Credit Suisse https://www.credit.org as part of their “Healthcare Disruptive Technologies and Innovations Series” hosted Joe Brennan, Founder of Moonshot Health Consulting, a company focused exclusively on telehealth at a virtual meeting with a group of investors. Before starting Moonshot Health Consulting, https://moonshot-health.com he served as the Senior Director of MedNow, the telehealth division of a 15 hospital, nonprofit health system based in Western Michigan.
As he reports, “Prior to COVID, health systems reported telehealth utilization in the 3-4% range. However, now in all the strategic conversations that Mr. Brennan is having with health systems, providers are planning and financially budgeting for a larger percentage of virtual care with the number being consistently discussed to be at 2-30%. Given such a large increase, Mr. Brennan believes that it will shake up facilities planning, for operational costs etc.
On changes in utilization trends in states that have started to reopen, Mr. Brennan noted that he hasn’t seen any major impact yet. But he notes that the question prior to COVID was “What use cases are appropriate for telehealth? “However, Post COVID, people are flipping the question to ask, “What is actually appropriate for a face-to-face visit?”
Overall, based on his experience in telehealth rollout and usage with health system clients, Mr. Brennan believes that almost 30% of ER visits can be handled virtually. However, in reality, a lot of people on Medicaid go to the ER for primary care because that is their only option. If the reimbursement environment for telehealth doesn’t get rolled back to pre-COVID levels and Medicaid patients start using telehealth consistently, he believes that there will be a reduction in ED visits or a transition from going to the ED to receiving care virtually since Medicaid will pay for it.
He told the investors, he believes that the expansion of providers to have the ability to get paid while the patient is in the home plus the expansion of services should and will likely remain post COVID. He however admits that some of the regulation changes will require lawmakers to get involved and that HIPAA will be modified. He doesn’t believe that providers will be able to use Facebook Messenger to provide telehealth, but he does believe that HIPAA is dated and needs to be updated.
Mr. Brennan does not believe that payment for telehealth will remain at the same level as face-to-face post COVID. However, based on talks with health systems, virtual care being reimbursed at 80% for a face-to-face visit might be reasonable. Also, concerning interstate licensing issues, Mr. Brennan believes that most states are ultimately likely to become part of the Interstate Medical Licensure Compact (IMLC).
He voiced his thoughts on recent partnerships. As for the Epic/Twilio partnership, he believes Twilio gave Epic the opportunity to have a bare-bones solution that could be implemented quickly in response to COVID for Epic customers who didn’t want to go through the integration process of Vidyo or Zoom at that time.
However, Mr. Brennan is very positive on Teleadoc’s acquisition of InTouch Health as it provides Teladoc an opportunity to take a direct-to-consumer product focused on employers and low acuity primary care, and then be able to focus inside the four walls of the hospital. For example, InTouch’s carts, are used for patients in ICUs and EDs. This gives Teladoc a holistic solution as relates to telehealth.
Discussing how insurance companies approach telemedicine will evolve since insurers are of the mindset that since they already have this virtual tool, they should be able to manage patients directly. Mr. Brennan believes that as insurers expand virtual capabilities and have direct interactions with those patients that cost them the most money, it’s advantageous for an insurer to offer programs for chronically ill patients. He also believes that more insurers are likely to expand their offerings beyond low acuity primary care.
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