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Monday June 1, 2020
 
 
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With more patients and providers being exposed to telehealth and virtual care, a report published Friday by McKinsey predicts that as much as $250 of current U.S. healthcare spending could theoretically be virtualized.

They key change has been the often-publicized surge of telehealth adoption accompanying the COVID-19 public health emergency.

Citing a handful of recent consumer and physician surveys conducted by the firm, the report's authors highlight a jump from 11% of U.S. consumers reporting use of these technologies in 2019 to 76% now saying they were moderately or highly likely to use telehealth going forward. Further, provider survey respondents said they are now conducting 50 to 175 times the number of telehealth visits than they did prior to COVID-19, with 57% noting that they now view telehealth more favorably.

"The current crisis has demonstrated the relevance of telehealth and created an opening to modernize the care delivery system," the report's authors wrote. "This modernization will be achieved by embedding telehealth in the care continuum at scale."

With these trends in mind, McKinsey analysts identified several nonacute care models that could be conducted virtually, which included: on-demand virtual urgent care, virtual office visits, near-virtual office visits, virtual home health services and tech-enabled home medication administration.

The analysts collected 2018 claims data representative for Medicare, commercial and Medicaid businesses, scaled spending and utilization to 2020 levels, and identified where those services could be replaced by the identified virtual-care use cases. Doing so yielded a potential $250 billion in virtual-care business – roughly 20% of all Medicare, Medicaid and commercial spend across outpatient, office and home health.

As a disclaimer, the report's authors noted that these are preliminary, non-exhaustive numbers that are being shared for "information purposes in response to the urgent need for measures to address the COVID-19 crisis."

WHAT'S THE IMPACT?

Shifting these areas of care to virtual services has had a short-term benefit during the COVID-19 crisis, but also has the potential to improve access to care, patient experience, health outcomes and healthcare-spending efficiency, the analysts wrote.

To realize these advantages, however, healthcare stakeholders across the board need to be prepared.

The analysts recommended that payers define a value-backed virtual health road map, accelerate value-based contracting that incentivizes telehealth, build new product designs with virtual health and better integrate virtual health into care delivery.

Investors, they continued, should assess the impact of virtual health across various services, and identify the specific assets and capabilities that will enable strong execution and value generation.

As for health systems, the key will be to prioritize a comprehensive digital front door for consumers, build virtual-care capabilities and incentives for clinicians, and better quantify outcomes and other benefits to support advocacy for these technologies.

"The seeds for success will be sown in the next few months during the COVID-19 crisis," they wrote. "Healthcare systems that come out ahead will be those who act decisively, invest to build capabilities at scale, work hard to rewire the care delivery model and deliver distinctive high-quality care to consumers."

THE LARGER TREND

There's little question that telehealth and virtual care services are having their moment in the spotlight.

Major telehealth vendors like Teladoc Health and AmWell  have each described major call-volume increases across their full range of offerings. Others, like HealHimsMedici, XRHealth and Tava Health, have either launched new telehealth offerings or received new investments amidst growing adoption. Further, the Centers for Medicare and Medicaid Services, the FDA, the FCC and Congress have all provided funds or relaxed restrictions on telehealth to expand their reach throughout the pandemic.

 
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Looking to the opioid use disorder space the National Institutes of Health has given Roundtrip, a software platform for organizing medical transport, a $252,000 Small Business Innovation Research (SBIR) Phase I grant in order to look at the impact of transportation on OUD treatment.

Specifically, the study will be zeroing in on appointment show-rates and patient experiences. Roundtrip, the University of Pennsylvania, Lyft and Contra Costa Health services are joining forces to conduct the study, which will predominantly use Lyft’s ride-sharing services to provide the transportation.

Roundtrip software was designed to help healthcare professionals order and coordinate a patients’ medical transport using a pool of available ride providers, whether they be Lyft drivers, facility-owned vehicles, volunteers or otherwise. The platform is available online and as a mobile app, and includes interfaces for providers and patients alike.

In order to be included in the program patients are required to be over the age of 18, be diagnosed with an OUD, report having a difficult time finding transportation, and be enrolled in an outpatient clinical treatment program. 

“This study builds on prior research we have conducted to understand the importance of “transportation and how patients engage with health care,” Dr. Krisda Chaiyachati, assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine and a leading investigator in the study, said in a statement. “Especially with the opioid crisis spread across the country, innovations and partnerships are needed to explore how gaps in access to medication assisted treatment can be bridged, and we are looking forward to working with Roundtrip to explore how their technology solution might offer a meaningful impact for this epidemic.”

WHT IT MATTERS

In the last decade we’ve seen America’s opioid epidemic spread. Since 1999 more than 750,000 individuals have died of opioid overdoses, according to the CDC. The epidemic hit its peak in 2016 with 42,000 deaths.

Some patients with OUD opt for Medication-Assisted treatment, which combines behavioral therapy and medications to treat the disorder. In this kind of treatment, a patient may be taking methadone, buprenorphine or naltrexone in order to treat the addiction, along with support from medical professionals, according to the Substance Abuse and Mental Health Services Administration

The researchers are pitching ride services as a way for people seeking such services to be able to easily get back and forth to treatment.

THE LARGER TREND 

This isn’t the first time that companies have studied the results of medical transport. In 2018 NEMT technology company Hitch Health and Lyft  announced the results of a year-long pilot partnership that suggest the joint service was responsible for a 27% reduction in clinic no-shows, as well as an increase in revenue for an internal medicine clinic in downtown Minneapolis. Similarly, Roundtrip also recently revealed that the MD Anderson Cancer Center in Camden, New Jersey, was able to reduce direct transportation costs by 30% with the service, and cut its no-show rate down to 4%.

 
 
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