The business drivers for telehealth after the pandemic

The surge in telehealth brought on by COVID-19 catalyzed an era of care distribution and decentralization powered by care delivered outside the traditional healthcare facility.

Business models that build on this momentum will require new payment and regulatory operating models and a frictionless experience for patients.

During a fireside chat at the Becker’s Healthcare Telehealth Virtual Forum on Nov. 3, Sara Vaezy, chief digital strategy and business development officer at Renton, Wash.-based Providence, and Derek Streat, CEO of DexCare, discussed new digital requirements for health systems and opportunities associated with the acceleration of digital health.

Note: The responses below are lightly edited for clarity and length.

Question: What are the business drivers for digitally enabled care post-pandemic?

Sara Vaezy: The pandemic has really exposed the fundamental flaws of a fee-for-service, nonpatient centric, nondigitally enabled health system. Health systems have faced a lot of challenges in terms of delivering care and declining revenue over the last eight months or so. Meanwhile, risk-bearing entities like payers are posting incredible profits. UnitedHealth Group posted a $3.2 billion profit last quarter while others are struggling. So, that really illustrates kind of a very basic set of problems around the business model. With that in mind, health systems are really looking to change that business model so we can serve our communities better and grow more effectively.

We’re seeing the market evolve in two ways. One is going to be a very consumer-centric model. We’ve been talking about consumerism in healthcare for many years, and it accelerated to some extent in the 2008-2009 financial crisis, when there was a lot of cost-shifting to individual consumers or folks with employer-sponsored insurance. That’s going to accelerate again. We’re seeing it already. There’s a lot more activity in fixed indemnity and high-deductible health plans, which emerged, really, 10 to 12 years ago. Think about those as traditional consumers.

There’s also going to be a sort of payer-driven market, but that payer-driven market will be probably with more risk shifted to the actual health systems. What that means is we’re actually going to finally see some movement toward risk for providers, which has happened in fits and starts. A lot of systems exist in mixed or still largely fee-for-service environment, despite the fact that we’ve been talking about risk and value-based care for so many years.

Q: How can digitally enabled care scale in its current form throughout health systems?

Derek Streat: Most health systems experienced with the COVID that there were a lot of breakdowns in just trying to get resources flexed and adapted over to this new way of delivering care and in very short order. But there are some things that are standing in the way. I would say the first is consumers need to be made aware of these options. It’s one thing when you’ve got kind of a unique environment where you’re closing down all the clinics and the only option available is to do a video visit, but that’s not really a normal environment. We’re going to come out of this. We’re at a point where there’s 20 percent to 30 percent maybe of care delivered digitally, and folks need to know that those options are available.

We have to do better than serving up to them a page of 15 different links of ways they could then go and try to figure telehealth out on their own, which gets to my kind of second point. To scale this, there needs to be more help around how folks are navigated and routed in an intelligent way based upon the data, the intent, motivation and clinical need that’s relevant to patients, first and foremost.