The COVID-19 pandemic has changed the healthcare industry in profound and long-lasting ways. One is the rapid adoption of telehealth. David Kirshner, an advisor with VisitPay and telehealth company AmWell, discusses what the telehealth shift means for health systems and how it affects the patient payment experience.
1) The COVID-19 pandemic has led to a step-change in the adoption of telehealth. How were health systems adopting telehealth prior to the pandemic, and how has that changed?
KIRSHNER: Before the pandemic, telehealth usage rates were around 9%. Patients were comfortable with their traditional methods of seeing their physicians in-person. The reimbursement system wasn’t necessarily in favor of doing things virtually, either, with many insurances not covering telehealth. Those habits and traditional models are slow to change. However, necessity has a way of speeding things up.
When the pandemic hit, many health systems went from 9% to 50% telehealth usage in just three to four weeks. The healthcare industry needed to respond to patients who were suddenly at home but still needed care. So, health systems adapted—out of necessity—and found a way to make telehealth work. And I believe it’s here to stay.
2) Does this shift signal broader implications for health systems in terms of consumer-directed care?
KIRSHNER: Traditionally, from a consumer acquisition and retention standpoint, patients valued easy navigation, early appointments, convenient location, and price, among a few other factors, when choosing between providers. For the first time, we’re seeing digital convenience as a point of competition between health systems.
There were early telehealth studies done that asked what people would do if they needed telehealth but their provider didn’t offer it. About half of the respondents said they would not stay with that health system—they’d find one that had what they needed. It’s safe to say that, as patients become more comfortable with virtual health, it will become a greater requirement and point of comparison when choosing a provider.
3) What similarities do you see between the adoption and financial justification of platforms to modernize the patient billing experience with the adoption and financial justification of telehealth?
KIRSHNER: The shift to telehealth is really just a microcosm of the consumer’s desire for digital experiences and the healthcare industry’s need to adapt to them. It’s clear that health systems won’t be able to rely on non-cloud-based trends, transactions, and EMR anymore. Patients will choose health systems that offer cloud-based platforms because they’re faster and easier to use. People can access portals from anywhere on their phones.
As health systems transition to digital solutions, no part of that experience is more relevant than the financial side. Consumers are looking for a financial experience that matches how they make other payments and conduct other communications. It’s time for health systems to fit that bill or risk losing patients.
4) Can you detail how telehealth supports self-service for the front-end of the healthcare experience? For the back-end?
KIRSHNER: Technologies like telehealth can have an immediate effect on the end-to-end consumer experience. Health systems need to make their patients aware that they can accomplish a lot of the same things through their phone or computer that they can by going into a brick-and-mortar emergency room, primary care clinic, or urgent care center. Through telehealth, they can be triaged and told whether or not they need to come in to see a provider. And, a study showed only 20% of the time an actual visit was needed. That takes a huge workload off the front-end of the health system experience.
Technology has also impacted the back-end of the consumer experience. It’s easier than ever for health systems and patients to stay connected once a procedure is completed—through the health system’s digital portal, for example. With more self-service options, the patient has more control over their communication and connectivity with the health system.
5) How does telehealth help hospitals strengthen a provider’s billing and payment collection?
KIRSHNER: One of the most practical, convenient services health systems can offer is an online payment platform. For services like telehealth, which is priced for consumers, there is no third-party insurance. Most revenue cycle systems are designed on an insurance-payment model, so a more sophisticated platform is needed to help patients make payments directly.
That has been a big hindrance to the adoption of telehealth as a whole: a poor insurance reimbursement experience for the patient. With the right digital platform, one that can handle the billing and collection of this new patient-paid model, it can be a seamless experience for both patient and provider—helping to drive higher rates of patient payment. VisitPay is in fact one of the most compelling investments for this very reason.
6) How has telehealth transformed reimbursement policies at health systems? Will these changes be long-lasting?
KIRSHNER: This is probably the most challenging issue for telehealth. Historically, insurance wouldn’t cover most telehealth costs. However, recent changes to traditional Medicare and commercial payer reimbursement policies in response to the COVID-19 pandemic have resulted in that exponential increase in telehealth use mentioned earlier.
It seems unlikely this trend will reverse. As more patients and healthcare providers become comfortable with telehealth, and it becomes more of a staple in the industry, payer reimbursement will likely become more uniform.
7) Is there anything else you think readers should know about telehealth and its connection to patient payments, the revenue cycle, and patient financial health?
KIRSHNER: If health systems can make it as easy as possible for patients to stay engaged with their provider, focusing on care management over the course of the patient’s life, health systems will make it a lot easier to keep the patients happy, loyal, and healthy.
Finally, dealing with the COVID-19 pandemic is emotional for all of us. But for some patients, the downstream effects of the pandemic can be overwhelming. The result is a challenging set of behavioral and financial issues at home. We have witnessed an explosion of telehealth use over the past several months, and it’s incumbent upon all of us as health care professionals to do all we can to ease these stresses for patients more now than ever.