Telehealth is here to stay, healthcare industry sees immense value in virtual care

Grainne CarlinJune 30, 2020
The Edge Report: Telehealth is here to stay

The COVID-19 pandemic forced the healthcare industry to adapt quickly, embrace change, and accelerate the adoption of telehealth practices for a variety of services.

Providers have reported that telehealth visits have increased 50 to 175 times during the pandemic, and Forrester Research anticipates that virtual appointments in the U.S. will exceed 1 billion in 2020.

Telehealth adoption will likely continue to increase as more payers, providers, and patients realize the immense value of virtual care quality and convenience.

Benefits of Telehealth

Telehealth removes barriers and enhances access to care in areas that typically experience shortages, such as behavioral health. As Fierce Healthcare notes, "One in five adults in the U.S. has a clinically significant mental health or substance use disorder, yet many people do not receive treatment for their problems because of a shortage of mental health providers and lack of access to mental health services."

And, in the time of a global pandemic, access to mental health services is more critical than ever. From healthcare workers, caretakers, to those dealing with job loss and isolation, the mental health impacts of COVID-19 are varied and far-reaching. A Teledoc Health survey found that 47% of the 1,001 respondents experienced a negative effect on their mental health during the pandemic. Further, virtual mental health appointments for patients between 18-30 doubled between March and April 2020.

Industry experts agree that the long-term sustainability of behavioral health integration requires enhanced technologies. Moving forward, telehealth will continue to play a vital role in providing easier, more convenient access to mental health options and services when patients need it most.

Telehealth enables the delivery of care without in-person contact. For many people, especially at-risk and elderly populations, virtual appointments are the most effective and safest way to get answers to their health care needs and access prescription refills and other services.

The flexibility CMS offered to providers to obtain Medicare reimbursement for telehealth during the pandemic caused a surge in telehealth visits. According to Medicare claims data, with 1.3 million members receiving virtual care in the week ending April 18, telehealth services increased more than 11,718% in just six weeks.

While CMS set these current waivers to expire when the public health emergency passes, many lobbying, and industry groups are requesting that CMS extend until the end of 2021. As more groups call for HHS to permanently relax certain restrictions, top health officials are open to exploring possibilities; if this happens, we will continue to see telehealth take on a larger share of the healthcare market.

What it means for payers

COVID-19 demonstrated the need for telehealth and unlocked endless benefits. In just a few short months, health plans across the country have invested in and expanded their telehealth offerings. 

Healthcare Finance reported that telehealth-related claims for privately insured populations increased 4,347% nationally from March 2019 to March 2020, and McKinsey predicts that telehealth could account for up to 20% of all Medicare, Medicaid, and commercial outpatient, office, and home health spend. Furthermore, more than 75% of consumers say they are likely to use telehealth in the future, demonstrating that telehealth is here to stay.

Telehealth supports and enhances the ways consumers can receive high-quality care. Payers should seize this opportunity to modernize their offerings. To remain competitive, health plans must respond to this industry trend, build telehealth into their products and payment models, and create awareness around telehealth offerings to drive growth and close the gap between interest and usage.

According to McKinsey, “Health plans should look to optimize provider networks and accelerate value-based contracting to incentivize telehealth. Align incentives for using telehealth, particularly for chronic patients, with the shift to risk-based payment models.”

The flexibility of HealthEdge’s solutions helps payers stay competitive and respond quickly to changing market dynamics like the increased adoption of telehealth. With HealthEdge, our customers can easily configure new lines of business and payment models, stay focused on innovation, and keep their members healthy.

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