Telehealth: the best idea that may never happen

Posted by Michael Renzi, DO, FACP on Mar 7, 2017 11:02:00 AM

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Telehealth is the wave of the future for PHM and VBC—but who’s going to pay?

When it comes to defining the factors that will have the biggest impact on the future of healthcare in the United States, it’s no wonder Telemedicine.jpgthat connected care is among them.  As our technology improves and new devices hit the market seemingly every week, the ability to capitalize on these innovations to improve care delivery and patient engagement is a no-brainer.

But, two questions come up when I talk to my clinical colleagues: Should I offer telehealth services, and how can I pay for them? My answers: yes, and maybe try a tip jar at the front desk.Right now, the payment models simply aren’t set up to incentivize telehealth practices—and when we talk about increasing productivity and improving workflows, that’s a big problem. Of the 18-22 patients I see every day, roughly two-thirds of the visits could be handled just as effectively by a remote connection—and would be a whole lot more efficient. That trend holds industry-wide as well. According to one recent study, 75 percent of in-person visits could be handled by a telehealth solution1.

This is a bigger issue than process and quality improvement. While I am a full believer in value-based care and alternative payment models, promoting remote visits right now would cannibalize my fee-for-service revenue. The only way I can collect a payment is to be in the room with the patient—any care I provide outside of that venue means I do not get reimbursed. It’s an archaic system, and we’ve got to find a way to shift those payments and incentives—but how?

Right now, the physician community should be doing all it can to close the historical gulf that’s existed between providers and payers. The more openly, clearly, and effectively we can communicate with the payer community (and the better we can listen to payers), the more we’ll be able to collaborate to implement payment structures that incentivize innovations like telehealth.

As we look to the future, we need to embrace effective innovations. The primary care provider is situated to be the key influencer on controlling healthcare spending in the United States—and it’s time for the industry as a whole to do more to clear the hurdles in front of those providers to drive true change in care delivery. Until then, great ideas like telehealth will struggle to become part of mainstream primary care.


Michael Renzi, DO, FACPMichael Renzi Headshot_LowRes.jpg

Dr. Renzi, the Chief Medical Officer for Continuum, is a leader in the value-based care world. He is instrumental in developing payer/provider relationships and enabling services across the healthcare spectrum. He provides guidance on programs involving advanced care coordination, practice transformation, patient-centered medical care, healthcare information technology and shared savings reimbursement models. A sought-after speaker and educator, Dr. Renzi presents at several conferences across the country annually.

Topics: payer reimbursement, Telehealth, Telemedicine

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