It took a pandemic for Americans to take advantage of this healthcare innovation

Kristi Henderson, Senior Vice President of Innovation and Telemedicine, UnitedHealth Group’s Optum Business, said: “I hear people in the telemedicine industry talking about what they’ve been working on for over a decade.“ Within a few weeks. [they] There have been more achievements than the whole decade. “

Since March, millions of Americans have been calling, message, or chatting with healthcare providers online, essentially conducting the first large-scale national experiment on telemedicine potential. I am. To some extent, the experiment is working.Recently Investigation After the pandemic, consulting firm West Monroe found that a quarter of 1,500 Americans prefer telemedicine to direct visits.

“New ideas are coming up and being tested,” said Eric Mayeda, analytics leader at the healthcare advisory firm Chartis Group. “It’s like the innovation cauldron we’re seeing right now.”

That said, the doctor is Apple Inc.Many of the experiments, such as enabling the use of everyday platforms like FaceTime
AAPL,
-0.81%

Or zoom
ZM,
-1.84%,
Trying out new ideas such as remote physiotherapy and pulmonary rehabilitation, and providing video access to clinicians with just a few mouse clicks raises questions about the feasibility and potential of future telemedicine. I am. How do you address the privacy concerns of non-HIPAA compliant platforms? Are low-income or ill patients excluded? Do fewer face-to-face tests often miss a diagnosis of a serious illness? Do people overuse telehealth once they understand how simple telehealth is? And what about medical expenses?

“We know that medical costs are rising, and our results haven’t improved,” Henderson said. “So we have to try something new, and there are various ways to put the safety net there so that it can be expanded as needed and replaced if applicable. In some cases, a quick video or asynchronous chat can actually solve the problem, and in other cases you need to take care of people. “

In our pre-pandemic life, telemedicine existed, but it was a rarely used resource. According to FAIR Health, various forms of telemedicine have existed for decades, but less than 1% of US medical claims in 2018 were telemedicine visits. White paper..

It is still unclear whether telemedicine can actually reduce US health care costs. However, the rapid or regular use of video calls with primary care physicians is expected to divert costly visits to emergency rooms and centers. These visits are more expensive for both patients and insurance companies. Experts should keep in mind that the use of telemedicine reduces costs only if it is used as an alternative rather than an additive.

As the virus strengthened its dominance in the United States this year, there were few care options other than telemedicine. Hospital or clinic canceled Selective surgery and appointment, and one Investigation Visits to outpatient providers were found to have fallen by 60% by early April. Outside the ER and intensive care units treating COVID-19 patients, dermatologists, primary care physicians and pediatricians have previously addressed telemedicine if they still want to take care of the patient and make money. I had to rethink the opposite.

The US government then implemented a set of temporary rules that made everything easy. Physicians treating Medicare beneficiaries can offer more types of remote visits, telemedicine calls are refunded at the same rate as office visits, and providers can use them. HIPAA non-compliant platforms such as FaceTime, Microsoft Corp.’s Skype, Zoom Video Communications Inc. (ByteDance Ltd.’s TikTok and Facebook Live)
FB,
+ 0.18%

Not allowed. )

“what [telehealth] What was missing was a catalytic event that pushed the industry out of its recruitment curve, “says Mayeda. “And COVID did it for sure.”

Approximately 1.7 million people targeted by Medicare There was a telemedicine call In the last week of April, the average number of people who used telemedicine before the pandemic increased from about 13,000, and from mid-March to mid-June, about 35 million telemedicine visits between Medicare and Medicaid beneficiaries. Was recorded. “President Trump will not return the genie to the bottle,” said Seama Bama, the administrator of the Medicare Medicaid Service Center, in a statement on October 14 that 11 new medical services will be covered by Medicare.

As of September 21, approximately 15,000 healthcare providers employed and contracted on the UnitedHealth Group network are living on telemedicine platforms from thousands of pre-pandemic patrons. Teledoc Health Inc., one of the few listed telemedicine providers, told investors that telemedicine visits using the technology nearly tripled in the second quarter.

Not surprisingly, investors are pleased with the outlook for telemedicine. Teradoc in August Spent $ 18.5 billion in cash and stock to buy Livongo Health Inc., Digital Health Coaching Provider. Its inventory has skyrocketed 164% so far this year. Another telemedicine platform, Amwell Inc. , Published During September. MDLive Inc., which brought in a $ 50 million crossover equity investment in mid-September, plans to open a public offering early next year, a spokeswoman for the company said.

Adoption has penetrated even small practices. Dr. William Sim, a physician in the suburbs of Los Angeles, Downy, California, said in August that 30% of his business was in telemedicine. March was zero.

This is the first time I have used telemedicine in my Sim practice. Most of his patients are elderly and have health insurance through Medicare, so he appointed a staff member to teach patients how to download and use Zoom. Sim finds this call interesting. This is a kind of virtual house call that allows you to observe the patient at home. He talks to older patients about how to fix loose rugs and sharp furniture corners, and focuses on construction workers at work.

“It’s better than nothing,” he said. “But there is no substitute for a physical examination by a doctor.”

It is still unclear how the spread of telemedicine during a pandemic helped reduce US health care costs in the first half of 2020, or how it helped. The general belief is that there was total spending, so it’s not a comparison between apples. In 2020, it declined as people stayed home during the pandemic and completely delayed care.

“We quickly realized that we saw the whole country, all health care systems, health practices, all states, public health agencies, and not as troublesome as I thought,” Henderson said. Says. “It taught many people about the possibilities.”

That said, direct visits to doctors began to recover as the state reopened its economy in May and June. According to the Commonwealth Fund, the total number of visits, which account for telemedicine and face-to-face visits, had recovered to some extent by July 27, a 9% decrease compared to the 57% decrease on April 5. Face-to-face visits decreased by 69% on April 5th and by the end of July only 16%. This underscores the less prominent but still prevalent role of telemedicine during the summer.

Many telemedicine professionals see the pandemic as an unexpected turning point, but it’s unclear how privacy regulations and reimbursement policies will work in the coming years. Many of the federal regulations enforced for telemedicine no longer exist after a federal public health emergency.

Already two major insurance companies — Anthem Inc.
ANTM,
+ 1.36%

And UnitedHealthcare
UNH,
+ 1.20%

— From October 1st, we have resumed cost sharing for telemedicine employers and individual plans other than COVID. This can be a potential obstacle for those unfamiliar with remote care.

“When we ask about the future of telemedicine, it depends heavily on how telemedicine is integrated into the healthcare business,” Alphabet Inc. Said Dr. Vivian Lee, President of the Health Platform of Verily Life Sciences. “We really encourage doctors, hospitals, and anyone in the medical business to do more, whether or not they improve their health.”

In Lee’s view, the path forward is to move from a service fee payment model to a value-based system where providers are paid a lump sum to care for a particular patient or their illness. Most US care is still believed to be paid on a service fee basis. In today’s world, where providers seem to have endless ways to communicate with patients, such as portals, text, email, phone calls, video chats, and face-to-face visits, the old model of paying for individual services has been added altogether. not. up.

In fact, the Federal Fund recently called for telemedicine to be reimbursed at a lower rate than visiting doctors directly, as part of post-pandemic regulation.

That said, many hospitals and clinicians hire new people to test new technologies and processes, or to focus on telemedicine if they are uncertain about how services will be paid in the long run. I’m even hesitant about that. However, the desire of both patients and healthcare providers to test telemedicine during a pandemic may be changing that.

“We are at a very important point,” Lee said. “Until COVID, I don’t think there was much motivation to change the payment method for medical expenses.”