These days, we are always online – scrolling through our phones, checking our emails and social media. So, it’s quite surprising that adoption and usage of telehealth services (videoconferencing with physicians/nurses, provider trainings, remote meetings, medical educational services, etc.) remains low – even with technological advancements in online connectivity and video transmission capabilities. Nobody loves waiting hours for their doctor, so why are we not hopping online for a check-up?
The demand is certainly there, 84 percent of commercial insurance subscribers said that they would use video or online services if they were offered, but telehealth care hasn’t fully come into the fold yet. According to Definitive Healthcare’s data, only one-third of inpatient hospitals and 45 percent of outpatient facilities provide telehealth solutions or services.
Why are providers slow to implement telehealth solutions?
Here are a few possible reasons:
Fraud – There have been a handful of high-profile fraud stories, with the most recent changes from just earlier this month. Five telemedicine companies were allegedly part of a complex scheme in which healthcare providers convinced Medicare beneficiaries that they needed back, shoulder, wrist, and/or knee braces, regardless of medical necessity. They laundered the proceeds through international shell corporations, which were then used to buy cars, yachts, and real estate. With charges like these, it’s no wonder that providers may be reticent to invest in virtual care technologies.
Policy – The movement toward telehealth may also be stalling due to federal policy and regulations. The Centers for Medicare and Medicaid Services (CMS) only just finalized expansion of provider reimbursement for telehealth and virtual care services in late 2018. In addition, as of 2020, Medicare Advantage members will have more access to virtual care visits, according to a new ruling from CMS that was recently finalized. Providers may be waiting for this new reimbursement ruling to go into place before installing telehealth technologies.
Cost – Cost may be the most significant barrier to wider telehealth adoption. Providers must consider if they want to make a large financial investment in a technology that may only apply to a small portion of their patients, especially as insurance reimbursement for telemedicine is still in the early stages.
Continuity of care – There is a concern that as telehealth solutions are added, providers may not be able to gather the personal insight that comes with consistent treatment by the same caregiver over time.
Playing the waiting game – When it comes to implementing new technology, the healthcare industry does lag behind every other industry. Providers’ budgets are tight, and human lives are at stake, so they typically prefer to invest in tried-and-true methods with proven ROI. Right now, many providers are simply watching to see how it all unfolds before committing to investing.
Telehealth market share across US hospitals
Currently, the telehealth vendor market share at U.S. hospitals is varied. According to Definitive Healthcare data, and as of April 2019, VRad, a radiology telehealth provider, holds a significant market share lead at 29 percent, followed by InTouch Health and American Well, with 19 and 11.2 percent respectively. MDLIVE, AMD Global Telemedicine, and AMC Health are also bigger players – each possessing a bit more than 5 percent of the market share.
Because only one-third of inpatient hospitals have a telehealth solution installed, there is lots of greenspace in this market.
Fig 1 Telehealth solution implementation by state, according to data from Definitive Healthcare's platform, as of April 18, 2019.
Utah, Iowa, and South Dakota have the highest reported implementations with 64 percent or more of the state’s hospitals reporting a solution. Northeastern states currently report the lowest level of adoptions, and therefore are prime for opportunity. Currently, about 136 hospitals are thinking of implementing a telehealth solution in the near future, according to Definitive Healthcare's hospital & IDN data.
Telehealth market share across outpatient facilities
Between 2017 and 2018, telehealth implementation in outpatient facilities remained fairly flat, rising only about five percentage points (44.8 percent to 49.4 percent).
However, outpatient telehealth procedures showed growth between these years among physicians, physician groups, and for outpatient hospital-based claims:
Fig 2 Light green (2018): number of HCPCS/CPT codes for outpatient telehealth services compared against darker green (2017) outpatient telehealth services – from the Definitive Healthcare platform.
Even though telehealth adoption in the outpatient setting is still maturing, the demand for these solutions clearly seems to be growing and is driving solution use at these facilities.
In our upcoming live webinar, Selling to Doctors in the Fast-Growing Outpatient Market, on May 1st at 2pm EST, Definitive Healthcare's very own Enterprise Account Executive Maggie Fortune will discuss how to identify selling opportunities in the rapidly-growing outpatient care market.