Ma­jor-player health sys­tems look to broaden tele­health’s band­width

Modern Healthcare - - NEWS - By Beth Kutscher

Com­mu­nity Health Sys­tems’ widereach­ing push into telemedicine sig­nals grow­ing de­mand for re­mote tech­nol­ogy that de­liv­ers lower costs and con­ve­nient ac­cess to care.

The Franklin, Tenn.-based chain, which runs more hos­pi­tals than any other U.S. health­care com­pany, has a non-ur­ban fo­cus and pre­vi­ously used telemedicine to pro­vide spe­cialty ser­vices to its pa­tients. But a new part­ner­ship with Amer­i­can Well, called Vir­tu­alHealth Now, will al­low pa­tients to ac­cess ur­gent-care ser­vices 24/7 in at least four states.

A grow­ing num­ber of health sys­tems are be­gin­ning to use the tech­nol­ogy not only to link ru­ral hos­pi­tals with ter­tiary-care fa­cil­i­ties, but also to pro­vide on­go­ing chronic dis­ease man­age­ment. Still, tele­health’s adop­tion re­mains com­pli­cated by reg­u­la­tory, fi­nan­cial and ad­min­is­tra­tive bar­ri­ers. Al­though many states, in­clud­ing Min­nesota and New York, have in­tro­duced or passed leg­is­la­tion in the past year to in­crease in­sur­ance cov­er­age for telemedicine vis­its, oth­ers—no­tably Texas—are mov­ing in the op­po­site di­rec­tion. A new Texas rule re­quires pa­tients to have an in-per­son provider visit be­fore they can use telemedicine tech­nolo­gies.

But those bar­ri­ers may fall away as large play­ers adopt tele­health ser­vices.

“What we’ve seen in the last two to three years is that providers of all types are think­ing, ‘How do we do more with less?’ ” said Danielle Russella, pres­i­dent of cus­tomer so­lu­tions at Amer­i­can Well. The Bos­ton-based com­pany pro­vides the mo­bile and Web plat­forms for tele­health pro­grams launched by Com­mu­nity and sev­eral other ma­jor health sys­tems, in­clud­ing the Cleve­land Clinic and Salt Lake City-based In­ter­moun­tain Health­care. “For us, it’s been kind of ex­plo­sive,” she said.

Al­lianceHealth Ok­la­homa and Rock­wood Health Sys­tem in Spokane, Wash., are Com­mu­nity’s first net­work hos­pi­tals to in­tro­duce tele­health ser- vices. In those mar­kets, pa­tients will be able to see a doc­tor through their smart­phone, com­puter or tablet, and the tech­nol­ogy can link di­rectly to their elec­tronic health records. Com­mu­nity also plans to add tele­health ser­vices in Ari­zona and Penn­syl­va­nia.

The mar­ket for telemedicine is pro­jected to grow at a rate of more than 50% a year—bal­loon­ing from $240 mil­lion in 2013 to $1.9 bil­lion by 2018, ac­cord­ing to IHS, a data and an­a­lyt­ics firm.

Health sys­tems are be­com­ing in­creas­ingly in­ter­ested in tele­health ser­vices as they en­ter more cap­i­tated pay­ment con­tracts and start to act more like health in­sur­ers, said Bryan Cote, man­ag­ing di­rec­tor at Berke­ley Re­search Group.

“This is an im­por­tant com­po­nent to our pri­mary-care strat­egy,” said Dr. Lynn Si­mon, Com­mu­nity’s chief qual­ity of­fi­cer. “Con­sumers want ac­cess and they want it to be con­ve­nient.”

Com­mu­nity al­ready uses tele­health in spe­cial­ties such as neu­rol­ogy, in­ten­sive care and home health, Si­mon said. But its lat­est part­ner­ship will pro­vide more ac­cess points for both cur­rent and new pa­tients. Ul­ti­mately, the sys­tem will of­fer sim­i­lar ser­vices for be­hav­ioral health and chronic dis­ease man­age­ment, and the plat­form may also be used to mon­i­tor newly dis­charged pa­tients as a way to pre­vent read­mis­sions.

The sys­tem also plans to of­fer tele­health ser­vices as part of its part­ner­ships with em­ploy­ers. It is work­ing to set up tele­health kiosks at work­sites, par­tic­u­larly in lo­ca­tions where work­ers don’t have tra­di­tional of­fice-based jobs, Russella said.

Con­sumers will pay a $39 fee for the ser­vice, but Com­mu­nity hopes that its re­la­tion­ships with em­ploy­ers and health plans will en­cour­age ser­vice charges to be off­set for some users.

“A big part of this is, how are the pay­ments made and is there par­ity with in-per­son vis­its,” said Mike Simmons, CEO of CredSim­ple, which of­fers cre­den­tial­ing soft­ware for providers. About half of CredSim­ple’s clients are tele­health com­pa­nies. “That pay­ment par­ity is hugely im­por­tant,” he said.

Some telemedicine firms are seek­ing cer­ti­fi­ca­tion from cre­den­tial­ing bod­ies such as the Na­tional Com­mit­tee for Qual­ity As­sur­ance as a way to gain a com­pet­i­tive ad­van­tage. “That’s one of the bot­tle­necks—how do you get the provider to be ac­cepted by the in­sur­ance provider?” Simmons said.

In re­sponse to the litany of re­quests they’re re­ceiv­ing from providers that want to of­fer tele­health ser­vices, com­mer­cial health in­sur­ers are start­ing to set up task forces, Cote said.

An Oc­to­ber sur­vey from An­them and the Amer­i­can Acad­emy of Fam­ily Physi­cians found that about 15% of pri­mary-care doc­tors had used some form of telemedicine tech­nol­ogy over the past year, but close to 90% said they would be more in­ter­ested if they got paid for it.

“What we’ve seen in the last two to three years is that providers of all types are think­ing, ‘How do we do more with less?’ ”

DANIELLE RUSSELLA, Pres­i­dent of cus­tomer so­lu­tions Amer­i­can Well

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