Saving a health plan $130 per episode of care, compared to an emergency room visit, thanks in part to new telehealth options, sounds pretty good.
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But when you multiply that by over 20,000 visits- it really begins to add up quickly, says Kim Jacobs, vice president of strategic business & consumer innovation at The UPMC Health Plan.
“Through the strategic expansion of telehealth capabilities, UPMC has been at the fore-front of leveraging technology to give consumers/patients expanded options to access world-class clinical care, while maximizing efficiencies, overcoming provider shortages and decreasing overall cost of care,” adds Natasa Sokolovich, executive director, telehealth at UPMC. As both a payor and a provider, UPMC is ideally positioned to maximize the opportunities that telehealth offers, and which CMS is supporting through additional reimbursement and alternative payment models.
UPMC began offering telehealth services in 2006 with the launch of 24/7 TeleStroke visits to community hospitals where access to a Stroke-certified Neurologist was lacking. Since that time, the expansion of both in-patient and out-patient services has grown to over 60 clinical specialties at more than 106 locations, and direct to patients’ homes via the launch of UPMC AnywhereCare in 2013.
“The opportunity to expand clinical care to patients, regardless of geographic location, supports the UPMC mission and allows us to leverage access to our world-class physicians,” says Sokolovich. UPMC currently offers over 35 clinical specialties via telemedicine, and more than 25,000 patients have accessed on-demand clinical care via the UPMC AnywhereCare platform.
The economic impact of UPMC AnywhereCare visits which are available for low-acuity conditions, like fever, cold & cough, sinusitis, flu and other common ailments that often result in an urgent care, emergency room or retail visit, is regularly monitored and analyzed by the UPMC Health Plan economic analytics team.
The initial analysis compared the use of an AnywhereCare on-line, virtual visit with the cost of an Emergency Department, urgent care, retail clinic, or primary care office visit and showed a potential savings of $86.64 per episode of care. As the cost of the “brick and mortar” care options continue to increase, the cost savings potential has increased, with the most recent economic analysis showing a cost savings of $131.71 per episode of care.
In addition, consumers and providers consistently rate their experience with the AnywhereCare virtual visit as a 4.8 to 4.9 out of 5 stars. Thus, you can quickly see how educating consumers about the option to access UPMC AnywhereCare is both a consumer and provider/payor satisfier.
For Jacobs and Sokolovich, who have been collaborating to strategically expand innovative virtual services for UPMC Health Plan members, patients and the provider and member network, it’s been exciting to prioritize the many potential telehealth opportunities to maximize impact and return on investment.
“We are fortunate to be part of the transformation of healthcare and are committed to continuing to identify innovative ways that expand and empower consumers to manage their well-being and access appropriate treatment,” says Jacobs.
Both Jacobs and Sokolovich look forward to sharing their insights, outcome metrics, and vision about the future of healthcare during their session, “Maximizing the Telehealth Opportunity across an Integrated Delivery System,” at the Telemed Leadership Forum 2019 beginning April 3 in Washington, D.C.
Over the past dozen years, UPMC has compiled an impressive first-in-class history, rich with telehealth milestones, including:
- 2006-2009: exploring and implementing tele-stroke, tele-psych and tele-derm.
- 2011-2012: pre-& post-operative visits, health plan employee on-site care, physical medicine and rehab
- 2012-2103: pediatric specialty, expanded inpatient and outpatient dermatology, virtual multi-specialty tele-consult centers
- 2013: UMPC AnywhereCare, 24/7 online virtual visits, tele-skilled nursing facility visits, in-patient and out-patient specialty services expansion, tele-maternal fetal medicine, surgical oncology/breast visits, infectious disease visits, telecardiac visits
- 2014-2015: expanded, 24/7 on-line eDermatology visits, expanded sub-specialty visits across adult and pediatric Services, transplant behavioral & nutrition counseling
- 2016-2017: online chronic care visits, remote monitoring, tele-consult center location expansion, integrated on-demand specialty visits through PCP practices
- UPMC continues to achieve extraordinary growth in telehealth, with over 250,000 telemedicine visits completed since inception and over 25,000 direct-to-consumer UPMC AnywhereCare visits.
While UPMC continues to analyze the outcomes of telehealth, the positive impact for patients is evident. Through patient satisfaction surveys, patients consistently rate their telemedicine experience as very high. More than 30 percent responded that if telemedicine was not available, they would have forgone care, Sokolovich shares.
“When you look at the population of patients that have access to specialists via telemedicine, you recognize that many of these patients have multiple, chronic conditions,” she says. “These are the patients that really need to see their provider regularly so that they don’t end up with an acute episodic event that ends up in the emergency department or as an avoidable admission to the Hospital,” she says.
It’s not just UPMC calling itself a leader in the telehealth technology revolution. Last July it was named one of the nation’s “Most Wired” health systems by the American Hospital Association’s (AHA) Health Forum, continuing its 19-year run on the annual list. The Health Care’s Most Wired survey measures information technology use and adoption among hospitals nationwide and examines how they are leveraging technology—including data analytic tools, telehealth systems and remote monitoring—to improve performance and value for patients.
The survey lauded UPMC’s commitment to telehealth in several areas. Over the past five years, UPMC has invested more than $1.5 billion in technology to support clinical excellence and administrative efficiency. UPMC is one of the nation’s earliest and most sophisticated users of electronic medical records (EMRs). More than a dozen UPMC hospitals, as well as UPMC outpatient facilities, are at the highest levels of EMR use, as measured by the Healthcare Information and Management Systems Society Analytics.
For Jacobs, Sokolovich and UPMC, the future looks bright. “We are focused on helping populations through a variety of services that include education, lifestyle and consumer-facing options to better manage each individual’s health journey,” says Jacobs.
Harnessing the power of telehealth is a key component.