Telehealth

Telehealth Visits Replace In-Person Visits, Rather than Supplement and Offer Cost-Savings for Insurance Providers

Mary Cunningham — Thu, 18 Aug 2022 19:32:31 +0000

Telehealth Visits Replace In-Person Visits, Rather than Supplement and Offer Cost-Savings for Insurance Providers Mary Cunningham Thu, 08/18/2022 - 15:32

In This Story

Alison Evans Cuellar, PhD, MBA

A new study from Health Administration and Policy Professor Alison Cuellar shows cost savings to insurance companies for telehealth visits because many people substitute virtual visits for in-person visits.

Health Administration and Policy Professor Alison Cuellar

Telehealth has expanded rapidly since the COVID-19 pandemic. Though patients generally find virtual visits beneficial, policymakers and health insurers have been concerned that telehealth visits could raise health care costs if patients supplement in-person visits with telehealth, rather than substitute them. This concern has prevented some health insurers from expanding telehealth coverage that could support more patients.

A new study from ��ӽ紫ý Health Administration and Policy Professor Alison Cuellar helps alleviate that fear. The study found that many people use telehealth as a substitute for in-person visits. The payment rates to the telehealth provider were lower than the average in-office visit, which further increased cost savings for the health insurer. Researchers studied the insurance claims from people with the three most common conditions (respiratory infections, diseases of the urinary system, and eye disorders) who used telehealth from a “direct-to-patient” telehealth provider.

A telehealth visit

“Private insurers and public programs are eager for research to show if telehealth offers a cost-effective alternative to in-person visits,” said Cuellar. “These findings can help inform how we think about telehealth coverage, both at federal and state levels. These patients benefitted from convenient tele-access to providers. More studies like this can help inform how patients choose their visits in a post-pandemic world.”

The study, “Outpatient Care Among Users and Nonusers of Direct-to-Patient Telehealth: Observational Study" was published in Journal of Medical Internet Research in June 2022.

Telehealth has improved access to health care by removing some barriers to in-person visits, such as transportation, unpaid time off, and childcare. Many health insurers created temporary telehealth policies during the height of the pandemic. However, these companies worry that telehealth visits in addition to in-person visits will cost the company more. The results of this study provide companies with data to support that virtual visits for three common conditions did not encourage more overall doctor’s visits and actually costs less overall.

The study, supported by the Agency for Heathcare Research and Quality, used 2017 private insurance claims for adults 18-64. The research team analyzed virtual visits, office-based primary care, urgent or retail clinics, and emergency departments based on claim codes. Virtual visit costs to insurers were the lowest among all the settings. Researchers acknowledge that the findings are limited by the parameters of the search, and findings may not apply to all forms of telehealth medicine.

Topics

CHHS

HAP Faculty

Department of Health Administration and Policy

Telehealth

Fall Church (VA) Patch: Picks up the News Desk piece about NIHCM grant recipients Dr. Alison Cuellar and Dr. Leah Adams and their research on health equity and Medicaid telehealth policy.

eander6 — Thu, 10 Feb 2022 16:07:31 +0000

Fall Church (VA) Patch: Picks up the News Desk piece about NIHCM grant recipients Dr. Alison Cuellar and Dr. Leah Adams and their research on health equity and Medicaid telehealth policy. eander6 Thu, 02/10/2022 - 11:07

In This Story

Alison Evans Cuellar, PhD, MBA

��ӽ紫ý: NIHCM Grant Recipients Takes Collaborative Approach On Health Equity, Medicaid Telehealth Policy.

Topics

College of Health and Human Services

College of Health and Human Services Department of Health Administration and Policy

Health Informatics Student Develops 5G-Enabled Telemedicine Technology

John Brandon Cantrell — Wed, 01 Dec 2021 21:44:11 +0000

Health Informatics Student Develops 5G-Enabled Telemedicine Technology John Brandon C… Wed, 12/01/2021 - 16:44

Topics

Commonwealth Cyber Initiative (CCI)

internships

Cyber Security Research

Tech Talent Investment Pipeline (TTIP)

TTIP

Tech Talent Investment Program

Patricia Tran integrates innovation and clinical experience as summer intern with Commonwealth Cyber Initiative

Tran's research as a CCI intern allowed her to create 5G-enabled wearable technology to detect Atrial fibrillation and support clinical decision making.

Patricia Tran, an alumna of Mason's Honors College, recognized the essential roles cybersecurity and health informatics have in health care while working as a nurse. Tran’s first-hand experience with electronic health record (EHR) systems sparked her interest in how new technology could enhance health care organizations’ telemedicine services. She is now pursuing a Master of Science in Health Informatics at Mason, where she integrates her passion for health care and technology to defeat digital threats that compromise the access and quality of care patients receive.

“In a field where every second matters, high latency and poor connectivity can have detrimental effects,” says Tran, who is interested in the way 5G-enabled technology can improve the telemedicine infrastructure. “5G has the potential to address these challenges and transform telemedicine.”

Tran pursued her interest in 5G during the summer of 2021 as one of the first summer interns at Commonwealth Cyber Initiative (CCI). CCI is a Virginia organization with a mission to establish the state as a global leader in cybersecurity while supporting world-class research and preparing future generations for careers in cybersecurity.

“Throughout the summer, we developed a proof-of-concept design for 5G-enabled telemedicine, incorporating RaspberryPi, Apple Watch health data, cloud computing, and OpenEMR to detect Atrial fibrillation and support clinical decision making in real-time,” says Tran.

Developers could also expand Tran’s research on wearable device technology to detect other ailments--a result of her passion for creating innovative, amendable solutions to enhance the quality-of-care patients receive.

