Iris Berman, VP of Telehealth Services at Northwell Health https://www.northwell.edu was hosted at a small group investor meeting in New York City as part of Credit Suisse’s “Healthcare Disruptive Technologies & Innovations” (HDT&I) series https://www.credit-suisse.com.
Northwell Health is New York’s largest private employer and healthcare provider with 23 hospitals and about 750 outpatient facilities. The company was one of the early pioneers of telemedicine and tele-ICU as they partnered with Philips https://www.usa.philips.com for their tele-ICU software 15 years ago.
In 2017, Northwell Health signed a contract with Avizia which was later acquired by American Well. However, Northwell uses only some of Avizia’s software products. The reason is that the health system does not want to be totally beholden to the vendor because it already has systems in place internally.
For many years, the health system’s telemedicine platform included telepsychiatry, tele-ICU, and tele-stroke services, plus a seven hospital eight-ICU subspecialty neuro-critical care program. In 2017, the health system expanded their telemedicine platform to include direct-to-consumer telehealth services.
Today, Northwell offers multiple telehealth services including acute care, ambulatory care, care in patient’s homes, and second opinion consultation programs. Northwell Health’s vision is that within 2-3 years, all physicians at Northwell will offer telehealth services.
Favorable reimbursement regulations have played a role in Northwell aggressively expanding their telehealth services. For example, once CMS decided to reimburse providers for telestroke, Northwell put telestroke services in place in all of their hospitals within two months.
However, Iris Berman notes that New York still has only coverage parity law but no payment parity law for telehealth. Providers in the state have been lobbying hard to get the payment parity law implemented in the state. Also, New York is not a part of the Nursing Licensure Compact which allows nurses to have one license to practice in multiple states.
She also notes that private payers are more interested in implementing telehealth in Medicare Advantage as both insurers and providers believe that it is more efficient to use telehealth for the senior population.
Northwell’ pricing structure with Philips involves an upfront licensing fee. Additionally, every year, Northwell pays Philips a 20% maintenance fee on the license. The fee paid to Philips goes up incrementally as the health system’s bed count increases.
Northwell while under American Well’s https://americanwell.com umbrella, is still using Avizia software. American Well has their own SDKs and each of the data kits have some cost involved. Northwell is analyzing the contract from an economic point of view if in the future, the health system should ever migrate from Avizia software to the American Well platform.
Another key focus for Northwell is to build a network for scheduling. In the event of an emergency, Northwell’s call center would receive the information, then trained nurses will go through the case and escalate the case to an available physician. However, if the patient can wait to schedule a visit, then a visit may be scheduled.
Iris Berman notes that employers and insurers want telehealth to be cheaper so that by keeping patients out of urgent care centers and ERs, they can generate cost savings. Providers on the other hand want payment parity.
In Credit Suisse’s recent review of 2020 Employer Benefit Guides, posted January 29, 2020, at http://federaltelemedicine.com/?p=8208#more-8208, it was found that employers were reducing the co-pays for telehealth services to drive more telehealth utilization. Also she believes that another way to reduce lost productivity for employers would be to have telehealth kiosks at work so that employees would be able to interact with physicians.
To improve interoperability Northwell has requested that vendors produce software with open APIs for better hardware/software communications. This remains difficult despite technology consolidations given the 3-5 contract lengths and the pace of technological change.
Iris Berman believes that the Teladoc’s https://www.teladoc.com purchase of InTouch Health https://intouchhealth.com makes sense as both companies complement each other. While Teladoc provides the software, it lacks expertise in hardware in an area where InTouch is exceptionally strong. Also, she believes that while InTouch Health’s products are relatively expensive, a combination with Teladoc should give InTouch the scale which should make their pricing more competitive.
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