20 Jan From NASA to You: Cashing-in on the Silver in COVID’s Silver Lining

The silver-lining that’s emerged from our collective COVID misery has been the rapid embrace of telehealth by physicians, therapists, pharmacists, and patients alike. In fact, “83% of patients expect to use telemedicine after the pandemic resolves.”

And while COVID catapulted telehealth’s usage last year, its genesis began over 50 years ago,

when according to MHealth Intelligence, telemedicine technology first began as a form of healthcare delivery in the late 1960s due to the needs of NASA, which wanted to ensure remote medical monitoring capabilities for long-duration space missions.

And the broadband enabler that we take for granted today?

It began with President Obama, in 2010, when he proposed “‘Connecting America: The National Broadband Plan’ to assist in the proliferation and improvement of broadband networks across the country, including the build-out and improvement of medical networks that facilitate remote patient monitoring, electronic health records, and other technology-based health services such as telemedicine.”

But, besides the broadband infrastructure, and easy-to-adopt tools like Zoom and Facetime, what largely made that transition possible was the silver in the silver lining.

Medicare was fast to grant “payment parity between telehealth and in-person clinical care for Medicare,” which most private payers followed. CMS issued waivers that added coverage for 135 services not previously on the Medicare telehealth services list. Meanwhile, they expanded the types of practitioners who could provide telehealth services, allowed providers to “cross state lines,” and encouraged Physician Assistants and Nurse Practitioners to work to the full scope of their licenses. During the COVID Spring peak, in Medicare Fee for Service, telehealth adoption increased by nearly 50% in primary care.

Last October, Teladoc reported that mental telehealth visits for men were up 79% since January, with rates for women not far behind. And by December, Doctor On Demand reported in a Harvard study that their telehealth surge – when total visit volume was up 59% from their baseline – was driven by behavioral health, followed by chronic health visits, with more calls from rural than urban residents. Earlier, insurance payer Humana had teamed up with Doctor On Demand, in 2019, to launch “On Hand,” a plan that “gives patients access to a dedicated primary care physician – as well as preventive, urgent, and behavioral health care, through video visits with lower monthly premiums,” according to Dr. Ian Tong, Doctor On Demand’s Chief Medical Officer. Now the telehealth company is “leaning more toward prospective payment arrangements and risk-based contracts because we’ve found a much more efficient way to deliver healthcare resources.” Not to be outdone, United Healthcare is expanding its telehealth offerings for employers with a new virtual service, provided by its telehealth provider partner, Amwell, which will provide the virtual platform as well as doctors on the plan through its medical group.

Of course, Kaiser Permanente, as the nation’s largest capitated, nonprofit integrated delivery system, is built on an economic model that encouraged investment in virtual healthcare – and they made it. When COVID first struck, according to Dr. Artie Southam, EVP of Health Plan Operations, Chief Growth Officer and the co-national executive sponsor of Kaiser Permanente’s Telehealth activities, they went from “conducting 15% of scheduled outpatient visits virtually, to 49% of all outpatient encounters for the year – including an 80% highpoint in the early spring.” That equates to 30.5 million (synchronous, voice or video) telehealth visits to Kaiser Permanente by 12.4 million members – that’s an average of 2.5 televisits per member!

Clearly, given the convenience and efficiency that telemedicine offers,

it’s little wonder that McKinsey projected back in May that, “up to $250 billion of the current [$3.8 trillion] U.S. healthcare spend could potentially be virtualized.” All thanks to NASA, President Obama, and a public health emergency called COVID.

By Mimi Grant, President, Adaptive Business Leaders (ABL) Organization – Round Tables and Events for CEOs of Healthcare and Technology Companies

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