Wednesday, September 30, 2020

Specialty telehealth supports chronic disease management and boosts Medicare Advantage value

Since chronic medical conditions are among the largest consumers of healthcare costs, telemedicine and telehealth solutions have emerged as potential cost-effective solutions to improve their management.


Approximately 80% of older adults have at least one chronic disease, and 77% have at least two, hence the urgent need to enhance and support the adoption of telemedicine and digital monitoring among Medicaid and Medicare Advantage (MA) patients. The Center for Medicare and Medicaid Services (CMS) has slowly come around to this realization, and cloud-based telehealth-based remote monitoring programs for managing chronic diseases are now reimbursable by CMS.


Utilizing Telemedicine for Chronic Disease Management


An Association of American Medical Colleges (AAMC) report in 2020 estimated a physician shortage in the United States of over 100,000 providers, distributed relatively evenly between primary and specialty doctors. Compounding the challenge of the physician shortage is the increased burden of chronic medical conditions.

For example, a Milken Institute report indicated that the U.S. health care costs for chronic diseases such as heart disease, cancer, diabetes, and Alzheimer’s disease totaled $1.1 trillion in 2016. When lost economic productivity is included, the total economic impact was $3.7 trillion. This is equivalent to nearly 20 percent of the U.S. gross domestic product.

Telemedicine and telehealth have been associated with improvements in patient’s HbA1c (17%, over 50% of patients)and 70% improvement in cholesterol management, important biomarkers for metabolic/chronic disease management. Telemedicine was also associated with significantly decreased wait times and improved visit attendance for patients with chronic conditions. This improved care led to 75% fewer hospitalizations and cost savings of almost $45,000 per patient per year.

Furthermore, managing a patient’s chronic condition from a distance reduces the need for office visits and in-person consultations, thereby mitigating viral transmission. Healthcare for the elderly and patients with chronic illnesses is being transformed to a virtual, home-based enterprise: a recent study indicated that a majority of MA participants used telemedicine services during the COVID pandemic, with over 90% satisfaction with the experience.

Telehealth and digital technologies are not only being used to help patients achieve long-term self-management of their chronic diseases, they can also facilitate collaboration among providers—an essential component in the management of patients with complicated chronic disease and comorbidities. This approach enhances symptom management and provides a channel to assess and improve patient compliance and adherence to prescribed regimens of care.


Rural Residents Increase Access to Specialized Care


With around 57 million Americans currently living in a rural area, many patients across the country lack adequate access to healthcare facilities and are forced to travel long distances to see their primary care provider or specialist. Individuals suffering from chronic diseases may face additional unique challenges such as a lack of mobility or difficulties sitting in a vehicle over long periods of time. Telemedicine resolves many of these issues, including the elimination of travel expenses, allowing patients to interact with specialty physicians or other providers from the comfort of their own home.


Monitor Patient Lifestyle Changes


As patients living with chronic conditions will benefit from lifestyle modifications, such as dietary changes, smoking cessation, and increased physical fitness, specialty telehealth consultations are critical to monitoring these changes. Digital devices, such as Bluetooth-enabled scales, blood pressure cuffs, and glucometers can monitor disease progression or regression. Physicians can also utilize mobile devices and live video and audio to quickly remind patients to take their medication, eat healthy, or find ways to stay active.



Reducing Hospital Admissions


Inpatient hospitalizations are among the most expensive component of managing patients with chronic diseases. By providing specialists the ability to remotely monitor a patient’s condition, treatment and management can be delivered in a timely and effective manner. This decreases care costs, promotes better care coordination, and reduces stress levels for both patients and families. Physicians can therefore utilize telemedicine to quickly respond to questions regarding medications or treatments and intervene on acute conditions that arise to reduce preventable hospital admissions.


Specialty Telemedicine for Chronic Diseases: Post-COVID-19 Safety


Undoubtedly, there is perhaps no more compelling benefit of telemedicine for chronic disease management than patient and provider safety, which has gained such importance during the COVID-19 pandemic. Specialty telemedicine in particular has been hailed as an imperative for CDM since it provides high quality care while still maintaining appropriate distancing measures, necessary to prevent viral transmission.

