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The opportunity to reshape care delivery and create a more efficient and cost-effective healthcare system is achievable because of the acceleration and adoption of technology.

In this issue of The Remington Report, we discussed the new era of care at home. Each of these discussions depends on the expansion of technology for care in the home. The invisible technology boundaries expand the rules of who can offer care in the home, how they will be paid, and create a less restrictive policy environment to deliver care at home.

TECHNOLOGIES THAT WILL TRANSFORM CARE AT HOME

  • Virtual visits in the home
  • Remote patient monitoring, wearable, and digital health
  • Data Analytics and EHRs

1. Virtual Visits in the Home

Virtual visits in the home now expand to the hospitalist, advanced practice provider-type roles, and physicians. They can access real-time, complete a visit, assess, diagnose, and implement interventions with individuals in their homes, and get reimbursed.

This is a real game-changer for care in the home providers. Strategically it is important to understand how to leverage new referrals and relationships and analyze who new market players are.

In this issue, we provided additional details about how transformation is creating new care models. Examples of expanded models supporting virtual visits in the home include:

  • The Acute Hospital Care at Home (see article pages 9-10). For beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis
  • The 2021 Physician Fee Schedule. The final rules permanently allow Medicare providers to use telehealth to carry out home visits for evaluation and management services and some visits for people with cognitive impairments. Medicare Advantage Plan.
  • Many Medicare Advantage Plans are including patient monitoring as a covered benefit, and the broader shift to value-based care is driving demand.

“The invisible technology boundaries expand the rules of who can offer care in the home, how they will be paid, and create a less restrictive policy environment to deliver care at home.”

2. Remote Patient Monitoring (RPM), Wearables, & Digital Health

Increased adoption of value-based care, and providers taking on the financial risk of managing chronically ill patients, have led to increased investment in remote patient monitoring (RPM) solutions. COVID-19 served as an accelerator and the industry’s trend toward caring for and managing patients from the comfort of their homes. Remote patient capabilities deliver a broad range of benefits from reduced readmissions and enhanced outcomes to improved chronic care management and better intelligence for managing risk and deploying timely care interventions.

In today’s more sophisticated predictive analytics and artificial intelligence, wearables enable clinicians to detect when a patient’s health is declining and to proactively intervene.

Thanks to expanded reimbursement, new players are entering telehealth. Community Health Access and Rural Transformation (CHART) Model allows rural health clinics and federally qualified health centers to be allowed to furnish Medicare telehealth services, and be reimbursed for virtual care at similar rates as comparable telehealth services under the Medicare Physician Fee Schedule.

STATES ARE EXPANDING TELEHEALTH

Colorado. The new law, which applies to state-regulated health plans and Medicaid, adds remote patient monitoring as a covered service and does away with restrictions on the technology used for telehealth visits. Some states are relaxing the rules around Medicaid coverage for home health care services. A new law enacted in Colorado allows home health care providers to prescribe and manage telehealth services.

Idaho. Taking steps to make permanent the waivers of telehealth rules and other regulations Idaho waivers have broadened the technology that could be used for telehealth, allowed telehealth providers to prescribe more medications, including medication- assisted treatment for substance use disorder.

10 states require commercial insurers to pay providers for a telehealth service at the same reimbursement rate for in-person care, according to Foley & Lardner’s.

3. Data Analytics and EHRs

Business and care analytics enable the health care industry to be more strategic about their home-care operations, expanded Acute Hospital Care at Home models, and to be better informed about their patients’ health, including risk factors, optimal care models, and interventions that can improve health and longevity. Data from RPM and other monitoring and engagement activities make available real-time data and actionable data to providers when interventions are needed.

EHR integration and interoperability will be increasingly important. For telehealth to go mainstream, the various telehealth platforms, asynchronous care delivery solutions, and digital health tools will need to integrate with the provider’s EHR system for streamlined scheduling, documentation, and billing purposes. Interoperability will be as important as ever to ensure that care coordination, quality, and the patient’s experience are optimized.

Increases in remote care and declines in in-person visits amid COVID-19 have hospital leaders reexamining how their organization can maintain a continued relationship with patients outside of the hospital. Moving forward, technology will not only play an essential role in clinical care delivery, it will also be a prevalent model that offers consumer choice and preference to have care delivered in their home.