Thread by @RahulRajkumar11

Important piece in @nytimes summarizing the promise and challenges ahead for #telehealth by @ReedAbelson. Privileged to join the conversation.

As I stated here, despite the promise, there’s a lot we don’t know about #telehealth. THREAD

nytimes.com/2020/08/03/hea…

We need to understand how it delivers value to patients by improving outcomes, quality, and affordability of care 2/

If the right hand is #telehealth, the left hand is #valuebased payment (including #PCPCapitation) - the method of how we pay matters a lot in motivating the behaviors we need to see in our delivery system. 3/

The right hand needs to know what the left hand is trying to achieve – which is to improve quality and reduce total cost of care 4/

Clinicians are adapting to telehealth, but systems/administrators are still figuring out in what cases is #telehealth a complement vs. substitute for in-person visits. 5/

Many are stuck in a fee for service (#FFS) state of mind – 15 minute visits overbooked to account for no-shows PLUS #telehealth visits crammed between. 6/

#telehealth makes the #FFS #hamsterwheel 🐹turn at twice the speed, toggling between in-person visits & telephone calls, working through complex algorithms to figure out how and what to bill. This approach is not sustainable. 7/

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An investment in new modes of care delivery needs an accompanying payment scheme to support its optimal use to improve outcomes, access, and affordability of care. 8/

Moreover, clinician #burnout may accelerate if #telehealth is not tied to a systemic change in how we pay and what we value in care delivery. This would be an even greater tragedy and hold back the ability to advance and modernize the health ecosystem. 9/

We can unlock the power of #telehealth when we link it to #valuebasedcare payment models including #PCPCapitation to deploy team-based care across mediums – in person, at 🏠 or by📞,💻,🤳.

The payment stream should accelerate tech + people in service to high value care. 10/

@BlueCrossNC has been all in on #telehealth. We were among the very first to announce payment for #telehealth at parity and will continue to do so through the end of 2020. 11/

https://twitter.com/RahulRajkumar11/status/1273634939561488385?s=20

The right hand of #telehealth knows that the left hand is trying to transform health care in #NC through our value-based programs. 12/

We will also rigorously evaluate the impact of and hold #telehealth providers accountable on outcomes, quality, and access to the care our members deserve 13/

We need #telehealth, but we also need primary care payment streams to fund and reward the effective delivery of those services, not merely open up a new wave of additional utilization that clinicians (and patients) are supposed to keep up with. 14/

Add to this, 40%+ of Medicare beneficiaries don’t have high speed wifi at home or on their phones. We have to ensure that we do not leave behind the patients who need us.(jamanetwork.com/journals/jamai…), 15/

What we need here is a national strategy that integrates payment, technology, AND the professionalism of clinicians – the health system’s greatest resource and hope for improvement end/

https://twitter.com/JMichaelMcW/status/1286012688271912962?s=20

@azaleakim @scottheiser