'Telemedicine is here to stay': Telehealth & the return on investment

Telemedicine is changing the healthcare landscape, offering opportunities for organizations to reduce costs and better serve patients.

A panel discussion at Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference in Chicago, Sept. 19-22, described telehealth's return on investment for health plans, employers and health systems. Panelists included:

  • Wallace Adamson, MD, staff vice president of Anthem's telehealth service LiveHealth Online
  • Calvin Heller, director of telehealth at West Des Moines, Iowa-based UnityPoint Health
  • Carey Officer, operational vice president of telemedicine for Jacksonville, Fla.-based Nemours Children's Health System

The health plan perspective

Anthem launched LiveHealth Online in 2013. The 24/7 telehealth service operates in all 50 states. Anthem's wholly-owned subsidiary HealthCore assessed more than 4,000 LiveHealth Online visits and found 11 conditions drive 60 percent of volume.

Anthem members who used LiveHealth Online saved about $201 per episode of care. "Anthem's usually the largest payer in the market and usually has the lowest rates," Dr. Adamson said. "We may not save as much as others, but we don't spend as much."

Dr. Adamson identified three "fundamental truths" about virtual visits:

  1. People who started with a LiveHealth online visit were less likely than those who started at a retail clinic or primary care provider to have another medical visit in the next three weeks.
  2. Prescribing rates were comparable to other sites of care.
  3. There was a lower incidence of lab work and imaging tests.

The employer perspective

"Being able to tie [telehealth] to a larger strategic goal is critical to success," said Mr. Heller. UnityPoint Health aimed to provide the same quality of care for lower acuity visits at a reduced cost. The company looked at more than 1,000 visits from its self-insured health plan, assessing the additional value it generated from its employees using telehealth rather than taking off of work for medical care.

Out of 1,000 visits, telehealth utilization generated around $146,000 in savings. "We really saw the importance of linking to a larger strategic goal and marketing to employees," Mr. Heller said.

The health system perspective

Nemours Children's Health System offers a 24/7, on-demand telemedicine program made up of a group of experienced employee pediatricians. The program is currently offered in six states and is preparing to move into Alabama.

"We really do believe in it," said Ms. Officer. "It really aligns with our strategy to meet patients and families where they are." The telehealth program also provides downstream revenue — 17 percent of utilizers are new patients, and 29 percent of those patients created specialty care revenue.

Ms. Officer described a study of Nemours' specialist telehealth services. The pediatric health system saved about $24 per orthopedic patient using telemedicine. On average, patients and their families traveled 85 miles round-trip for in-person services; with telemedicine, they received care without leaving their homes. "It's cost-saving, and time-saving, for patients and families," said Ms. Officer. "Telemedicine is here to stay."


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