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Underestimated Value of Telehealth

Implemented correctly, this population health management tool advances patient engagement while cutting costs and reducing readmissions.

With healthcare's emerging focus on value-based care and payments related to proven outcomes, all stakeholders involved in providing patient care are realizing the importance of tools that allow them to capture the full spectrum of how an individual's health condition is progressing.

This idea, whether it is accomplished via patient engagement tactics or remote monitoring, is increasingly accomplished through telehealth technology.

Better than halfway through 2016, it's safe to say that telehealth is healthcare's hottest buzzword, but the effective use of this technology is still largely limited in terms of ROI and improved health results. Telehealth is more than just phone calls. These interactions allow Medicare patients to stay in control of their health while speaking with medical professionals on a regular basis, for example.

If implemented correctly, there is huge potential for healthcare facilities that use telehealth effectively to improve patient engagement while cutting costs and helping to reduce readmission rates.

Essentially, telehealth is a win-win for all those involved:Patients have the role of providing their health data to medical professionals so they are able to make accurate and informed decisions regarding the proper course of treatment, while healthcare professionals are able to be reimbursed for their services. Telehealth, with emphasis on the telephone portion of that word, is increasingly becoming the front line of home care for most PCPs helping to support at-risk patients.

Chronic Care Management

The estimated annual cost of total readmissions for Medicare in 2014 was $26 billion. Of that total, $17 billion was considered "avoidable." As these numbers indicate, there is a clear incentive for healthcare providers to adopt the technology to help keep their patients happy and aging healthily in their homes.  

To gain a better understanding of how providers can use telehealth to increase patient engagement, cut costs, and gather valuable information useful for improving care delivery, one needs to look no further than Medicare's Chronic Care Management Program (CCM).

Over the past year, physicians and a large amount of practices have adopted telehealth CCM as a way to increase patient engagement and help older adults better understand their care. It has been proven that patients suffering from multiple chronic conditions benefit from speaking with medical professionals on a monthly basis to discuss how they are feeling, if they are having success with their treatment plans, or experiencing any pain or discomfort.

At its core, CCM is designed to treat the most expensive Medicare beneficiaries, or those patients who suffer from multiple chronic health problems and disabilities. The number of Americans over the age of 65 is set to double by 2050, with this increase suggesting that the use of telehealth will soon be a crucial method of providing care to older Americans who are aging in their home and don't want to rely on expensive nursing homes and other facilities.

Telehealth allows for these patients to be treated remotely and safely, while fostering an improved care plan, decreased healthcare costs, and a better quality of life.

More Timely Reimbursements

The increase in Medicare patients means that around 15% of most physicians' patients are eligible for the CCM program - providing a valuable opportunity for front-line providers to enhance the care of these at-risk individuals and be reimbursed for doing so. In a time where telemedicine reimbursements are struggling, CCM is able to ensure physicians are paid timely and efficiently for their efforts.

While telehealth is rooted in the idea of extended clinical care, adopting telehealth doesn't necessarily mean that the physicians will be taking on more work. CCM patients are managed by medical professionals who oversee their care plans. Under these professionals, the patients are continuously monitored and matched with the best CCM resources suited for their needs.

Although the patients are not being called by their primary care physicians, the doctors are able to stay up to date on their patients due to real-time information being shared through the EMR. After each completed telehealth call, notes from the medical professionals are delivered directly to the patient's referring provider. Not only does this allow for the Medicare patients to remain in their own homes with their families, it reduces cluttered office visits and unnecessary traveling.

CCM patients not only benefit from remaining in their home, but the telehealth calls are able to answer any questions that the patients may have regarding their health. If a patient is confused about their medication routine or their medical technology is working incorrectly, a quick phone call to their CCM contact is all that is needed to clarify the matter.

Similarly, if a patient is having problems with their walker or wheelchair, they may not feel like it is worth a trip to their PCP, but may be more likely to discuss the issue over a phone call. With CCM, the medical professional can spot these issues and adjust the routine accordingly, using clinical judgment to prevent any complications and a possible negative outcome.

Staying in Touch

Due to their multiple and often serious symptoms, it is crucial for patients with chronic conditions to speak with medical professionals on a monthly basis. In the traditional patient-doctor relationship, it may be weeks or even months in between in-person check-ins; too large of a timeframe to accurately and safely manage the patients' continuous symptoms.

Without these monthly calls, it's easy to see how a patient could incorrectly take their medicine, which is often the fastest path to the nearest emergency department. Instead, monthly check-ins with true clinical value are helping provide more meaningful office visits, which ultimately can keep patients out of urgent care centers or EDs. In 2014, a study published in the Journal of the American Geriatrics Society found that care that was delivered at home saved around 17% in health spending due to the reduction of unnecessary readmissions.

With each monthly telehealth call currently around $8 a month for Medicare patients and the average copay for an emergency room visit around $100, it is easy to see why patients would prefer to speak to medical professionals if they are having any concerns, especially if the patient's issue could have been solved by a quick telehealth call. The call could have saved the patient the cost of an ambulance ride and the ER copay as well as convenience for immobile patients. A total of $96 per year may seem like a high cost for phone calls, but when compared to the possible costs that could add up to an ER visit, it's easy to see why telehealth calls are a better value proposition than a hospital readmission and its associated care.

Better Patient Access

Medicare officials are realizing that patients with multiple chronic conditions may have difficulties caring for themselves, while lacking the mobility to travel to their primary care physicians.

CCM not only can improve the care of elderly patients at home, but also these monthly visits are able to save Medicare money, while providing practices and participating doctors with additional revenue. Chronic care management and telehealth are great examples of Medicare's commitment to treating patients the right way by offering personalized and thoughtful proactive care solutions.

In a nutshell, telehealth programs provide patients with in-depth and personalized care that would they would not receive from yearly checkups or costly emergency room visits. For patients with multiple chronic conditions, recognizing simple factors such as a missed medication or expired bandage could be the difference between a positive outcome and a costly hospital readmission.

With the success that physicians are having with CCM, it's easy to imagine a future where telehealth alleviates post-discharge concerns, allowing for the effective management of each patient population, and ultimately, improved care for all involved.

Nat Findlay is CEO of Hello Health.

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While 'telehealth' here is defined as telephone calls tied into a CCM model, real telehealth can do so much more in CCM. For instance, a remote hub can record and transmit vital signs (either via Bluetooth or USB connection from device or manually entered) to a secure portal--for instance, blood pressure, glucose, weight, PT/INR, peak flow and more. Some of these hubs can also transmit images for wound management or live video consults. And very soon you are going to see how mobile devices, in addition to desktop/laptop, can send the same info online to the same portal.

Disclosure: I work for one of those companies, Viterion Digital Health, and have been in the field of telecare and telehealth for 10 years.

Donna Cusano,  Marketing DirectorAugust 25, 2016
Elmsford, NY




     

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