Telehealth in the Post. Covid 19 era

The Covid 19 pandemic created many changes in health care.  Perhaps the most obvious one was the accessibility of telehealth caused by rules regarding distancing to prevent further spread of the virus.

Contrary to expectations medical offices and clinics were not overwhelmed with worried patients. Medical facilities quickly organized their office visit procedures, including personal protective equipment, careful scheduling, the use of text messaging to patients indicating when they could enter the office. Reception areas were emptied using the new format.

Online portals, and telemedicine removed the necessity for face-to-face visits unless absolutely necessary. Most practices that had adopted EHR in the past ten years were in good position to make a rapid pivot to the new norm.

CMS and private plans quickly began to reimburse for telehealth as well.  Although this may have increased reimbursements, the offsets for better care, and perhaps sicker patients more than offset this expense.  No facts have been released by insurers as yet.

UnitedHealth’s Optum To Broaden Telehealth Offerings In All 50 States

UnitedHealth Group’s Optum healthcare services unit has launched a virtual care business that is expanding telehealth across the U.S. with more specialized medical care providers and services.

UnitedHealth and Optum executives say they have already launched a product they are calling “Optum Virtual Care” that is live in all 50 U.S. states. The effort is “integrating physical care, virtual care, home care and behavioral care,” executives told analysts on a call with Wall Street analysts last week to discuss the company’s first quarter earnings and outlook for the remainder of 2021.

The move deeper into virtual care could have ramifications for smaller telehealth companies given the access to capital Optum has to expand and given UnitedHealth’s status as the nation’s largest health insurer and as a massive provider of medical care. On Monday, UnitedHealth rival Cigna’s Evernorth healthcare services business took a bigger step in the telehealth arena by closing on its acquisition of MDLive.

To compete, Walmart had to acquire telehealth business

“Walmart has had a slow roll out of physical clinics compared to other retail storefronts; they needed a partner to achieve national presence with their healthcare strategy,” Forrester Principal Analyst Arielle Trzcinski wrote in an email. “Without a comprehensive primary care and chronic care delivery model that met consumers in their homes, they would struggle to gain market share against others like Amazon Care that focus on convenience, as well as cost.”

Scottsdale, Ariz.-based MeMD was founded in 2010 by an ER physician, and offers virtual urgent care and behavioral health services. Currently, MeMD’s visits are priced at $65 for an urgent care visit and $230 for a psychiatry visit, according to its website.

Low-tech but high-value: Don’t stop reimbursing phone-only telehealth visits

At the start of the Covid-19 pandemic, the Centers for Medicare and Medicaid Services and private insurers made the timely decision to rapidly expand coverage for telehealth visits, throwing a lifeline to millions of Americans who needed ongoing medical care despite nationwide stay-at-home orders.

At the time, virtual visits done by video or by telephone were covered at the same rates as conventional, in-person office visits.

Since then, telehealth has become an indispensable part of the U.S. health care system, helping provide patients with safe access to medical care. While video visits have some advantages over telephone visits, they require access to technology, digital literacy, and broadband internet access that are far from ubiquitous. Telehealth access that includes telephone-only visits can help reduce certain health care disparities, as these low-tech visits provide access to essential health care for many whose alternative is no care at all.

A great concern is that payers will revert to old reimbursement restrictions for telemedicine visits. Those rules restricted telehealth visits to remote areas where physician access is limited.

This lifeline may be cut, as CMS has signaled it plans to end reimbursement for telephone-only visits when the public health emergency ends.