Major-player health systems want to broaden telehealth's bandwidth

Community Health Systems' wide-reaching push into telemedicine signals growing demand for remote technology that delivers lower costs and convenient access to care.

The Franklin, Tenn.-based chain, which runs more hospitals than any other U.S. healthcare company, has a non-urban focus and previously used telemedicine to provide specialty services to its patients. But a new partnership with American Well, called VirtualHealth Now, will allow patients to access urgent-care services 24/7 in at least four states.

A growing number of health systems are beginning to use the technology not only to link rural hospitals with tertiary-care facilities, but also to provide ongoing chronic disease management. Still, telehealth's adoption remains complicated by regulatory, financial and administrative barriers. Although many states, including Minnesota and New York, have introduced or passed legislation in the past year to increase insurance coverage for telemedicine visits, others—notably Texas—are moving in the opposite direction. A new Texas rule requires patients to have an in-person provider visit before they can use telemedicine technologies.

But those barriers may fall away as large players adopt telehealth services.

“What we've seen in the last two to three years is that providers of all types are thinking, 'How do we do more with less?' ” said Danielle Russella, president of customer solutions at American Well. The Boston-based company provides the mobile and Web platforms for telehealth programs launched by Community and several other major health systems, including the Cleveland Clinic and Salt Lake City-based Intermountain Healthcare. “For us, it's been kind of explosive,” she said.

AllianceHealth Oklahoma and Rockwood Health System in Spokane, Wash., are Community's first network hospitals to introduce telehealth services. In those markets, patients will be able to see a doctor through their smartphone, computer or tablet, and the technology can link directly to their electronic health records. Community also plans to add telehealth services in Arizona and Pennsylvania.

The market for telemedicine is projected 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 enter more capitated payment contracts and start to act more like health insurers, said Bryan Cote, managing director at Berkeley Research Group.

“This is an important component to our primary-care strategy,” said Dr. Lynn Simon, Community's 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 its latest partnership will provide more access points for both current and new patients. Ultimately, the system will offer similar services for behavioral health and chronic disease management, and the platform may also be used to monitor newly discharged patients as a way to prevent readmissions.

The system also plans to offer telehealth services as part of its partnerships with employers. It is working to set up telehealth kiosks at worksites, particularly in locations where workers don't have traditional office-based jobs, Russella said.

Consumers will pay a $39 fee for the service, but Community hopes that its relationships with employers and health plans will encourage service charges to be offset for some users.

“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 CredSimple's clients are telehealth companies. “That payment parity is hugely important,” he said.

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.

In response to the litany of requests they're receiving from providers that want to offer telehealth services, commercial health insurers are starting to set up task forces, Cote said.

An October survey from Anthem and the American Academy of Family Physicians found that about 15% of primary-care doctors had used some form of telemedicine technology over the past year, but close to 90% said they would be more interested if they got paid for it.