Tran and her research team discovered that the current telemedicine infrastructure is not fully-equipped to handle the nuances of Internet of Things (IoT) technology, which are devices that connect to cloud services to access information. She believes that her 5G-enabled technology research can help overcome these obstacles by providing stronger connectivity, enhanced security, and faster speeds to telemedicine technology.

“In health care, 5G is still a relatively new technology and could have tremendous impacts on telemedicine and care delivery, so our research addresses these opportunities for advancement as well as challenges that may arise,” says Tran.

Tran’s clinical background as a nurse, coursework knowledge from her program, and strong work ethic helped her succeed throughout the internship. The many skills she gained throughout the health informatics program, such as database management, data analysis, and programming, allowed her to successfully work with real-world applications in health care.

The CCI internship inspired Tran to encourage other students to pursue research initiatives that interest them. “Research in general can be overwhelming at times, but with the right attitude, you might be surprised at how much you can learn and discover,” says Tran.

Tran aims to work with a leading EHR system as a developer or analyst after graduating with her master’s degree in health informatics to continue discovering innovative ways to address health care technological problems.

True Innovation in Telehealth Requires Addressing All the Opportunities and Challenges. Can We Deliver on the Promise?

mthomp7 — Wed, 28 Apr 2021 18:51:56 +0000

True Innovation in Telehealth Requires Addressing All the Opportunities and Challenges. Can We Deliver on the Promise? mthomp7 Wed, 04/28/2021 - 14:51

In This Story

Alison Evans Cuellar, PhD, MBA

Mason faculty outlines what is required to develop a coherent telehealth strategy that increases access, addresses disparities, and improves care.

Telehealth as a channel for delivering care has boomed in the past few years in response to the growing need for more flexible opioid treatment options and limitations to in-person care during the COVID-19 pandemic. But for states, payers, and providers to deliver on the long-term promise of telehealth, areas such as funding, infrastructure, policy, access points, and coverage must also evolve.

A recent issue brief, Steps Toward a Coherent Telehealth Policy, by Alison Cuellar, PhD, Professor in the Department of Health Administration and Policy at ��ӽ紫ý, provides a comprehensive overview of the opportunities to innovate telehealth policy to drive adoption, expand coverage, and improve care. The brief, co-written with Anton Arbatov, adjunct faculty and vice president at SOC Telehealth, and Constance Owens, PhD student in the Health Services Research program, explores the complexities of licensure, payment policy, and policies for safety net providers.

While many of us equate innovation and telehealth with virtual visits with a doctor, this form of telehealth makes up less than 40% of revenues. Cuellar explains that there are actually three major segments of the telehealth sector: virtual visits (whether between patient and provider or two providers), remote monitoring services, and store-and- forward services for sharing digital images and video between providers. Cuellar examines the three models as well as their unique policy, delivery, and cost-structuring challenges—helping readers navigate the complexities and considerations.

“The true innovation related to telehealth is not just the technology – it is the behind the scenes work to foster wide-spread and equitable adoption. This will require creative and flexible ways of thinking about who can provide telehealth services, what kind of services will be covered, where the patient can receive care, and who will pay for it. There is too much at stake not to innovate,” says Cuellar.

Cuellar’s Policy Brief addresses some of the unknowns and obstacles associated with telehealth- such as whether increased convenience will lead to more appointments and higher costs, but with marginal benefits– and the challenges associated with conducting a physical exam remotely. The brief focuses on policy issues such as reimbursement policies and how they differ across payers and activities. For example, she illustrates differences in Medicare coverage depending on the “originating site of care”, the nature of the service provided, and how the service is delivered. Cuellar also authored an opinion piece in The Hill on March 20, which further explored a “post-COVID reimagining of telehealth in Medicare.”

An expert in health policy and health systems, Cuellar points to amazing innovations whereby dentists deliver care, children receive care at school, and psychiatrists see patients in emergency rooms – all remotely. States are also expanding the list of eligible providers who can be paid for their remote care to include dentists, speech or physical therapists, for example. Allowing more providers to deliver care across state lines though licensure changes is also key to expanding telehealth. The Brief underscores the need for further innovation in these areas to reach the full potential for addressing disparities and reaching underserved populations.

The Brief outlines many opportunities for innovation. For example, Cuellar sees behavioral health and counseling services as areas where telehealth can help address growing demand and provider shortages. She encourages payers to consider the types of care that are possible via remote video, how to expand access and improve care, and the types of care that could originate in a patient’s home.

In some instances, regulation has not been able to keep pace with changes in state laws creating a dynamic environment. Cuellar foresees that definitions of telehealth modalities, cross-state licensure, patient consent, and online prescribing as “active areas of policy development.”

While telehealth innovation was originally driven by the opioid crisis and COVID-19, all three segments of telehealth hold great potential for improving access and quality of care. Advancements in the areas of federal and state investment, coverage, licensure, and payment policy can further promote innovative care and reduce disparities.

For questions about telehealth policy or other matters related the health policy, contact Alison Cuellar at aevanscu@gmu.edu.

Topics

Telehealth

Health Policy

Medicare

Centers for Medicare & Medicaid Services (CMS)

faculty spotlight

CHHS News

Mason Momentum

The Hill: Dr. Alison E. Cuellar writes opinion piece about reimagining post-COVID telehealth in medicine.

Anonymous — Wed, 24 Mar 2021 18:36:29 +0000

The Hill: Dr. Alison E. Cuellar writes opinion piece about reimagining post-COVID telehealth in medicine. Anonymous (not verified) Wed, 03/24/2021 - 14:36

In This Story

Alison Evans Cuellar, PhD, MBA

A post-COVID reimagining of telehealth in Medicare

Topics

Telehealth

Medicare

CHHS in the Media

College of Health and Human Services

College of Health and Human Services Department of Health Administration and Policy