Telemedicine solidified its place in primary care

Kathy Driscoll, MSN, RN, CCM

Senior VP and Chief Nursing Officer

Bio

Ms. Driscoll oversees Humana’s strategy of improving the experiences of the company’s 10,000 nurses, care managers and social workers. Her efforts focus on promoting a culture that engages, values and inspires clinical professionals while impacting health outcomes.
Primary care telemedicine use in 2020 rose faster and reached higher levels among Humana MA patients affiliated with value-based organizations compared with those in non-value-based arrangements.

Accountability for cost, quality and disease management under value-based payment models may have been a stronger catalyst for telemedicine adoption than recouping revenue from deferred in-person visits, a study of health maintenance organization (HMO) members from March 1-Sept. 30 by Humana Healthcare Research suggests. Within the shared-savings categories of the value-based primary care continuum, adoption happened at an even quicker pace among physicians at the greatest risk level, according to the research.

In late April, at the peak of use, value-based physicians used the technology at a rate of 50.1 telehealth visits per 1,000 members per week compared to 9.3 visits per 1,000 within the non-value-based space.1

Additionally, many value-based practices were helped by infrastructure, technology and management systems in place at the start of the COVID-19 outbreak, interviews with study participants revealed.

Why it matters:

Patterns of outpatient care shifted drastically during the early stages of the COVID-19 pandemic, with deferred in-person care leading to substantial revenue losses for many non-value-based primary care organizations. The shift created a strong financial incentive to move to telemedicine visits, especially among value-based organizations focused on quality and continuity over quantity of care.

The way forward:

Though the study period examined telemedicine use between January and September, the trend among value-based practices continued through the rest of the year. It remains a vital connection tool for physicians as some patients remain leery of in-person contact or prefer the platform’s convenience.

Physicians interviewed for the study said they believe telehealth is here to stay. While continuing to use it, a number of physicians are changing their approach. Some are no longer writing prescriptions for certain conditions until patients are seen physically. Others are using the momentum of telemedicine’s acceptance to expand virtual offerings.

Mercy Health in Missouri, looking to capitalize on convenience for patients and enhance the customer experience, built the ExpressCare platform. Though being piloted, the tool, accessible via an app, enables users to fill out a brief questionnaire. Those answers prompt a personalized escalation path that connects them to the proper provider.

“It breaks that boundary of time and space. Even telehealth is bound by the time there is a person on video and structured by a schedule. This platform lets patients be asynchronous. Whenever they want to start the encounter, they can start that conversation.”
Michael Michetti
Mercy’s senior vice president of clinical operations