Crafting a Telehealth Strategy for Population Health

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1 Crafting a Telehealth Strategy for Population Health Interested in learning more about the dedicated resources available through Population Health Advisor? Contact Ellie Barlow at barlowe@advisory.com or M Street NW Washington DC P F advisory.com

2 Telehealth is a multidimensional tool that can be used for asynchronous, real-time, and continuous communication. As population managers implement new payment systems and care models, telehealth offers a promising strategy to facilitate high quality care delivery to patients at an appropriate site in a timely fashion. The term telehealth refers to a group of technologies and clinical services that facilitate the electronic exchange of medical information. Telehealth services can be divided into three categories: store and forward, live consultations, and remote monitoring. Mobile health, a fourth category, continues to develop technologically and involves the use of mobile applications to track specific metrics and promote patient engagement The Advisory Board Company 2 advisory.com/research/population-health-advisor

3 Choose from the array of technologies based on clinical needs, available staff, and telehealth growth strategy. Hundreds of vendors offer telehealth products or peripherals that range from simple videoconferencing software to hospital unit-wide monitoring systems to turnkey solutions that bundle hardware, software, and implementation support. This broad market can be broken down by where technologies fall in the care pathway. For instance, some technologies are more commonly used for episodic disease treatment, either in the acute or ambulatory setting. Others are better suited for disease prevention or management and are more often deployed in clinics or patient homes. While some technologies combine two or more functionalities, this classification method facilitates analysis of the telehealth landscape. Several considerations should guide selection of a technology platform from among the range of options, including the clinical use of the technology, the desired intensity of support staff involvement, hospital priorities and growth strategy, and existing vendor relationships The Advisory Board Company 3 advisory.com/research/population-health-advisor

4 Telehealth is growing across applications, with disease management realizing the fastest growth among national Medicare claims. Growth in the telehealth market is notoriously difficult to track due to a lack of transparency into encounters occurring nationally. Since telehealth is not often reimbursed, clinicians do not always submit claims for telehealth encounters, and there are few codes indicating the use of telehealth. For the short list of codes that are reimbursed by Medicare, coders attach one of two modifiers to signify that the encounter involved telehealth technology. While these codes represent a smaller subset of telehealth visits in the Medicare population, they offer insight into telehealth growth. The provision of care via telehealth has increased significantly across the board, though the biggest increase is in disease management The Advisory Board Company 4 advisory.com/research/population-health-advisor

5 Think beyond FFS reimbursement for telehealth. Many organizations use population-risk payment models, grants and contractual arrangements to remain economically viable. Under traditional fee-for-service payment, telehealth is generally reimbursed at modest rates. Medicare will reimburse telehealth encounters for approved codes, though only when certain providers see patients at specific facilities outside of metropolitan statistical areas or in rural designated provider shortage areas. Several states mandate that private insurers and/or Medicaid provide reimbursement for telehealth, but such reimbursement is typically limited to specific types of encounters, providers, and/or locations. Given the investment required to acquire and maintain telehealth platforms and staff, cost has been prohibitive for many institutions. However, institutions are beginning to finance telehealth through population risk-based reimbursement models and managed care arrangements, and many states are evaluating additional legislation mandating coverage The Advisory Board Company 5 advisory.com/research/population-health-advisor

6 Assemble a multidisciplinary team to manage telehealth implementation challenges. Beyond funding, hospitals and health systems face several operational challenges when implementing telehealth initiatives. Given the multidisciplinary nature of these challenges, physicians, frontline staff, administrators, IT personnel, and other non-clinical stakeholders must collaborate to identify solutions that best fit their institution. Such collaboration often comes in the form of a telehealth taskforce or even a dedicated telehealth department for organizations with large, hospital or system-wide programs The Advisory Board Company 6 advisory.com/research/population-health-advisor

7 Consider the following strategies for enterprise-level telehealth development: 2013 The Advisory Board Company 7 advisory.com/research/population-health-advisor

8 About Population Health Advisor Population Health Advisor provides customized, on-demand guidance for care transformation strategy and execution. Working collaboratively with members Chief Transformation Officer, the Population Health Advisor team conducts quantitative and qualitative analysis to help to prioritize key population health management investments, develop initiative-specific action plans, and provide ongoing research and expertise. As an increasing number of health systems seek to manage populations, the ability to quickly develop organizational infrastructure from medical home development to care transitions and post-acute provider alignment will prove critical to success. Population Health Advisor accelerates the transition towards population health management and provides targeted support for members. Population Health Advisor s Pillars of Value Identify programmatic strengths and opportunities in order to prioritize key investments Initiative-Specific Gap Analyses Customized analysis for strategic prioritization Research and insights tailored to member institutions based on organizational data, market information, and patient demographics Evaluate new initiatives and execute on strategic objectives with customized action plans Customized Action Plans On-demand execution guidance Tactical guidance, strategic recommendations, and operational considerations for go/no-go decisions and roll out planning Develop performance metrics and monitor success of implemented initiatives Embedded Metric Sets and Dashboards Embedded metric sets and dashboards Define, capture, and compare metrics on key initiatives Monitor performance to capture success, quantify value creation Deploy our full time staff of analysts and consultants to leverage existing expertise Access to Expertise Peer summits and dedicated research Biannual working summits with like-minded organizations Dedicated research for care transformation executives Terrains of Expertise 2013 The Advisory Board Company 8 advisory.com/research/population-health-advisor