One of the stro
ngest arguments in favor of adopting telemedicine has always been cost efficiency. With estimated savings that total in the billions, telemedicine has been viewed as a no-brainer solution to a national healthcare system most strongly characterized by crippling, prohibitive cost.
This line of reasoning found itself under scrutiny recently from the Medicare Payment Advisory Committee, as reported by mHealthIntelligence. A major discussion point centered on whether patients, with lowered barriers to access, were now seeking more care than was strictly necessary. The average telemedicine appointment costs between $40 and $50 compared to an estimated $176 for in-person visits. It’s reasonable to assume that, even occurring with increased frequency, virtual appointments still provide substantial savings.
Preventative medicine has long been a deficiency of the US healthcare system – despite its proven benefits. Our reactive attitude traditionally leads to much higher associated costs. With increased focus on preventative care and consistent provider interaction, emergency room and hospitalization costs are mitigated.
At its core, telemedicine is positioned as a means by which to make quality care easy and affordable to access. Surely increased appointment volume is an indication of success, not cause for concern.
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Telemedicine, as a natural next step to catch up to how we already communicate with each other and carry out business or professional communication, is long over-due; but it will not bend the cost curve or solve the access problem until we actually identify WHY costs are so high. There are many factors affecting costs, but the single most important driver in the U.S. system is precisely a function of how we are forced to access, pay for and get reimbursed for care.
It is a perverse combination of mandated coverage combined with all manner of direct and indirect subsidies and contractually mandating “claims” protocol that prohibits market forces from having a desirable effect. This leads to a distortion of demand on the patient side and a perverse incentive to code/bill for revenue on the provider. Almost all of the money available for healthcare is trapped within premiums and then is obligated to flow through the billing cycle.
I implore those in the Telemedicine space, as well as policy-shapers, not to make the mistake of pushing a mandate requiring that telemedicine be paid for by third-party payers. This is exactly the wrong approach if we really want to see cost curve bend down (disinflation and deflation). Mandating coverage always results in higher aggregate costs in the long run and secondary to that it often results in less access, not more, due to higher and higher premiums and spiral of increasing cost-sharing (profit support subsidies for the the third-party) that occur when services are placed under the “insurance” umbrella. We see this phenomenon played out all the time, especially at the state level, where the accumulation of mandated coverage for a whole host of quasi-medical services have made coverage unaffordable for 1 of 4 people.
Once I explain exactly what telemedicine looks like in practice and debunk those myths, a majority of doctors are ready to come onboard or are at least open to considering telemedicine. So the challenge is educating providers about that misinformation. What s true about telemedicine and what s not?