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@_ACHPwww.achp.org
Telehealth in the Spotlight
July 23, 2020
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Thank you to our Sponsors
CAP MEMBERSA SPECIAL THANK YOU TO OUR CORPORATE ALLIANCE MEMBERS
TELEHEALTH IN THE
SPOTLIGHT
2
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Agenda
➢ Opening Remarks
➢ Ceci Connolly, President & CEO
➢ Congressional Perspective on the Future of Telehealth
➢ ACHP Member Insights
➢ Telehealth in Rural Communities - Security Health Plan
➢ Telehealth Before and After COVID-19 – Intermountain/SelectHealth
➢ Telehealth and Social Disparities – Kaiser Permanente
➢ ACHP Telehealth Policy Recommendations
➢ Tricia Barrentine Guay, Director, Legislative Affairs33
JULY 23, 2020
TELEHEALTH IN THE
SPOTLIGHT
Opening Remarks
Ceci Connolly, President & CEOAlliance of Community Health Plans
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Telehealth During the Public Health
Emergency: Increased Utilization
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
5
ACHP members have seen increases in telehealth utilization
across all lines of business
• PacificSource, operating in the Western United States, has seen a 4600% increase in telehealth utilization.
• Presbyterian Health Plan in New Mexico has seen an increase of 1200% in telehealth use compared to before the pandemic.
• UCare in Minnesota has seen an over 1000% increase in telehealth utilization.
The demand for telehealth services is set to grow by 64.3% in the United States in 2020 alone.
The telehealth market in the United States is estimated to display a staggering seven-fold growth by 2025, resulting in a five-year compound annual growth rate of 38.2%.
The number of Medicare FFS beneficiaries who utilized telehealth in a week skyrocketed from roughly 13,000 before the pandemic to 1.7 million in the last week of April.
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ACHP Members Lead Innovations
in Telehealth
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
6
CDPHP in Albany, NY, provides all members access to virtual emergency medicine services 24/7, ensuring the pandemic is not a barrier to receiving emergency care.
CommunityCare in Tulsa, OK, deployed telemedicine and e-visit options in the wake of the crisis, expanding coverage for all medically necessary services, including behavioral health services.
Geisinger Health Plan in Danville, PA, and Priority Health in Grand Rapids, MI, are deploying chatbots to help triage and screen patients remotely.
Dean Health Plan in Madison, WI, expanded access to telehealth services through FaceTime, Skype and Zoom so members have broader means to medical services.
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Many, Including Vulnerable
Populations, are Delaying Care
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
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72%
41%
53%
60%
38%
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Telehealth Usage Nearly Triples
Previously Documented
Averages
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
8
Representative Mike Thompson (CA-5), Founder and Co-ChairCongressional Telehealth Caucus
Congressional Perspective on the Future of Telehealth
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Leadership for the Future of
Telehealth
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
Representative Mike Thompson (CA-5)
Founder and Co-ChairCongressional Telehealth
Caucus 10
Telehealth in Rural Communities
Julie Brussow, CEO Security Health Plan
Our reach around Wisconsin
13
• 59 of 72 counties served with a network product
• Members in all 72 counties• Major network providers:
Marshfield Clinic Health System
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Our Service Area: A Uniquely Rural Perspective
• 80% of rural residents reside in the MCHS/SHP service area – MCHS is by far the largest provider of primary care in the region
• Geographic isolation is a challenge
Median Age
39.2State
44.9MCHS
Median Income
$59KState
$51KMCHS
Percent in Poverty
11%State
12.5%MCHS
Children eligible for Free/Reduced Lunch
37%State
42%MCHS
State vs MCHS Service Area
15
MCHS: Virtual Care and Telehealth Volumes
Virtual Care Phone Only Care
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Key Observations
• Telehealth rapidly accepted by providers and patients
• High rates of adoption and satisfaction
• All specialties were able to adapt (to varying degrees)
• Success of behavioral health
• Modalities varied by user
• Telephone only service higher rates than video-conference in our service area
• Video visits limited by lack of access to broadband and smartphone
• Patients seem to be reverting to in-person visits unless prompted, and the same holds true for providers
• Reimbursement certainly will spur commitment and investment by providers and health systems in general to make telehealth permanent and part of standard practice
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Policy Recommendations
• Congress and HHS should make permanent changes related to telehealth eligibility and reimbursement
• Site of Service
• Patient Relationship With Provider
• Telephone Only Visits
• Expanded list of eligible services
• Clinician training
• Infrastructure investment to bridge digital divide
Telehealth Before and After COVID-19
Jim Sheets, VP, Outreach Services Development & Telehealth Intermountain Healthcare
Intermountain Connect: Expanding Reach
• Intermountain Connect Sites
20 partners
8 core programs
1.3 M + interactions
35+ services
Transforming Telehealth Rooted in Decades of Expertise
Intermountain Connect Vision: Providing Care When, Where, and How People Need It
• Technologically advanced virtual hospital based on Intermountain’s 45 years of evidence-based care process models
• Provider network available 24/7/365
• Connect Care (DTC Services) offers consumers direct access to providers in 3 core areas
• Connect Care Pro (B2B Services) provides health systems and rural hospitals access to Intermountain clinical expertise in 6 clinical programs
• Connect Care Pro – Pediatrics includes Emergency/Trauma, Critical Care, Newborn Resuscitation, etc.
