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PAGE / SLIDE / 1 @_ACHP www.achp.org Telehealth in the Spotlight July 23, 2020

Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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Page 1: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

PAGE /

SL I DE /

1

@_ACHPwww.achp.org

Telehealth in the Spotlight

July 23, 2020

Page 2: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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Thank you to our Sponsors

CAP MEMBERSA SPECIAL THANK YOU TO OUR CORPORATE ALLIANCE MEMBERS

TELEHEALTH IN THE

SPOTLIGHT

2

Page 3: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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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

Page 4: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

Opening Remarks

Ceci Connolly, President & CEOAlliance of Community Health Plans

Page 5: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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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.

Page 6: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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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

7

72%

41%

53%

60%

38%

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Telehealth Usage Nearly Triples

Previously Documented

Averages

TELEHEALTH IN THE

SPOTLIGHT

JULY 23, 2020

8

Page 9: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

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Telehealth in Rural Communities

Julie Brussow, CEO Security Health Plan

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Page 13: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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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14

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

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15

MCHS: Virtual Care and Telehealth Volumes

Virtual Care Phone Only Care

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16

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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17

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

Page 18: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

Telehealth Before and After COVID-19

Jim Sheets, VP, Outreach Services Development & Telehealth Intermountain Healthcare

Page 19: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

Page 20: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

Page 21: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

Page 22: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

Page 23: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

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Telehealth and Health Disparities

Sarita A. Mohanty, MDVP, Care Coordination, Medicaid and Vulnerable PopulationsKaiser Permanente

Page 25: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

TOTAL HEALTH

25

Social health is the health of a person's situation.

Page 26: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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

Page 27: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

% 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

Page 28: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

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.

Page 29: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

Thank You

Page 30: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

ACHP Telehealth Policy Recommendations

Tricia Barrentine Guay, Director, Legislative AffairsAlliance of Community Health Plans

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PAGE /

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

31

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Meet the ACHP Advocacy Team

TELEHEALTH IN THE

SPOTLIGHT

JULY 23, 2020

Tricia Barrentine GuayDirector, Legislative [email protected]

Matt DoBiasAssociate Director, External [email protected]

Anthony MontoyaPublic Policy [email protected]

Michael BagelDirector, Public [email protected]

Virginia WhitmanPublic Policy [email protected]

Tricia BrooksVP, External [email protected]

32

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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

Page 34: Telehealth in the Spotlight · 2020. 7. 24. · PAGE / ACHP Members Lead Innovations in Telehealth TELEHEALTH IN THE SPOTLIGHT JULY 23, 2020 6 CDPHP in Albany, NY, provides all members

Think Big