Despite the many unknowns facing the healthcare industry in 2017, the new year appears to offer at least one sure thing — telemedicine and telehealth (used interchangeably in this blog) will continue to experience growth and acceptance among patients, healthcare providers, and payers.
Rock Health, a research firm dedicated to digital health, released its annual survey in December 2016 on how patients use digital health services. The survey, which more than 4,000 patients across the United States completed, found that 22 percent of respondents utilized telemedicine at some point in 2016. This represents over a 200 percent increase in utilization of telemedicine compared to Rock Health’s 2015 survey, where only 7 percent of respondents utilized telemedicine. The survey also found that patients reported satisfaction rates above 75 percent across all telemedicine platforms.
In an eye-popping utilization study, Kaiser Permanente was reported to offer 52 percent of its total visits over the previous year via online portals, virtual visits or mobile health apps. Patients’ usage of telemedicine will likely continue to increase in 2017 due to reduced travel time, medical efficacy, affordability, and increased access to individual care facilitated by telemedicine.
Naturally, provider trends are mirroring this increased patient utilization. 2016 saw many significant partnerships between large health systems and telehealth companies of various sorts. AmericanWell had an especially busy year, striking deals with New York Presbyterian, the Cleveland Clinic, Bon Secours (Md.), and Baptist Health South Florida, among others. Other 2016 partnerships included Teladoc’s affiliation with Hackensack Meridian Health (NJ) and endorsement from the American Hospital Association, Doctor on Demand’s link with Saint Francis Health System (Ok.), and, more locally, Spartanburg Regional Healthcare System’s adoption of MDLIVE and Piedmont Healthcare’s white-label partnership with Alii Healthcare. Already in 2017, Northwell Health (NY) has announced a partnership with Avizia.
State and federal legislatures and medical boards will also be busy with telemedicine policy in the coming year. The Federation of State Medical Boards (FSMB), a private, non-profit organization, announced in December 2016 that telemedicine is currently the most important medical regulatory topic to state medical boards. The survey respondents were asked to name issues and topics impacting their mission to protect public well-being. Approximately 75 percent of medical boards completing the survey identified telemedicine as an important regulatory issue. FSMB initiated the Interstate Medical Licensure Compact, an interstate licensing model that gained six states in 2016, bringing its total to 18.
In 2016, at least seven state legislatures and/or medical boards passed laws governing the practice standards for telemedicine, including significant endorsements of physician-patient relationships established by telemedicine in Wisconsin and Missouri, and similar progress in Arkansas. State legislatures also took up telemedicine parity with Rhode Island becoming the latest state to pass a parity law, and New York grappling with “payment parity” after passing a coverage parity law in 2015. Last year also demonstrated how laws affecting telemedicine will come in a variety of shapes and sizes, as Indiana, Michigan, Georgia and others passed laws prohibiting online-only eye exams of the kind popularized by the company Opternative.
At the federal level, the recently passed 21st Century Cures Act, the ECHO Act, and expansion of telehealth services in TRICARE are directives from Congress that telehealth is being gradually phased into federally driven healthcare. CMS also continued to update its Medicare claims processing manual regarding telehealth in 2016.
Finally, telehealth will be a hot topic among employers and schools in 2017. US employers began to enthusiastically support telemedicine services in 2016. According to Mercer’s National Survey of Employer-Sponsored Health Plans, 59 percent of large employers covered telemedicine services in 2016 compared to the 30 percent of large employers who covered such services in 2015. With large health insurers partnering with telehealth technology companies (see below), this trend figures only to increase. Telemedicine is also becoming increasingly present in school settings, an exciting development with proven efficacy, and also a host of novel legal questions.
Disclaimer: The foregoing materials are provided for informational purposes only, and are not to be construed as legal advice. Please consult an attorney before applying this guidance to any particular facts or circumstances.