A new partnership between a small Utah health plan and a telemedicine provider may signal the growing acceptance of telemedicine in the payer community.
Arches Health has forged a deal with TruClinic, also based in Salt Lake City, that makes TruClinic's web-based platform available to some 1,000 Utah providers and health plan members inside the Arches Preferred Care Clinics program. More significantly, the independent payer has created 30 CPT codes "specifically for reimbursement of patient-centric care solutions that streamline the channels of care for both the patients and the providers."
Essentially, Arches is creating a payment formula that targets telemedicine, and it's including benefits that many other payers don't cover, like telephone and online consultations, group visits and a wider range of preventive services.
"Arches Health Plan has activated over 30 CPT codes to pay providers to be more proactive and practical in how they treat patients," Arches co-founder Josh Nelson told mHealth News. "Examples include payment for telephone visits, online consultations and group visits, as well as analysis of patient data to proactively identify those needing to be seen, and even to hold care coordination team conferences with family members and other specialists."
"Providers like being paid for activities they know are best for patients, but which are not paid by traditional insurance plans," Nelson added. "Patients like having easier access to their providers, test results, and follow-up questions."
Company officials said they've modeled the two-year-old consumer-oriented and operated health plan with an eye toward payment reform. Telemedicine, in fact, was built into the payer's original business plan, according to Glen Herzberg, a marketing research analyst for the health plan.
"Really, it's just allowing people to access their doctors," he told mHealth News. "From the beginning, we've been dedicated to changing the atmosphere of payment and treatment."
Arches executives have big plans for their new partnership. They're allowing providers to make the service available to non-Arches members until September, and expect to have more than 4,500 providers in their network on the TruClinic platform in time.
TruClinic was launched roughly four years ago by Justin Kahn, and gained a foothold in 2012 in providing a telehealth platform to several Native American tribes in and around Utah. The company also has partnerships with the University of Utah Health Care and Utah Valley University, and more recently joined forces with the Zahra Charity to bring telehealth services to Morocco.
In a 2013 interview with mHealth News, Kahn said his goal was to "provide a service that eliminates as many barriers of entry as possible into telehealth."
For providers, one of the chief barriers is reimbursement. Indeed, Kahn said in a prepared statement that TruClinic is hoping that what Arches accomplishes "will resound across the country," as the plan establishes a spectrum of telemedicine services and best practices
Walgreens to open more health clinics in Texas Chicago Tribune Walgreen Co. said Wednesday it will expand its retail health clinics into the Dallas-Fort Worth metro area, part of a nationwide push to extend its health care offerings.
With news that Richard Branson sees telemedicine as a decent investment opportunity, it raises the question of whether a dominant telemedicine model will emerge. That was one of the observations shared by Katerina Fialkovskaya, co-founder and managing partner at Boston-based OKM Capital.
She welcomed Branson’s entrance into the market last week and noted:
“The flow of investment into the space will certainly accelerate the process and help to figure out the winning model. Whoever is the winner, the benefits for the society, that mobile technology is to bring by disrupting the health care, are incomparable to the social network revolution.”
It’s too early to say which model will win, since familiarity with telemedicine will take some time before it works its way into the mainstream awareness. But here’s a sense of how some companies are approaching telemedicine models.
Web-based and mobile companies like Doctor on Demand, in which Branson invested, provide feedback to patients based on the symptoms they give. They tend to generate revenue from employers interested in whittling down healthcare expenses and whose employees tend to have high out-of-pocket costs. Users tend to get whoever is qualified to provide medical advice in their community. Some also offer the services to consumers for a flat fee, such as $50-$60.
What’s interesting is the scope for specialty medicine in this area such as dermatology. Dermatologist on Call is a direct to consumer mobile platform that lets users take a picture of a rash or mole and send it to the company and receive a response from a dermatologist in three business days. Second opinions are also another part of the model. MDLive recently partnered with Children’s Hospital of Pittsburgh to offer second opinions in pediatric cases. For $3,000 2ndMD customers can speak with two to five specialists, depending on their condition, after providing lab, test results and a physician’s assessment or recommendation for treatment a few days before.
The healthcare kiosk has the feel of stepping into some futuristic pod. HealthSpot and SoloHealth are the dominant companies in this space. HealthSpot users connect with a physician online and tend to play an active role in the exam by using one of a handful of electronic medical devices such as a thermometer, stethoscope, an otoscope to get a better view of an ear and a dermascope to get a better view of a rash or skin problem. Non emergency medicine tends to dominate in telemedicine and kiosks are no exception. Each of the devices transmits an image or reading to the physician on the other side of the screen. It’s formed a joint venture with Cleveland Clinic after doing a pilot of the service for one year which raises some interesting questions about which directions it could go in. It’s also providing it kiosk service through an employer wellness plan by Kaiser Permanente to one of its company clients.
With healthcare kiosks and many of the online models, the physician tends to be someone the patient hasn’t previously met. But the founders of these businesses take the view that access triumphs familiarity. SoloHealth has kiosks in retail sites and lets consumers in high-traffic retail locations monitor their blood pressure, central vision and weight, as well as get a health-risk assessment. Users can identify and contact local physicians. WellPoint and Coinstar are among its investors.
