iPatientCare Blog - How is Telehealth shifting to Demand-Driven Delivery?

How is Telehealth shifting to Demand-Driven Delivery?

In healthcare today, time is the most valuable resource. The practices are providing access to quality healthcare when and where needed. Previously, telehealth was only utilized for the patients who were in remote areas where they had no access to any healthcare facilities. But now telehealth is for all patients who want to waste less time in the emergency ward or waiting room.

What are the benefits of Telehealth?

  1. Applying higher standards of care when diagnosing patients for various illnesses or other health conditions, now patients can expect better outcomes because they have faster access to specialists.
  2. There is a reduction in unnecessary admissions and readmissions due to remote consultations and monitoring, which allows patients to manage health conditions more effectively at home.
  3. Also, the specialists can determine if the patient needs to be moved to another facility or if they can stay where they are; that is closer to the medical support network.
  4. Even when patients are at home, the facility can easily access the important information quickly and efficiently. The patients who are in the facility can also have easy access to their records from specialists, thus improving the level of care.
  5. Help retain the revenues for the facility, when some patients are not required to be moved to a health facility that is not in their network.
  6. Facilities can make the community as a whole, know that these advanced solutions would not be possible without the components of telehealth.
  7. The patients who need expert advice from the providers would miss out on the care without telehealth if the providers were not able to easily reach to their patients.
  8. Being on-call for tele-consulting can be fruitful for the providers as they can earn some incentives in some instances.
  9. There will be no time wasted for the providers on traveling between facilities.
  10. More revenue can be earned by tertiary care facilities if they can quickly identify remote patients who are sure to benefit from being transferred to their facilities.
  11. Tertiary facilities can also assist the under-served facilities by transferring patients to their facilities as another way to incur added revenue.
  12. Telehealth helps save beds, which can be more useful for other patients who need immediate and serious attention to their health.
  13. The specialists avoid making unnecessary admissions, transfers, and readmissions, making the facility more efficient, due to payors having fewer costs when the specialists address to specific patient concerns.
  14. By increasing the number of patients and decreasing the number of providers needed for those patients, the entire health care system can benefit from the telehealth methods.
  15. Having access to the right provider can help a particular patient avoid an adverse health situation.
  16. Access to the providers at the proper time will reduce inefficiencies in overall care, thus benefiting the healthcare system.

Telehealth is now a bridge that fills the large gap that existed between patients and providers. Patients now feel more empowered in keeping their health checkups, and the providers have more freedom to review individual cases as they are having external support from specialists and other providers.

How other Organizations are adopting Telehealth?

As telehealth simplifies the healthcare experience, other organizations are showing more interest in their employees’ health. The organizations are providing virtual care (diagnosis, referrals, labs, prescriptions, advice), and are observing that it has positive effects such as:

  1. Increased productivity
  2. Less absenteeism
  3. Increased employees satisfaction
  4. Improved work-life balance

Most of the providers, payors, and consumers are looking to adapt and connect to health technology.

What is the difference between mHealth and Telehealth?

mHealth is about modern healthcare technologies like telehealth and remote patient monitoring (RPM). While telehealth encompasses all the other technologies and methodologies enabling remote care; mHealth is like a sub-set of the broader ‘telehealth’ pertaining to a specific way to utilize mobile technology like smartphones and tablet to capture one’s own health data, to achieve improved health goals. mHealth is more of a user-directed technology, whereas telehealth is accurately defined as provider-to-patient interaction.

Regardless of the diversity of the definitions, telehealth is rapidly growing. CMS also reimburses providers based on the usage of remote patient monitoring services.

What about reimbursement in Telehealth?

Centers for Medicaid and Medicare services do reimburse healthcare providers for utilizing certain telehealth services and connecting care services that enable providers to manage and coordinate care at home. Providers should make note of new CPT codes and should not miss opportunities for communicating with patients. The telehealth seems to benefit mostly rural providers, but this is not true. Access to care is not a rural issue, it is something patients struggle throughout the country.

The facility is entitled to bill the facility fee, and the remote provider is entitled to bill for the professional services. When submitting the claims, the provider must add a billing code modifier to correctly identify the telehealth service.

For the non-Medicare patients, the reimbursement depends on the location of the patient receiving the services. There is a lack of uniformity when it comes to different states as each state has its own legal policy governing the telehealth services. Each state weighs its services depending on the type of technology they use, the areas of site-of-service and variation regarding private insurers (whether they are obligated to reimburse for the telehealth services).

There is a requirement for most states to cover telehealth services. Some states require private insurers to reimburse for telehealth services at the same rates as the service provided in person. Some states are silent with respect to parity for reimbursement; while other states do have some form of requirement for reimbursing telehealth services. The only thing to keep in mind is the rates of telehealth reimbursement may not exceed the reimbursement rate if the service was provided in person.

What are other factors driving Telehealth?

  1. There is an improvement in data management.
  2. Ensuring that the patient gets the care they are looking for.
  3. There is an increase in reimbursement by the CMS.

Therefore, when conducting within the context of appropriate standards of care, the expanded use of telehealth and telemedicine has an appropriate and efficient means of improving health. Both the providers and patients can benefit from utilizing these telehealth services.


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