The Rewards of Telemedicine Investments for ACOs


How integrating telemedicine helps fulfill your accountable care organization’s mission to transform care

Accountable care organizations that invest in the right kind of telemedicine stand to reap the benefits of greater patient acquisition, improved health outcomes and cost savings, while the rest stand to be left behind. The right kind of telemedicine is a no-regrets investment for any health system-led ACO.

With health systems embracing telemedicine at steadily increasing rates, we are at the verge of a tipping point. In fact, HIMSS Analytics expects between 51-53% of U.S. hospitals to have added telemedicine capabilities by 2020. Spurred by consumer demand for convenient, on-demand care, health systems have accelerated adoption of telemedicine.

Couple this with the fact that the number of ACO-covered lives will quadruple, increasing from 23 million to 105 million by 2020, according to Leavitt Partners, and you begin to see the precipice of another tipping point; how long before ACO adoption of telemedicine becomes widespread as well?

Instead of waiting for the answer, or simply placing telemedicine under consideration, ACOs should act now. So what is the right kind of telemedicine for ACOs?

Like any potential ACO care investment, the right kind of telemedicine, or “virtual care,” must be fully-integrated into the care delivery system, delivered under the organization’s brand and reflect the business and clinical goals for the population. Urgent virtual visits or on-demand primary care is the best consumer-facing starting point for most.

Cost Avoidance

Reducing avoidable emergency department and urgent care utilization is critical in an ACO population. And telemedicine’s value here is hard to beat. Integrated telemedicine offers patients a convenient and efficient front door to their healthcare provider, the emergency department or urgent care clinic. This, of course, leads to more efficient emergency department and urgent care utilization.

Still, telemedicine’s ability to attract and retain patients might be an even more significant value. With tech companies flooding the market with app-focused telemedicine offerings and commercial vendors fighting for patient share as well, an ACO that fails to offer telemedicine could see their patients seeking care outside of their system.

ACOs are often complex service organizations, including network services outside the usual health system boundaries. To create a single, consumer-facing “front door” to this complex network gives patients a unified starting point for in-network care.

Many of the contracted responsibilities of an ACO are fulfilled within primary care provider workflow. A properly-executed telemedicine program helps drive patients back into the primary care network, where a full complement of appropriate care can be delivered. It is in the primary care provider workflow where gaps in care are identified and closed, preventative care is delivered and risks are managed.

As the industry learns how to optimize various attribution models, panel size and patient activity within PCP networks will continue to underpin ACO contracting. A virtual clinic opens the front door to an ACO’s community, inviting in consumers who will become patients after a convenient and high-quality experience. ACOs will benefit from telemedicine services capable of functioning as a fully-connected care team link. Integrated telemedicine will make better care coordination, transition of care management, gap closure and specialty service access a reality for ACOs.

Integrated telemedicine also brings continuity of quality care. Correctly executed, telemedicine will deliver high-quality care that is aligned to an ACO’s standards, not the standards of a third-party vendor. It’s not enough to know only that a patient had a virtual visit while an office was closed or booked full with in-person encounters. ACOs need to know that their patient received high-quality care, and not a treatment delay or inappropriate treatment with no integrated next step.

Build a Digital Advantage

ACOs that delay telemedicine adoption expose their organization to additional risks. Every day without telemedicine, they face a triple threat – digital competitors luring patients out of network; bearing the costs of unneeded facility visits; and patients slipping out of engagement strategies and missing crucial primary care. ACOs that place telemedicine adoption on the back-burner are hurting their bottom line as each day passes.

Integrating telemedicine requires an organizational capacity that few have today. ACOs should take steps that prepare them to travel up the organizational learning curve early. Making a strategic investment now to build an ACO’s knowledge of telemedicine and learning the local market and consumer preferences will put them ahead of the curve when adoption begins. A well-prepared ACO investigates everything from local access trends to the requirements for their own clinicians to staff virtual visits.

Lastly, ACOs must put patients first through all of this. A virtual visit, on the patient’s schedule, with minimal waiting and no travel required, sets a new standard for convenience. Many traditional barriers to access, like transportation, become a non-issue. Integrating telemedicine helps fulfill an ACO’s mission to transform care in a way that prioritizes quality over quantity while serving their business in an evolving healthcare landscape.

When the tipping point is reached, on which side of the fulcrum will your ACO be?


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About Author

Ralph C. Derrickson

Ralph C. Derrickson has served as Carena’s president and CEO since 2006. Under his leadership, Carena has grown into a nationally recognized provider of virtual clinics for health system clients.

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