Patients are becoming more and more interested in getting cared for by their provider at home, whether through tech or otherwise.
Today's patients may be busy, convenience-driven and tech-savvy, but they often face financial and logistical constraints too. To better meet the needs of patients, some practices are evaluating 'alternative visit models' that effectively mobilize patient care and bring it beyond practice walls to patients in the community. If you want to avoid the risk of losing (more) visits to 'convenient care', you need to get on this trend rather quickly as innovators are offering a variety of creative ways to meet the needs of patients better than traditional practices can.
How Prevalent Are Alternative Visits Becoming?
According to the American Academy of Home Care Medicine, Medicare Part B paid for 2,599,346 house calls in 2015. In fact, Medicare is actively researching the benefits of providing patient care in the home via their Independence at Home Demonstration, in which their stated goals are to "test the effectiveness of delivering comprehensive primary care services at home and if doing so improves care for Medicare beneficiaries with multiple chronic conditions."
In a two-year study across 15 enrolled practices, a savings of $7,821,374 has been demonstrated. Converted to per-patient cost savings, that's an average of $746 per beneficiary, so you can expect to continue to see Medicare invest there.
However, it is not just Medicare taking an interest and it is not just a service for the chronically ill and aged. There are a number of innovators ready to meet 'house call' demand and fill the void left by more traditional practices. Companies are actively marketing their visiting doctor services in specific regions as a convenient and comprehensive alternative to the typical medical practice visit. These organizations accept private insurance and Medicare plans, and are directly competing with practices and urgent-care facilities alike for your patients.
While some are tackling convenient house calls, others are developing mobile clinics nationwide. These practices on wheels are designed to meet the needs of patients with transportation and work scheduling issues. Mobile clinics are fully equipped to offer radiology, preventive health physicals, immunizations, and employee check-up clinics. Several of these models are designed toward providing free or low-cost care to underserved populations, while others, such as the Medicine on the Move Mobile Medical Center, accepts all kinds of healthcare insurance plans and is a convenient-care model.
What About Virtual Care and Telehealth?
Telehealth, telemedicine, e-Health, m-Health - there are many names for the rapidly emerging technology platforms that enable the 'virtual' visit.
The ability to visit with the doctor by video is nearly every bit as convenient as having providers conduct house calls. The use of telehealth is varied and broad, and tackles such areas as providing care access for rural health areas, replacing urgent care or on-call visits after (and sometimes during) open office hours, and for concerns that require frequent check-ins, such as managing diabetes and behavioral health. According to a Harris Poll, 65 percent of consumers are interested in seeing their primary-care provider (PCP) over video, and 20 percent of consumers said they were willing to switch to a PCP that offered video visits. That means that your ability to offer patients access to alternative ways to access care will impact your business and budget over time.
So How Can You Better Mobilize Care?
First, determine which services make the most sense to offer your patients:
• Survey your patients to ask them which types of services they would like to have available at your practice
• Evaluate your patients' access patterns to determine if there is opportunity to expand your geographic footprint through telemedicine. For example, are patients frequently accessing urgent care closer to their homes?
• Identify the prevalence of chronic care needs across your patient populations, they will be candidates for chronic care management, which can be delivered in a variety of ways.
Second, evaluate provider schedules and determine where there are opportunities to develop alternative visits, such as after hours when you can reduce overhead by not needing staff to service patients that providers may be able to 'see' via telehealth solo instead.
Utilize your mid-levels. They are well trained in patient management and make the most sense for delivering services which may not pay as well as in-office visits. You might consider sending nurse practitioners to 'round' on newborns or the recently discharged elderly patients in their homes. Carving an hour or two out of the office for more complicated and better-paying types of visits makes sense to do.
And don't overlook researching payment policies with Medicare, Medicaid, and commercial insurance payers to determine the following:
• Are home visits and video, text or other telehealth visits are covered?
• If so, are there specific requirements that need to be met in order for services to be covered?
• Which types of providers eligible for coverage?
• Which CPT and HCPCS codes are eligible for payment?
• Become familiar with your state laws on telehealth and make sure to follow any specific regulations http://www.cchpca.org/state-laws-and-reimbursement-policies
Being prepared to compete directly with convenient care by offering alternative visits through your traditional practice is the way to ensure that your business can thrive in the mobilized world of healthcare.