This is particularly relevant for MA beneficiaries whose underlying comorbid medical conditions place them at high risk for severe COVID-19 sequelae, yet simultaneously also necessitate relatively frequent medical consultations.

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Tuesday, September 29, 2020

Cloud-based interoperability will accelerate clinical outcomes

There are several factors driving collaboration across the healthcare ecosystem. Consumer demand, the shift to value-based care, and the regulatory push for transparency are fueling the need for seamless integration and data sharing only achieved with cloud-based interoperability. COVID-19 further underscores the importance of a centralized approach, which can more quickly arm the medical community with real-time information to help them fight the pandemic in addition to driving efficiencies and reducing costs in accessing, providing, and paying for healthcare.


The healthcare system has traditionally relied on manual, point-to-point systems to access and share clinical and financial data. Modern healthcare can now automate access to this data through a centralized, secure, and cloud-based infrastructure that adheres to industry standards for exchanging health information. Physicians are increasingly adopting cloud-based interoperability, creating a more connected system that can streamline the healthcare process, which delivers better clinical and financial outcomes and ultimately improves the healthcare experience for all.


Clinical Outcomes and Cloud-Based Interoperability


Cloud-based interoperability enables physicians and their staff to focus on patient care rather than managing overly burdensome administrative work resulting from a fragmented IT infrastructure. In addition to caring for their patients, many physicians are often tasked with managing multiple point-to-point connections to share clinical data with other parties such as labs, referring physicians, and payers. It’s a cumbersome, time-intensive, costly, and often manual process. For example, sharing clinical care data with a payer requires manually retrieving, reviewing, and photocopying millions of patient charts. Physicians must dedicate scarce time and resources to providing a great deal of information and answering questions about patient care. Given that practices typically have more than a dozen payer relationships and a 5-to-1 ratio of support staff to physicians, this antiquated process significantly impacts provider operations and hijacks resources that could otherwise be applied to patient care.

On the clinical side, cloud-based interoperability creates efficiencies for all parties while supporting both patient access and treatment. Individuals have greater access to their own records and those records can be more easily and securely shared among providers or with other parties. This leads to better care coordination, health outcomes, and experiences for patients and business operations for practices.

Public health also benefits from cloud-based interoperability. COVID-19 testing issues brought the need for interoperability into the focus of mainstream media outlets. One of the underlying barriers was the absence of digital processes and continued reliance upon outdated communication technology like fax machines. These issues were also hampering physicians’ ability to find a lab and order a test in a timely manner. Given the wide range of provider organizations ordering tests and the fragmented approach to processing, knowing when results would come back was a guessing game. Cloud-based interoperability allows for a nationwide lab network that helps to coordinate testing and provides physicians with better and more options to identify a lab, order a test, get the results, and initiate care for positive tests, while alleviating worries for patients who test negative.

Interoperability is becoming essential to the modern Electronic Health Record (EHR) as vendors increasingly adopt interoperability standards of the not-for-profit trade association, CommonWell® Health Alliance. As more providers join alliances like CommonWell, there will be a network effect. The more systems that are connected, the more patients, providers, and payers will want to be connected, leading to better clinical and financial outcomes.


Financial Flexibility and Fitness


Physicians can make it easier and more convenient for their patients to pay by adopting cloud-based interoperability solutions. Providers are able to offer a wide range of payment options and methods, which speeds-up collections while also improving patient satisfaction. Cloud-based interoperability optimizes the collections workflow by integrating with major EHR and Health Information Systems (HIS), reducing third-party collections by increasing payments and streamlining vendor management.

Integrating payers into this process through interoperability further enhances utility and efficacy. As mentioned above, physicians typically maintain more than a dozen payer relationships. Each payer has a different process and requires different information when fulfilling claims. As more physicians adopt interoperability and accompanying standards, the payment process will become increasingly consistent and streamlined. Standardization will improve claims payments and strengthen a physicians’ revenue cycle.

