Community Health Systems, the largest U.S. healthcare chain by hospital count, is rolling out a wide-reaching telehealth program for primary-care services in at least four states.
The Franklin, Tenn.-based company, which has a non-urban focus, has previously used telemedicine to provide specialty services to patients. But a new partnership with American Well, called VirtualHealth Now, will allow patients to access urgent care services 24 hours a day, seven days a week.
The move from a large player like Community highlights the growing push from healthcare providers to expand access to telemedicine. The technology is being used not only to link rural hospitals with tertiary care facilities but to provide ongoing chronic disease management.
“What we've seen in the last two to three years is that providers of all types are thinking about how do we do more with less,” said Danielle Russella, president of customer solutions at American Well. “For us, it's been kind of explosive.”
AllianceHealth Oklahoma and Rockwood Health System in Spokane, Wash., are the first hospitals in Community's network to introduce the service. In those markets, patients will be able to see a doctor through their smartphone, computer or tablet, and the technology can link directly to electronic health records. Telehealth services also will be added in Arizona and Pennsylvania.
“This is an important component to our primary care strategy,” said Dr. Lynn Simon, chief quality officer. “Consumers want access and they want it to be convenient.”
Community already uses telehealth in specialties such as neurology, intensive care and home health, Simon said. But the latest partnership will provide more access points both for existing and new patients.
The idea to ultimately offer similar services for behavioral health and chronic disease management. The platform also could be used for monitoring newly discharged patients as a way to prevent readmissions.
Moreover, telehealth services will be offered as part of Community's partnerships with employers. The company is working to set up telehealth kiosks at employee worksites, particularly where people don't have traditional office-based jobs, Russella said.
Consumers will pay a $39 fee for the service, Simon said, but Community hopes that its relationships with employers and health plans will help offset the charge for some patients.
The market for telemedicine is expected to grow at a rate of more than 50% a year—ballooning from $240 million in 2013 to $1.9 billion by 2018, according to IHS, a data and analytics firm.
Health systems are becoming increasingly interested in telehealth services as they add more capitated payment contracts and start to act more like health insurers, said Bryan Cote, managing director at Berkeley Research Group.
But a number of barriers still remain, including financial, regulatory and administrative challenges. Many states, including New York and Minnesota, have introduced or passed legislation in the past year to increase insurance coverage for telemedicine visits. But a few states, such as Texas, are moving in the other direction, making it more difficult for patients to access telehealth services. A new Texas rule requires patients to have an in-person visit before they can use telemedicine technologies.
“A big part of this is, how are the payments made and is there parity with in-person visits,” said Mike Simmons, CEO of CredSimple, which offers credentialing software for providers. About half of its clients are telehealth companies. “That payment parity is hugely important.”
Some telemedicine firms are seeking certification from credentialing bodies such as the National Committee for Quality Assurance as a way to gain a competitive advantage. “That's one of the bottlenecks—how do you get the provider to be accepted by the insurance provider?” Simmons said.
An October survey from Anthem and the American Academy of Family Physicians found that about 15% of primary-care doctors had used telemedicine technology over the past year, but close to 90% would be interested if they got paid for it.
Doctors who were younger, rural and already using an EHR were more likely to be offering telehealth services.
Commercial health insurers are starting to set up task forces to respond to the litany of requests they are receiving from providers that want to offer the service.
“It's a reaction to the market,” Cote said. “They've begun to get more interest from all different points in healthcare.”
The real test of telemedicine, however, will be whether it can bend the cost curve and whether patients will be compliant enough with the technology to make a difference. “I think telehealth will get sped up if you see it have an impact on things like readmissions,” Cote said.