By Dr. Bill Lewis, MD & MBA, Chief Medical Advisor for Soul Being
Difficult and challenging times often create great opportunities to rethink your practice and business model. There are some healthcare thought leaders including myself that think this epidemic, as horrific as it is, will lead to a major realigning of healthcare towards telemedicine and e-health. A force arose that will create major disruption in the industry, which provides an excellent opportunity for wellness providers to leverage resources that can significantly improve patient access and bring efficiencies to their practice.
Prior to the COVID-19 outbreak, e-health and telemedicine were still not universally accepted by the public. Recent studies showed a range of 30-50% of patients had no knowledge of the capabilities of this approach. Additionally, state and payer regulations have slowed the adoption of e-health. For example, Medicare fee-for-service was not reimbursable, but Medicare Advantage adopted telemedicine in 2020 as a Part B Benefit. Commercial payers are likewise inconsistent in terms of what types of care they have reimbursed. Forty-two states have adopted parity laws that require telemedicine to be reimbursed equally to live visits. Loose regulations can leave Health Plans with the ability to discount these types of services.
In our current climate however, it would be hard to believe that anyone has not at least heard of this type of care. Now in the midst of the crisis, audio and visual encounters for the major telemedicine companies are currently up over 300%, some with 3-5 hour wait times. Audio-video conferencing enables provider groups to expand their geographic coverage and patient acquisition, as well as improve retention.
Millennials are particularly adaptable to these services in the healthcare arena as they are familiar with this approach through their usage of technological disruptors across many industries, including Uber, Doordash, and Seamless. The convenience, decreased travel, and “anywhere/anytime” capabilities offered through telemedicine serve as major advantages for a practice and its patients. Other more subtle benefits are efficiencies for the practitioner in terms of their time, and also in decreasing traffic flow in their clinics or offices. Some practices committed to telemedicine and e-health are already scaling down their floor plans and office square footage because of these new capabilities. This also leads to less staffing strain and decreased operating expenses.
In response to the current state-of-emergency, Federal and State government regulations have been implemented suspending many of the rules that limited access to telemedicine. Previously, a live visit or demonstrated establishment of a patient relationship was required before being able to conduct an e-health visit. These “originating site” limitations have now largely been removed, allowing patients to be seen from the home or any other institutional setting.
The Notification of Enforcement Discretion on Telehealth Remote Communications allows the usage of non-HIPPA complaint communication platforms like Face Time, Skype, Messenger or Hangouts. The Office for Civil Rights will waive potential penalties for HIPAA violations through these technologies during the COVID-19 public health emergency, improving access and flexibility for all to seek medical care through telehealth.
Simultaneously, states are taking comprehensive actions to enable telemedicine visits, with executive orders requiring health care insurance companies to expand telemedicine coverage for all services that would normally be covered for an in-person visit in many states. This ensures that those who are sick or under quarantine can access care from their homes and avoid potentially risky trips to a healthcare provider.
Although the relaxation of these rules around e-health may not be permanent in the general way applicable to the current state-of-emergency, we will certainly never go back to the previous baseline now that the true value of virtual healthcare has been recognized. Many wellness services can be very amenable to virtual encounters. Patients can be counseled and psychologically supported with behavioral therapy using audio-visual technologies. Dietary and lifestyle modification changes can be supported with educational content and videos. Tele-Physical-Therapy is rapidly gaining acceptance and is thus applicable for follow-up visits for chiropractic and athletic trainer visits. Patient can be talked through passive ROM, observed performing their stretches and exercise program while modifications are being made. The applications are almost limitless.
This is an ideal time to experiment and try providing some or additional virtual services for your practice. There are literally no barriers to entry during this cycle. Please investigate the specific state laws that apply to your practice and consult with legal counsel if you have any questions on state or federal regulations.
Soul Being can serve as a practice gateway for e-visits in terms of patient acquisition, and we are also in development of a real-time virtual telehealth service to support and guide each individual’s personalized health journey. If this sounds interesting to your practice, please notify us and communicate what type of services would be most valuable so you can help inform our design process. The ability to market your services, acquire new clientele, schedule, and see your patients on a single platform will have significant value to any practice well beyond our current state-of-emergency.
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