Aquina Blog

A recent article in the Wall Street Journal explores the rapid rise of consumers and doctors turning to easier, faster and more convenient ways to meet - Telemedicine

Doctors are linking up with patients by phone, email and webcam. They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes.

Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by.

“35% decrease in patients’ average length of stay and
30% fewer deaths than anticipated.”

As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.

A McKinsey & Company report discussed a rising concern for healthcare providers, the concept of retail health. Rather than visiting a traditional practice, many patients are simply visiting clinics located in their local grocery stores or pharmacies.

 “2 out of 3 patients are more willing to use
retail services over traditional healthcare providers.”

The main reason is that the cost is typically lower due to employee health plans or out of pocket expenses. Similar services compare at $110 for retail and $166 for a doctor’s office.

The article suggests that while patients may not be seeing a doctor at a retail clinic, they’re typically seeing a nurse practitioner. Other benefits are wait times are almost always shorter and there is no need for an appointment. Retail health is becoming a more viable option every year. On average, there are 10 million visits in over 1,800 locations each year. That amounts to $1,952 in lost revenue for each primary care provider.

In a Milliman Medical Index (MMI) study last year, patients are continuing to seek out high-deductible health plans to offset the financial burden caused by a health concern.

A high-deductible health plan is any plan with a deductible of at least $1,300/year for individuals, $2,600/ year for families, where out of pocket expenses such as deductibles and copays equal no more than $6,500/year or $13,100/year, respectively.

FINANCIAL IMPACT ON PATIENTS

The study noted that the average total cost of care for a family of 4 now equals almost $26,000 annually. To make matters worse, employee expenses continue to rise faster than employer expenses.

In a recent report from the Bipartisan Policy Center, which examines current issues in the delivery system reform effort, states that Centers for Medicare and Medicaid Services (CMS) can wield important influence as a health care purchaser.

The report goes on to suggest Medicare payment amounts can also form the basis of commercial payers’ negotiated payment rates and reimbursement approaches.

“CMS has shown preliminary success in shifting Medicare’s delivery
system into value-based care.”

 The agency has already met its initial goal of tying at least 30 percent of Medicare payments to quality performance or value-based arrangements by 2016 and remains on track to cross 50 percent by 2018.