Coronavirus May Reshape Investment, Value-Based Reimbursement

Value based reimbursement

The coronavirus pandemic will reshape where and how organizations invest moving forward, according to industry leaders at the Value-Based Care Summit | Telehealth20: Virtual Series.

The coronavirus created an unprecedented rise in telehealth across the industry. Projects that would take years to implement were switched on in a matter of days in order to fit the growing need for virtual care.

As the use of telehealth grew, reimbursement for these services also transformed. The Centers for Medicare and Medicaid Services (CMS) expanded coverage and are supporting hospitals and health systems to implement telehealth programs.

It is clear telehealth is here to stay.

At the Value-Based Care Summit | Telehealth20: Virtual Series, Shara McClure, divisional senior vice president of Texas Health Care Delivery at Blue Cross and Blue Shield of Texas, discussed the COVID-19 pandemic had a few silver linings. One of those is the growth of telehealth.

Many conference attendees echoed this sentiment. In fact, 68 percent said their organization plans to continue investing in telehealth capabilities.

But in order to make these investments, organizations need robust IT infrastructure. So it is unsurprising that 44 percent of respondents said they were also planning to invest in health IT infrastructure and capabilities following the coronavirus pandemic.

Respondents pointed out other investments but none as adamantly as telehealth: 29 percent are investing in emergency preparedness and response, 20 percent in supplies and inventory, 18 percent in their workforce, and 12 percent in building facilities including upgrading their building capabilities.

It is clear that organizations will continue to prioritize telehealth investments and tools that ensure these programs can thrive.

Part of the success of these programs, though, is tied to reimbursement. If telehealth is reimbursed at a lower rate than traditional, in-person visits, organizations will financially struggle as telehealth becomes more widely used.

Value-based reimbursement models overcome these challenges. Bulk payments or performance-based payments mean providers are not reliant on bringing patients into the office to receive adequate reimbursement for care delivery.

Many leaders believe the coronavirus pandemic will propel the industry further towards value-based care.

Over half (55 percent) of those polled at the Virtual Summit agreed that the public health crisis would push the industry further away from fee-for-service. Another 22 percent strongly agreed with the statement. The overwhelming majority of industry leaders see how the pandemic is pushing for a change in reimbursement.

Only eight percent disagreed or strongly disagreed that the coronavirus pandemic would push the industry further away from fee-for-service.

The pandemic shone a light on many of the challenges the healthcare industry was facing. To combat these challenges, the industry relied heavily on telehealth.

As states begin reopening and hospitals and health systems resume elective care, organizations need to understand the role telehealth will play in the new care delivery system.

A large part of this change will require new models of reimbursement and value-based care if organizations are to truly succeed.

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