Knowing that healthcare costs will continue to rise, leaders within the healthcare sector are searching for solutions to minimize cost without jeopardizing quality of care. These two factors may seem contradictory; however, Vice President of Government Affairs for American Well, Kofi Jones feels as though these two do not have to be mutually exclusive. Jones published a post on The Health Care Blog encouraging ACOs to integrate telehealth in order to produce revenue and engagement. (Jones, 2016) While Jone’s solution seems practical, there are many uncertainties that make this proposal unlikely to gain traction.

As outlined by the CMS, ACO’s primary goal is to provide “coordinated care to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical error.” (CMMS, 2016) In other words, ACOs mission is to deliver high-quality care while spending less by offering all levels of care through a one-stop shop approach. However, can telehealth alone bridge the gap between patient care and cost? It is safe to say that telehealth by itself cannot solve the entire healthcare inadequacies. Nonetheless, as outlined by Jones, telehealth can serve as a starting point.

Jones believes that telehealth is a solution in the right direction and ACOs should consider this tool as a viable option. The American Telemedicine Association (ATM) lists four telehealth competencies: improved access to care, improve quality of care, increase cost efficiencies, and meet patient demands. (ATM, 2017) Living in the age of technology, Jones questions why the uptake of telehealth by ACOs has not been ubiquitous. Considering that telehealth is a vehicle through which ACOs can achieve better, faster, and cheaper health, administrators should take action and enable these services.

ACO critics fear that consolidating treatment and payment methods may lead to a monopolized healthcare system that can in return drive the cost of treatment for individual patients. Political commentator, Avik Roy states, “powerful hospital chains know their insurers have no choice but to accept their jacked-up rates, and the cost of health insurance goes up whenever it suits their needs.” (Roy, 2011) For Roy, merging physicians and hospitals is contrary to what ACOs are actually trying to accomplish. Economics theory of supply and demand would agree with Roy.

While concerns presented by the opposition are valid, it is important to look at current integrated managed care consortiums like Kaiser Permanente that mirrors the ACO model. Overall, Kaiser offers most of their treatment to patients through unilateral, in-house services. This presents many great benefits because the increased communication between all parties care for patients fosters a teamwork environment. (Kaiser, 2015) For instance, having individuals move back and forth between providers for treatment can result in the loss of patient follow-up through lack of coordination and miscommunication errors. Contrary to this disorienting model, Kaiser facilitates the sharing of patient information so that patients received the best treatment based on in-site, holistic evaluations.

In order for ACOs to continue improving, there are implementations that can help more providers follow the Kaiser Permanent blueprint. As described earlier, Jones makes it clear that telehealth can spearhead this mission. Furthermore, Chief Policy Officer of the ATA, Gary Capistrant agrees with Jones: “We think all Meducare ACOs should be able to use telehealth to provide the Medicare range of coverage” and this new innovation can “better serve Medicare beneficiaries.” (ATA, 2016)

So what can telehealth exactly do for ACOs? Chiron Health, a telemedicine company advocates telehealth for individuals with chronic conditions. This is particularly beneficial for those that need ongoing monitoring. (Smith, 2016) This can be particularly beneficial for those with chronic conditions that need ongoing monitoring. For instance, the quick access to a medical provider will play an important role in preventative health. This tool can greatly reduce patients from checking into hospitals when their conditions have reached extreme conditions. Often waiting for extreme conditions lead to immediate treatment that is expensive. Moreover, because one of ACOs major incentives is monetary compensation through bonuses by reducing cost, then telehealth can be become a great resource for efficiency.

One major challenge of incorporating telehealth lies heavily on getting people to adopt this method of preventative health. For telehealth to functions at its full capacity; physicians, clinics, and the general public need to adopt the technology and integrate it at all levels. The challenge lies on the lack of research to demonstrate the positive effects of telehealth on the healthcare system. As a result, people are skeptical about this transition. Without knowing the benefits of telehealth, Medicare programs are unlikely to incorporate this method to their proposed ACO models. Brining in technology like telehealth is a big investment and providers don’t want to gamble on projects that yield mixed results.

Moving forward, it is consequential for ACOs to consider which type of technology they are willing to invest in so that they can reduce healthcare costs. The right kind of technology can make all the difference. In her blog, Jones ends her commentary on telehealth with “the good news outweighs the bad.” (Jones, 2016) It can be inferred from Jones’ statement that telehealth alone is not a one-size-fits-all solution. Yet, the benefits of this technology are critical for the success of ACOs. With healthcare costs on the rise, decisions have to be made. To mediate healthcare costs, telehealth can be a steppingstone in the right direction.

Good news that nothing is static and the thought that telemedicine will be used in conjunction with what there is today, improvement is underway!

Or,
Is telehealth presently set up so that the doc has an docent/assistant at the patient’s side who can do these things and see that their results are adequatly sent to the doc?

And,

Is it even possible to transmit some of these data? Eg. feeling the thickness of a suspicious nevus is important. Do you think this can be done through telehealth techniques? Telling a benign lipoma from a more ominous neoplasm might be impossible without actually doing it yourself.