Telemedicine as a revenue generator: Big ideas from Beebe Healthcare CEO Dr. David Tam

When David Tam, MD, joined Lewes, Del.-based Beebe Healthcare as CEO in February, one of his top priorities was examining the system's telehealth program and finding ways to optimize it.

In the following weeks, as the pandemic hit, Dr. Tam's focus on telehealth became even more urgent. CMS and commercial payers lifted telehealth restrictions during the pandemic to allow all members access to virtual care and to pay the same rates as in-person care. CMS has not yet announced permanent changes to the telehealth program, and rolling back some of the benefits or pay rates is a real possibility. But that won't stop many organizations from moving forward with their telemedicine initiatives, and Dr. Tam sees revenue-generating possibilities with the expanded services.

Here, Dr. Tam discusses Beebe Healthcare's telehealth strategy and where there will be the best opportunities for strategic growth in the coming years.

Question: Do you have a plan in place for how you will move forward with telehealth if reimbursement rates drop?

Dr. David Tam: We are very grateful that CMS made those changes. I just got to this job three months ago, right when the pandemic started, and even then I was looking at where we are at Beebe Healthcare with telemedicine and knew that telemedicine was going to be one of our cornerstones for the expansion of our platform to take care of patients throughout the county. Even if the CMS rates change back to where they were before, Beebe Healthcare is strategically focusing on continuing to expand our telemedicine functionality for the people of this county.

My goal is to expand telehealth. There are so many things we need to do in our market, which is a very diverse area of wealthy people along the coast as well as more vulnerable populations further inland as we get into agriculture, so having the ability to do more advanced telemedicine is critical to our mission of taking care of everyone in the county.

Q: From the financial perspective, if the reimbursement rates are rolled back, the health system may end up performing a larger percentage of virtual visits that would have lower reimbursement rates. Are there ways you are retooling your plan for strategic growth based on that possibility?

DT: To improve our financial status as a result of addressing telemedicine, I think of telemedicine as a revenue generator as well as serving the community, especially as we advance in the technology. Number two, I think it will actually improve our ability to get secondary services and therefore enhance our revenue in terms of testing, imaging capability and other ancillary services because we are really talking about increasing our ability to see more patients. We have so many people here that live in the county that may not have transportation or may have language barriers, and that is how telemedicine can really play a significant role to reach out to patients that we have never had a chance to reach out to before and take care of. That will generate secondary revenue in a variety of different ways. This is a way to enhance our revenue generation even if the CMS reimbursement changes back to where they were before.

Q: How do you see telehealth expanding further in the future? What do you anticipate you will be able to offer going forward that you don't do today?

DT: Number one, I think there is a greater opportunity with the new technical advancements that we have in imagery in terms of optics to look at things like specialty services, with the right platform. Telemedicine isn't just your iPhone or your smartphone; it can be a remote service that allows for better cameras and lighting, you can do things like dermatology or neurology and mental health. There are a lot of functions that expand the capacity of specialty services, not just primary care.

The second thing I think is that with a robust telemedicine program comes the idea of how to move out with things like lab and imaging into communities where we can provide those services and therefore expand once again to meet the needs of our community and contribute to financial recovery by doing more labs rather than having patients not come to our hospital because they are unable to. Instead, we could have a mobile van go out and draw blood or do other kinds of testing that would generate revenue and take care of patients.

The third thing is what I'm really excited about: There are now models out there for hospital-at-home where you provide inpatient services in limited ways where patients are actually in their home. That's a great opportunity when dealing with a potential pandemic in the future, is how to keep patients from coming into the hospital, or how to keep patients from creating so much patient population that your hospital is inundated. If you can manage an uncomplicated patient at home as an inpatient with the right technology monitoring their vital signs, IVs and having doctors and nurses that are physically there or zooming in, you really have a change in paradigm of healthcare delivery by moving them simply out of the brick-and-mortar hospital. That is an area where we would love to pursue; in order to do that, we have to get telemedicine out there and people used to telemedicine and have the tech be robust in terms of Wi-Fi and the cloud, and those are things I'm looking forward to doing at Beebe Healthcare.

Q: How are you planning on moving forward with virtual care and telehealth initiatives?

DT: The environment is very open to this kind of telemedicine technology. With the coronavirus that hit so many people, I think there are new opportunities for companies, not healthcare companies, but other companies looking at remote work and not necessarily being restricted to a metropolitan area. When you start thinking about telemedicine, it's a whole new paradigm in terms of how a community health system like us can partner with other places and perform telemedicine service jointly for things like advanced cancer or immunology or advanced neurosciences. These are all things that are now open because the population is no longer focused on their specific hospital in Baltimore and only going to one hospital. Now they may want to live somewhere farther away, more like where we are in Delaware, but in telemedicine we can provide the higher level of care that they wouldn't be able to have 10-15 years ago.

It's a new paradigm for community healthcare organizations that have struggled because they could not necessarily compete with the healthcare organizations in metropolitan areas. Telemedicine allows for really a partnership between rural systems. We're not a small, disproportional critical access hospital, but to be able to partner with other large institutions to talk about what are the things we can do together to provide services at home under a telemedicine umbrella is really exciting.

The community still needs an emergency room, inpatient bed and a convener, the community health system, to interface with the high specialty services. But it will change the paradigm of what mergers and acquisitions look like in the future to grow large organizations.

More articles on telehealth:
Will health systems sustain telehealth if pandemic pay rates, coverage drop?
FCC telehealth awards surpass $100M; Here are the 11 hospitals, health systems that have received the most funding
4 payers that have extended telehealth coverage through 2020

 

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