdup?

7. Patients are most likely to utilize telehealth services if they are priced at slightly less than a traditional visit with a primary care provider. Interestingly, utilization tends to decrease if the service is free. Putting a price on the service highlights its value; and, as Chris points out, “Americans aren’t used to getting things for free, especially health care.”

8. Provider-to-provider consults represent the newest telehealth functionality and have notable implications for increasing in-network referrals. A treating provider can use the telehealth app to find available providers of a particular specialty within their network and connect immediately for live video visits. This makes in-network referrals convenient and seamless, and also allows for greater efficiencies within the health system.

9. Provider participation is the next key to unlocking telehealth adoption. With health systems recognizing the value of virtual visits across the care continuum and consumers now ready to embrace telehealth, making telehealth convenient for clinicians is critical to its evolution. Chris discussed the company’s significant focus on developing mobile apps for providers that allow clinicians to manage their telehealth practice and have live video visits on their smartphones and tablets.

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