• More programs under development
Urgent Care Scheduled Video Visits
OncologyCritical Care
Stroke Crisis Care
Infections Disease
Hospitalist
Behavioral Health
Telehealth and Digital Interactions(cumulative since Inception)
40,089
96,837
193,217
350,083
566,806
845,769
1,194,907
1,286,574
-
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
2014 2015 2016 2017 2018 2019 May-20 20-Jun
Big 4
Urgent Connect Care
ScheduledVideo Visits
COVID Pandemic
Connect Care(100K visits)
Pilot systems
Pilot: TeleCritical Care, Crisis Care, TeleStroke, Newborn Critical Care, Lactation, Craniofacial, Neuro Oncology
Big 4: TeleCritical Care, Crisis Care, TeleStroke, Newborn Critical Care
May 2020 : > 1,000,000 Interactions, Connect Care > 100K visits
Chat Bot Screener Covid Call Center
Key Program AttributesOVERVIEW• A virtual COVID-19 screening/symptom checking tool• 10-15 questions covering clinical indicators and risk
factors
Key Program Attributes
OVERVIEW• A 24/7 COVID-19 community call center• Screening and test referral service• Based on CDC guidelines
121,014
60,497
10,984 12,941
March April May June
2020 Chat Bot Clinical Screenings37,701
16,00219,433 20,337
March April May June
2020 Clinical Covid Screenings
Urgent Care Scheduled Video Visits
4,924 4,530
10,301
16,20218,425
15325
0
5,000
10,000
15,000
20,000
Jan Feb March April May June
2020 Completed Visits
Key Program AttributesOVERVIEW• Provides patients with direct access to clinicians 24/7/365
for a variety of Urgent Care needs with maximum convenience
Key Program Attributes
OVERVIEW• Video visits with
physicians to replace in person clinic visits
• Outpatient Telehealth utilization increased from roughly 3% of visits to over 35% of visits in April
Implemented over 15 Federal Waivers
• Key waivers implemented include:o Expanded coverage for telehealth services
➢ Medicaid and Medicare expanded the list of covered services➢ Waiving of cost sharing obligations➢ Removal of frequency limitations
o Ability for providers to connect with patients across state boundarieso Expanded technology solutions
➢ Privacy and security flexibilities
o Expansion of eligible providers to include PT/OT/ST o Reduced restrictions on the location of the patiento Flexibilities for Home Health and Hospice Serviceso DEA flexibilities to allow prescribing of controlled substances via technologyo Remote Patient Monitoring flexibilities
Telehealth and Health Disparities
Sarita A. Mohanty, MDVP, Care Coordination, Medicaid and Vulnerable PopulationsKaiser Permanente
TOTAL HEALTH
25
Social health is the health of a person's situation.
Kaiser PermanenteVisit Distribution - % of Total Visits
Among In-Person, Scheduled Telephone, and Video Visits
Scheduled Telephone and Video visits have increased from 15% of visits in Jan 2020 (pre COVID-19) to 55% of visits in June 2020.
85.3% 85.2%
60.9%
34.3%39.1%
45.0%
14.4% 14.5%
37.5%
58.9% 48.4%41.5%
1.6%6.8%
12.5% 13.4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Jan '20 Feb '20 Mar '20 Apr '20 May '20 Jun '20
% o
f T
ota
l V
isits
In-Person Scheduled Telephone Video
COVID-19
% Video VisitsAs a percent of Video and Scheduled Telephones
By Line of Business – Kaiser Permanente
0%
5%
10%
15%
20%
25%
30%
Jan '20 Feb '20 Mar '20 Apr '20 May '20 Jun '20
% V
ideo
Vis
its
Medicaid Commercial Medicare
Data source: IDR Metrics Mart. Markets: NCAL, SCAL, NW, HI, MASCOVID-19
Video visits (as a % of video and scheduled telephone visits) have increased for all lines of business; however, rates are still
lower for Medicaid and Medicare compared to Commercial
Supplemental Nutrition Assistance Program (SNAP) Enrollment
In 2019, KP’s multimodal outreach campaign helped 15,000 people apply for CalFresh benefits (California's SNAP program).
In April 2020, the CalFresh outreach campaigns were accelerated to meet growing demand.
Approximately 45,000 additional people have submitted applications, far exceeding the rate of engagement from prior campaigns.
Expansion of SNAP enrollment to other KP markets is underway.
Thank You
ACHP Telehealth Policy Recommendations
Tricia Barrentine Guay, Director, Legislative AffairsAlliance of Community Health Plans
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ACHP Telehealth Recommendations
to Congress
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
Make site of service flexibilities permanent
Expand provider groups eligible to provide telehealth services
Include telehealth in Medicare Advantage risk adjustment
Relax federal licensure restrictions
Expand broadband access
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Meet the ACHP Advocacy Team
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
Tricia Barrentine GuayDirector, Legislative Affairstguay@achp.org
Matt DoBiasAssociate Director, External Affairsmdobias@achp.org
Anthony MontoyaPublic Policy Associateamontoya@achp.org
Michael BagelDirector, Public Policymbagel@achp.org
Virginia WhitmanPublic Policy Associatevwhitman@achp.org
Tricia BrooksVP, External Affairstbrooks@achp.org
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Join the Weekly Telehealth
Conversation
#TelemedNow
TELEHEALTH IN THE
SPOTLIGHT
JULY 23, 2020
Keep the Conversation Going#TelemedNow
Wednesdays at 8:00pm
33
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