Telehealth is a winning long-term strategy but it also needs to be a short-term solution as well. For a limited time, CMS and private insurers will pay providers for more visits over more channels. Even more extended reimbursable services began being available December 1st. Providers will have a short window to share the risk of adopting next-generation workflows.
CMS reimburses specific services when delivered over specific channels.
The challenge is, in order to properly do this, new infrastructure and processes are required. For telehealth to truly work, it needs to be part of a digital transformation process that includes:
Healthcare as practiced today consists of a large number of individual services that are often delivered by different people using different tools.
Creating a “digital front door” doesn’t automatically resolve this fractured service structure.
In order to deliver on the promises of a digital front door, you have to architect what is behind the door.
See You Have a Digital Front Door Problem.
As we mentioned, the government is willing for a limited time to reimburse patient access. Unfortunately, they are not reimbursing healthcare for building new infrastructure to make this viable. If you look at the Patient Service Maturity Model, organizations need to go through steps of establishing a basic platform, coordinating data sources and silos, and then automating the difficult services before digital front-door technologies can truly make a difference.
CMS is only reimbursing final delivery.
Healthcare providers have a choice
As organizations invest in this infrastructure, the benefits of telehealth reimbursements ramp up. While full benefits take years to realize, low-hanging fruit can be automated within just a few months. Telemedicine can become easier and less stressful. Clients are able to cut down phone time by 20-50% within 4 months. You can get 30% of appointments self-scheduled within 6 months.
The fact that we are ramping up use during a pandemic, short-term need has hidden the long-term implications.
PATIENT BENEFITS
PATIENT RESULTS
ORGANIZATIONAL BENEFITS
HRSA defines telehealth technologies as:
“Technologies include videoconferencing, the internet, store and-forward imaging, streaming media, and landline and wireless communications.”
CMS determines reimbursement by channel-service pairs. In other words, the type of consultation, combined with the channel being used dictates the type of reimbursement the provider receives (if any).
A key step in pursuing a holistic telehealth strategy is to determine which reimbursable services your organization will provide and over which channels.
See all CMS synchronous telehealth reimbursement codes, including which are available for audio-only, here: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
Online messaging (“store-and-forward”) – asynchronous messaging can remove wait times, and overcome language and cultural barriers. It has been especially effective for specialties like dermatology or even urology where imaging is important. Advanced providers are using real-time chat, asynchronous texting, online messaging facilitated by web AI.
As a patient channel, however, there is no reimbursement
Please refer to:
At Keona Health, we believe that relationships matter. We know that a clinic’s triage system can test a patient-doctor relationship, especially if a patient cannot easily get the help he or she is seeking. Keona Health offers healthcare software and automation solutions to ease the burden of telephone triage on medical practices and help medical professionals better communicate with patients.