Kristen McGovern on Cost Concerns and the Increasing Use of Telehealth

Despite concerns, the use of telehealth visits does not have a significant impact on the overall budget, explained Kristen McGovern, JD, partner at Sirona Strategies. In fact, a recent study found that using telehealth services decreased costs over the long term.

Transcript (slightly modified)

What are the concerns around controlling the utilization of telehealth services?

So the concern is that telehealth is so easy and so convenient that it will blow the budget by encouraging people who would have otherwise not sought care to seek care. They will suddenly have the ability to do it over their smartphones or though their computers and it will just be a lot easier and so there will be more utilization of the services.

The Alliance for Connected Care, which is the advocacy organization in DC that’s really trying to move the dial on reimbursement for the Medicare population specifically, did a study. We commissioned an actuary, you know the highest academic standards, and we asked them to look at, using commercial data because of course there’s very limited Medicare data since there’s very limited reimbursement, but using Medicare data he looked at utilization to see, is this a real concern? Is there a real foundation in the evidence for this? What he found was that a little more than 10% of the time, patients said that they were using telemedicine rather than doing nothing. Some people said they would have gone to an urgent care, but 10%, a little more than 10%, said that they would have otherwise done nothing. Then he looked at what would be the tipping point, so where would we really start to see a budget impact and he found that that number would have to grow to almost 33% for there to be an impact.

So, the takeaway there is that there may be some people that use services that would not otherwise access care, but that their ability to access telehealth and solve their problems on the spot contributes to decreased costs over the long term, and thus we would have to see a lot of people really using telehealth instead of doing nothing over time.

For the populations who may not be seeking any sort of care at all, is telehealth the lesser of 2 evils?

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So that’s what they found is that telehealth, generally 83% of the time, the telehealth visit resolves whatever the patient’s problem was. So the most common diagnoses are, over telehealth, urinary tract infection, sinus infection, pink eyesomething that’s fairly easily treated in a 1-time sort of visit. And then it’s that 17% where you think, "okay, if the telehealth visit didn’t resolve it, what would they have done and where would they have gone?" and so they basically found that there is cost savings down the road because people are able to treat things before they turn into a more acute problem.