The highest profile national drugstores are still experimenting with how they approach telemedicine through in-store clinics. The furthest along appears to be Rite Aid. It embraces both telemedicine through the in-store clinic and the online experience. Its NowClinic is available at 58 of its stores through a collaboration with UnitedHealthcare’s Optum Health Solutions. It started with nine stores in Detroit in 2011, but now has a presence in stores around Baltimore, Philadelphia and Pittsburgh. In some states providers — doctors or nurse practitioners can prescribe medication based on their diagnosis. But it also offers 24/7 access to providers online. Users log in and complete their contact details and health history. They can also get a copy of the physician’s summary sent to their primary care provider and integrated into their health record.
CVS uses nurse practitioners to provide telemedicine services to patients in the presence of a nurse. Although its initial focus has been rural communities where Medicare tends to reimburse for telehealth care, an increasing number of states require private insurers to cover telemedicine, including California. That’s where CVS is piloting telehealth in 28 states. Walmart is collaborating with Humana to provide telemedicine access in a handful of stores at Humana Health and Well Being Centers.
Following the launch of the first-of-its-kind partnership between group prenatal care and maternal-fetal telemedicine, the percentage of pre-term deliveries and low birth-weight babies continues to be well below baseline rates in target populations.
Taking a hint from on-demand car service Uber, several US companies have developed smartphone apps that bring physicians directly to patients—often for less that it would cost to receive treatment elsewhere.
Too humble to tout an “I told you so,” this pioneering field proved early-on that there can be better and more efficient ways to deliver care than within the brick-and-mortar confines of the healthcare space.
Telemedical treatment has been a tantalizing possibility for many years, for reasons including a failure of health plans to pay for it and too little bandwidth to support it, but those reasons are quickly being trumped by the need for quick, cheap, convenient care.
In fact, according to research by Deloitte, 75 million of 600 million appointments with general practitioners will be via telemedicine channels this year alone.
While one might assume that this influx is coming from traditional primary care practices which are finding their way online, that doesn’t seem to be the case.
Instead,a growing number of entrepreneurial startups are delivering primary care via smart phone and tablet, including Doctor on Demand and HealthTap, which offers videoconferences with PCPs, and options like Healthcare Magic and JustAnswer, which offer consumers the opportunity to get written responses to their healthcare queries from doctors.
Primary care doctors going into direct primary care are also joining the primary care telemedicine revolution; a key part of their business is based on making themselves available for consultation through all channels, including Skype/Facetime/Google Hangout meetings.
To date, most of the thinking about telemedicine have been that it’s an add-on service which is far to one side of the standard provision of primary care. However,with so many consumers paying out of pocket for primary care — and virtual visits typically priced far more cheaply than on-site visits — we may see a new paradigm emerge in which victims of high-deductible plans and the uninsured rely completely on telemedical PCPs.
Rather than being merely a new technical development, I believe that the delivery of primary care via telemedical channels is a new form of ongoing primary care delivery.
It will take some work on the part of the telemedicine companies to sustain long-term relationships with patients, notably the use of an EMR to track ongoing care. And telemedicine PCPs will need to develop new approaches to working with other providers smoothly, as coordination of care will remain important. Health IT companies would be wise to consider robust, unified platforms that allow all of this to happen smoothly.
Regardless, the bottom line is that primary care telemedicine isn’t an intriguing sideline, it’s the birth of a new way to think about financing and delivery of care. Let’s see if traditional providers jump in, or if they let the agile new virtual PCP companies take over.
Retail Clinics Make Being Sick a Little Easier Cape May County Herald (press release) In your travels recently, you may have noticed that retail health clinics are popping up to meet the need for walk-in healthcare in growing communities, like Cape...
The 2014 U.S. Telemedicine Study, the first of HIMSS Analytics' new Essentials Briefs series, tracks a technology strategy that's increasingly finding favor among healthcare providers who are seeking ways to deliver better care to a larger patient populations at lower costs.
"Organizations continue to strive toward a value-based rather than volume-based care model, and many telemedicine technologies can aid in that transition," said HIMSS Analytics Research Director Brendan FitzGerald in a press statement.
Some 46 percent of respondents deploy up to four telemedicine technologies within their organization.
Two-way video/webcam is the most widely used (57.8 percent) and most widely considered (67.1 percent) for those making a telemedicine investment.
This report, which polled both hospitals and physician practices, shows that "organizational needs will vary based upon provider type," FitzGerald said -- pointing out that "the numerous technologies under the telemedicine umbrella will add to the complexity of the market."
This news brief seeks to offer insights into how and why providers are adopting telemedicine tools, exploring topics such as integration with electronic health records, their product wants and needs and their timeline and investment strategies for the next 12 to 24 months.
"As healthcare organizations continue down the path of meeting meaningful use criteria, collaboration and coordination of care is a subject that remains a top concern," according to HIMSS Analytics. "One of the ways healthcare providers, whether large hospitals, rural healthcare settings or physician practices, have been able to increase their care coverage and extend the continuity of care within the market, is to rely on telemedicine technologies."
It’s Monday morning and you wake up with a throbbing headache, stuffy and dizzy, recognizing that the next thing you absolutely positively need to hear is, “The doctor will see you now.” You roll over in bed, pick up your tablet, open your...
Allegheny Health Network in Pittsburgh, Pennsylvania has begun a one-year pilot of a novel telemedicine program, one that will allow first responders to connect select patients to a doctor via an iPad rather than actually transporting them to the hospital. “The benefits of telemedicine to the