The State of Telemedicine

By Jennifer Jones, Sr. Director of Health Strategy Services

“In the midst of chaos, there is also opportunity.” - Sun Tzu

COVID-19 has created an unimaginable sense of chaos for millions of Americans, but in turn, it has also presented us with an opportunity to change healthcare as we know it. Telemedicine is a key component of this opportunity that can offer a cost-effective solution or alternative to in-person visits for low acuity conditions or those not requiring physical contact. As we have allowed technology to improve our lives in so many facets, we need to allow the delivery of healthcare to catch up. With over 81% of Americans owning a smartphone and over 75% owning a desktop or laptop computer, consumers are poised and have adapted to the necessary shifts required during the pandemic.

Surprisingly, experimentation with telemedicine is a century-old field that began with the invention of the radio and telephone. As technology and times advanced, telemedicine began to see progress and innovation with the funding of NASA’s projects to provide healthcare to astronauts and as the US government developed ways to address healthcare professional shortages and lack of available care in rural areas.

But it wasn't until the late 1990s and early 2000s that telemedicine began to see wider adoption due to some reimbursements from Centers for Medicare & Medicaid Services (CMS) and the development of video chat services. As we compare the integration of technology in our everyday lives to integration of healthcare delivery, the growth rates are significantly different.

Necessity Drives Adoption

Before the pandemic, only 11% of healthcare consumers were utilizing telemedicine visits; however, once COVID-19 was declared a public health emergency and stay-at-home orders were in place, healthcare providers were forced to look for another way to care for their patients. With the waiving of regulations and the expansion of telemedicine services, utilization skyrocketed. By April 2020, nearly 45% of healthcare users had a telemedicine claim.

Seeking to explore the overall trend of telemedicine visits within our own Springbuk book of business, we identified the following utilization trends. Since the onset of the pandemic (March 1, 2020), total telemedicine visits increased by over 3800%; this equated to 1100% increase in the number of claimants with a telemedicine claim. As stay-at-home orders have lapsed, and offices are beginning to open again, telemedicine encounters are on a steady decline. However, compared to this time last year (claims incurred Aug. 2019 vs. Aug. 2020), these encounters remain over 1500% higher. This may be an early indicator of a more permanent adoption of telemedicine.

Saving Money is One of Many Benefits

Telemedicine is likely to remain a primary option for many Americans to receive their care until there is either a significant eradication of COVID-19 or an effective vaccine is available. The challenge will be keeping the momentum moving forward for telemedicine to remain a viable option for healthcare delivery.

McKinsey & Company predicts that ~20% of all visits (outpatient, office, and home health) could be virtualized in the future resulting in over $250 billion of savings. This includes reducing avoidable ER visits, increasing virtual home health and office visits as well as providing tech-enabled home medication administration. And despite the savings, the shift to higher utilization of telemedicine could have various other benefits, including:

• Improved efficiency and convenience: Patients can remain in the comfort of their home for their visits. In addition, the reduction in drive and wait times allows for easier expansion of after-hour visits that could help reduce ER/Urgent care visits. Telemedicine visits also remove barriers to care for patients that may not have sought care due to physical distance or significant travel.
• Reduced exposure to infection: A reduction in the number of patients in the physical office environment can minimize spread of disease.
• Increased capacity for mental health services: Telemedicine providers that offer specific teletherapy services have seen a significant increase in utilization since the pandemic - across all ages and demographics, indicating an increase in demand for services, and demonstrating patients are comfortable using this modality for therapy services.
  

Sources:

Demand for virtual mental health care is soaring. Here are key trends on who is using it and why. Oct. 23, 2020
Digital behavioral health startups scored $588M in funding amid COVID-19 pandemic July 6, 2020
HHS Issues New Report Highlighting Dramatic Trends in Medicare Beneficiary Telehealth Utilization amid COVID-19 July 29, 2020
How COVID-19 shifted healthcare executives' technology priorities and what to expect in 2021 Oct. 21, 2020
Kaiser Permanente: 'Virtual-first' health plan in Washington Sept. 14, 2020
Pew Research Center: Mobile Fact Sheet June 12, 2019
Telemedicine: A Guide to Assessing Telecommunications in Health Care. 1996
Telehealth: A quarter-trillion-dollar post-COVID-19 reality? May 2020
The History of Telemedicine Infographic Feb. 25, 2016
The Impact of the COVID-19 Pandemic on Outpatient Visits: Practices Are Adapting to the New Normal June 25, 2020
Top of Mind for Top Health Systems 2021 report Oct. 2020
Will 2020 Be the Year That Medicine Was Saved? April 14, 2020