Build a sustainable telehealth practice
The COVID-19 public health emergency has created an urgent need for telehealth and telemedicine services. Patients will likely expect their providers to continue providing high-quality, value-based virtual care. Value-based care is a type of program that ties payment to the quality of care received instead of the number of patients treated.
There are several factors to keep in mind when building a telehealth practice that is successful in the short term and the future.
- Telehealth Start-Up and Resource Guide (PDF) – The Office of the National Coordinator for Health Information Technology (ONC)
- Telehealth and COVID-19: Provider Innovations and The Need To Think Sustainably (PDF) – from the Georgia Health Policy Center
Choosing telehealth technology
Reliable, accessible technology is the foundation of any telehealth practice.
The federal government decided not to enforce certain rules in the Health Insurance Portability and Accountability Act (HIPAA) in early 2020 due to the COVID-19 public health emergency. This decision allows providers to use common video conferencing platforms that are not normally considered HIPAA-compliant.
These rules may change soon. You can prepare for when that happens by asking yourself these questions:
- What technology do I already have? You may already have tools like videoconferencing, billing software, and digital patient intake forms
- How do I protect my patients’ information? Your electronic health record (EHR) system can be used to make your telehealth practice more efficient
- What services do my patients need? Your patients may have specific needs such as remote glucose monitoring
- What is my telehealth budget? This will vary based on the type and size of your practice
Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency – from the Department of Health and Human Services (HHS)
A well-prepared staff is key to creating a sustainable telehealth practice.
- Schedule trainings to increase comfort with telehealth technology
- Actively seek feedback from staff to find out what is working well and what is not
- Be willing to shift staff roles and responsibilities or provide dedicated staff in charge of telehealth coordination
Staff Training, Education May Be The Keys To Telehealth Sustainability – from The National Consortium Of Telehealth Resource Centers
Federal and state governments have implemented a variety of policy changes to support provider billing and payment. Services affected during the COVID-19 public health emergency include:
- Expanding the location of where services may originate
- The types of services that may be provided
- Increasing the rate of reimbursement for services delivered virtually
- Adjusting payment financial risk models
Did you know?
During the COVID-19 public health emergency, any healthcare provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. For more information, see:
- Medicare Coverage and Payment of Virtual Services (video) — from the Centers for Medicare & Medicaid Services
- List of Telehealth Services — from the Centers for Medicare & Medicaid Services
- Current State Laws & Reimbursement Policies — from the National Policy Center - Center for Connected Health Policy
Evaluating your practice
As your telehealth practice evolves, you may need to maintain, increase, or secure new funding. Tracking your practice’s performance can help you demonstrate the value of your virtual care and find areas of improvement.
Valuable metrics to consider include:
- Satisfaction — Are patients and providers happy with their telehealth experience? Are post-visit surveys regularly distributed?
- Technical performance — How long does it take patients to connect to the videoconferencing service? How often are calls dropped due to technical difficulties?
- Financial impact — What is the average cost per visit? How many patient travel miles have been saved? What is the return on investment?
Metrics for Assessing the Reliability of a Telemedicine Remote Monitoring System – from National Institutes of Health
The Evidence Base for Telehealth – from The Agency for Healthcare Research and Quality
Ensuring patient access
Unequal access to health care is a societal issue that exists beyond telehealth.
These groups may need your support to receive the virtual care they need:
- People with disabilities
- Older individuals
- The uninsured and underinsured
- Those with limited English proficiency or limited digital literacy
- Those with limited internet access
Get creative to ensure equal access for your patients.
- For patients in rural areas with limited internet service, suggest central locations with Wi-Fi. Examples include schools, libraries, and community centers
- Consider “drive-up” telehealth options, where patients drive to the office’s parking lot and a staff member brings out a tablet for their telehealth visit
- Offer materials accessible in different formats and multiple languages
- The Telehealth Partner Toolkit has ready-made, customizable content designed to help patients and caregivers learn about telehealth
Telehealth & Health Equity (PDF) – from Centers for Disease Control and Prevention