TechHealth Perspectives STRATEGY, ANALYSIS, AND COMMENTARY ON CURRENT AND NEW HEALTH TECHNOLOGIES

Telemedicine and the ACA Triple Aim of Improving Access and Quality and Lowering Cost

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The Patient Protection and Affordable Care Act has an awful lot in it.  But at its core, the legislation is an attempt to achieve a few key goals:

  1. Improve access to healthcare,
  2. Increase healthcare quality, and
  3. Bend the cost curve to make healthcare more affordable.

There is little debate that each of these goals is worthy of achievement – but beyond that there is little agreement.  Debate around the “individual mandate”, accountable care organizations, health insurance exchanges and the myriad other care delivery and payment reforms adopted in the ACA have grabbed the headlines of mainstream media and trade publications.  There is some good (and some bad) debate going on about these provisions, many of which come from the experiences of payers and providers, private and public, that have been trying to improve healthcare for years.

But when it comes to the triple aim, not enough has been said about the possibilities of telemedicine in achieving those laudable goals.

Telemedicine is beginning to receive media attention, and increasingly serious thought is being given to telemedicine as something more than a way to address only one of the triple aims.

Certainly, telemedicine has proven itself to be effective in spreading access; but increasingly telehealth, telemedicine, mhealth, and connected health (a rose by any other name . . . . ) are being seen as providing solutions to achieve the other two of the triple aim – reducing cost and improving quality.  In addition, telemedicine (generally) has the additional advantage of engaging the patient directly, unlike many ACA reforms which focus on the healthcare infrastructure.

Will technology save healthcare?  Unlikely, I believe; but it certainly can be a part of the solution.  It is easy to get ahead of ourselves; and there is a need to proceed carefully in order to avoid the pitfalls that invariable appear whenever innovation is near.

But proceed we will.  I am no historian, but I cannot think of a time in the history of humans when we turned our back on technological advancements.  Instead, we put it to use wherever we can, and in so doing, constantly evolve and advance our relationship with technology.

There is simply no reason to think technology (including social media) will not increasingly be used by hospitals, physicians and patients – regardless of the efforts of the luddites among us.

Which brings me back to the main point of this post.

With little change in regulatory, reimbursement or delivery structures from on high, telemedicine efforts are proving, in some cases, that they can help achieve the triple aim.  A case in point is the effort of Saint Vincent Health System in Erie, PA.  According to a report by HealthCare Finance News, Saint Vincent has:

  •  reduced readmissions,
  •  expanded access multi-specialty teams,
  •  expanded medical education opportunities,
  •  realized a nearly 100% ROI over a two month period with respect to one telehealth initiative, and
  •  reduced patient and payer costs.

Not every telemedicine project has such a striking impact; and proceeding cautiously is warranted.  Nonetheless, the experiences of Saint Vincent are not unique.

While the adoption of the ACA may be a watershed moment – signifying a shift in the goals of our regulated healthcare infrastructure – in years to come, we may point to telemedicine as the most significant factor in improving access, increasing quality and reducing the costs of healthcare.