Adopting cloud-based interoperability makes business and strategic sense for physicians. The resulting transparency strengthens physicians’ relationships with payers and patients. While it requires a great deal of trust among all parties, interoperability is needed to support other trends including the move to value-based care, the building of systems with much greater transparency, and the rise of virtual care due in part to the COVID-19 healthcare crisis. By adopting cloud-based interoperability, physicians and providers can come to together to realize these clinical and financial benefits sooner. They can create a more patient-centered healthcare system and an experience that is better for everyone.

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Monday, September 28, 2020

Integrating EHRs and telehealth platforms can benefit ambulatory care providers

What was a small spark of interest in telehealth over the past decade quickly ignited in 2020 as the COVID-19 pandemic swept the country. As a result, many ambulatory care providers were forced to quickly pivot and find new, creative ways to connect with and treat patients outside of the four walls of their practice.


While once a fantasy, telehealth now makes this a reality.


From Then to Now: The Rapid Growth in Telehealth


Interestingly, in 2018 MGMA asked healthcare leaders what impact they thought telehealth would have on their organization, and only 48% responded they believed it would be positive, compared to 6% who responded it would be negative. Furthermore, 23% believed it would have no impact, and 23% were unsure.

At the start of 2020, Forrester estimated that only about 24% of U.S. healthcare organizations had virtual care programs. Just a few months later, the entire healthcare landscape dramatically changed. Today, 97% have cited expanding telehealth access and use amid COVID-19. And now, the number of practices relying on telehealth is anticipated to soar by the end of this year – with more than one billion telehealth visits projected, including 900 million related to COVID-19.


Propelling Telehealth in Day-to-Day Practice


Much of this growth can be attributed to government actions addressing the COVID-19 public health emergency. For example, the U.S Department of Health and Human Services took steps to make it easier for providers to offer telehealth services in situations like routine healthcare, such as greater flexibility in HIPAA rules to enable practices to continue offering services like wellness visits, medication consults, eye exams, and mental health counseling. Otherwise, many practices would have had to close their doors during the height of the pandemic.

The Centers for Medicare & Medicaid Services (CMS) also made temporary policy changes, simplifying the process for people enrolled in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) to receive medical care through telehealth services. After CMS announced these changes, many private insurers followed suit, too, further fostering the use of telehealth during the pandemic.

By April 2020, telehealth claims increased 8,336% year-over-year. And within the first three months of COVID, more than nine million Medicare beneficiaries used telehealth services.

Regardless of rules governing privacy and reimbursement, patients and providers are advocating for telehealth moving forward.


Why EHR-Integrated Telehealth Solutions Are Key for Ambulatory Care Providers


For ambulatory care providers, having a telehealth solution integrated with its core EHR is a key component to reducing provider burnout and maximizing the efficiency of the practice. Furthermore, an integrated telehealth solution arms practices with a complete interoperable health-IT solution – which is critically needed to succeed in a post-COVID environment.

While there are hundreds of telehealth platforms on the market today, the benefits of EHR-integrated solutions include:
  • A comprehensive view of the patient – Having a cohesive platform with a single dashboard enables providers to have all patient information convenient in one location, whether they’re being seen in-person or remotely, to make the best possible care decisions.
  • Greater efficiency – Tying these components together eliminates staff having to update the same information in different systems, and minimizes confusion associated with maintaining duplicate records or processes.
  • Responsive reporting and billing – Navigating telehealth billing guidelines and the ever-changing requirements of CMS can be a challenge for practices, so it’s important that reporting and billing processes are flexible and easily adaptable to ensure proper reimbursements and payments.
  • Ability to see more patients – A streamlined workflow, without duplicate processes, frees providers and staff from unnecessary administrative work, enabling them to do more of what they do best: treat and see patients.
  • Increased revenue – As a result of increased patient volumes and greater efficiency, practices will benefit from stronger revenue streams, keeping the practice healthy and viable and thus maintaining business continuity.


By now, we all know that telehealth is here to stay. But in order for this technology to deliver on its true promise, especially as shutdowns and quarantines are nearing their end, today’s providers need virtual care solutions that can be fully implemented and integrated into established workflows, thus enabling an entirely remote patient-provider experience that can deliver on improving outcomes.

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