Foley & Lardner LLP

11 November 2014

2014 Telemedicine Survey Executive Summary

As health care executives transform operations to comply with the Affordable Care Act, they are gearing up for the next monumental shift in the industry: telemedicine.

Technology has influenced nearly every sector of the economy, and the health care industry is following suit. Among telemedicine’s many benefits are the potential to exponentially expand a provider’s geographic footprint, use doctors’ time more efficiently and dramatically reduce the barriers to patient interaction.

Health care leaders tell us that their organizations are committed to continuing to implement telemedicine programs, even as they face challenges such as getting doctors to buy into the programs and insurers to pay for them. Why? For the majority of respondents, it’s simple — they believe telemedicine will help them keep patients healthier.

This report is based on feedback from health care leaders, the majority of whom are C-level executives from for-profit and nonprofit care providers, including hospitals, home health organizations and physician group practices. We asked them to evaluate the prospects for improved patient care and streamlined operations through telemedicine advancements, as well as regulatory hurdles and obstacles to reimbursement.

Executives Are Embracing Telemedicine

Telemedicine is not a distant possibility; it is here and in play now. The vast majority of leaders (90 percent) report that their organizations have already begun developing or implementing a telemedicine program. Most also say that offering meaningful telemedicine services will be critical to the future success of their organizations.

  • Eighty-four (84) percent of respondents felt that the development of telemedicine services is either very important (52 percent) or important (32 percent) to their organizations. Virtually none said they considered the technology to be unimportant (3 percent).
  • While just 6 percent of respondents categorized their telemedicine programs as “mature,” only 8 percent said they had none at all. The remainders of responses are clustered somewhere in the middle: 34 percent are under consideration or in development, 18 percent are in the optimization phase, and the remaining 36 percent are being piloted or implemented.
  • A majority of respondents already offer remote monitoring (64 percent), store and forward technology (54 percent), and real-time interaction capabilities (52 percent). Additionally, 39 percent say they have services that qualify as mHealth — patient-driven apps and online portals.

The Affordable Care Act Is Driving Telemedicine Advancements

This attitude is partly due to the shift in financial and payment incentives under the ACA. As health care providers move from a fee-for-service model to one that reimburses based on positive patient outcomes, providers bear a greater share of the risk — and potential reward — for keeping their patients healthy. In addition, the level of responsibility shifts even more for providers in risk-bearing contracts or capitated arrangements, in which payments are made per person rather than per service. For executives under pressure to find cost-effective methods of engagement with their patients, telemedicine offers ways to streamline operations and create multiple touch points with patients, making it one of the most reliable methods for transitioning to a post-ACA, forward-looking reimbursement model.

  • Executives are most excited about telemedicine’s potential to keep patients healthier. Half of respondents (50 percent) ranked improving the quality of care as their number one rationale for implementing telemedicine. Another 18 percent were most excited about reaching new patients.
  • Despite the cost savings tied to telemedicine, health care leaders do not expect an immediate economic return on investment. A minimal percentage of respondents ranked the potential for increased revenue/ profitability (11 percent) and getting a jump on the competition (4 percent) as their top motivators.

Reimbursement Is the Primary Obstacle to Implementation

Although leaders fully endorsed the robust prospects of telemedicine, they were less confident about its immediate adoption. The widespread use of telemedicine requires doctors to be willing to transform the look and feel of the traditional, in-person patient visit. Meanwhile, the customary fee-for-service environment makes it challenging to be paid for medicine practiced outside the traditional spheres of interaction.

  • Being paid for telemedicine remains an uphill battle, as indicated by 41 percent of respondents who said they are not reimbursed at all for telemedicine services, and 21 percent who reported receiving lower rates from managed care companies for telemedicine than for in-person care.
  • Aside from reimbursement challenges, 48 percent of executives say they are more concerned with convincing doctors about the credibility of telemedicine than they are with convincing doctors that they will be adequately compensated for practicing it (36 percent).
  • This uncertain environment led 87 percent of respondents to report that they do not believe a majority of their patients will be using any of their organization’s telemedicine services three years from now. Almost one-quarter said they anticipated fewer than 10 percent of their patients utilizing their organization’s services.