Telehealth: A Primer - Arkansas HFMA. Telehealth - Abraham.pdf2-Time No ED Visits 1-Time Visited 3+ 11.3% reduction in low intensity ER visits $1.5M in annualized savings + & Case

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© 2018 American Well Corporation | Confidential

Telehealth: A PrimerHFMA Arkansas

1© 2018 American Well Corporation | Confidential |

MISSIONTo connect and engage providers, insurers, patients, and

innovators to deliver greater access to more affordable,

higher quality care.

CULTURE AND VALUES

CUSTOMER FIRST

ONE TEAM

DELIVER AWESOME

300 health systems

2000+ hospitals

150M Americans covered

4.8 of 5 Patient satisfaction rating

Top Rated in KLAS

Telehealth provider for:

Samsung, Apple, Philips, Medtronic, Cerner

Accredited NCQA/URAC, HiTrust, ATA, ISO, CE

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Our Eco-System

> 55 Payers > 7000 Employers > 130 Health Systems Pharma and Devices

HEALTH PLANS EMPLOYERS HEALTH SYSTEMS HEALTH TECH RETAIL & WELLNESS

Consumer Platforms


The use of electronic information and communication technology to deliver healthcare services

including without limitation, the assessment, diagnosis, consultation, treatment, education, care

management, and self-management of a patient.

Includes store-and-forward technology & RPM

Source:

AR Medicaid Provider Manual. Section I General Policy. Rule 105.190. Updated Aug. 1, 2018. (Accessed Mar. 2019).

Section III Billing Documentation. Rule 305.000. Updated Aug. 1, 2018. (Accessed Mar. 2019).

What is telehealth?

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Is telehealth a real trend?

2015

2016

2017

2018

40X growth in three years

2X growth in three months


Why Telehealth? Strategic Goals

• Attract new patients

• Prevent leakage

• Improve convenience

• Patient & employee perception

ATTRACT & RETAIN PATIENTS

IMPROVE CARE DELIVERY

• Increase visit volumes

• Reduce patient wait times

• Bring healthcare to the patient

• Improve outcomes

• Reduce readmissions

IMPROVE CLINICIAN EXPERIENCE

• Work at “top of license”

• Attract new clinicians

• Retain existing clinicians

• User-friendly technology

• Busy but not swamped

• Improve work/life balance

• Opportunities for growth

IMPROVE OPERATIONAL EFFICIENCY

• Optimize ACO

• Reduce unnecessary costs

• Improve resource allocation

• Improve no-show rates

• Reduce ED utilization

• Reduce need for brick/mortar locations

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ROI example

2%

58%25%

4%

11%

Virtual Care Urgent Care PCP Emergency Room Do Nothing

Not-for-profit health system based in Salt Lake City, Utah

Integrated health plan (SelectHealth)

Conducted a virtual visit claims study in 2018

$429 $661 $707

$3,403

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

Total Claims

Virtual Care Urgent Care PCP Emergency Room

Savings per claim

$367

Claims 5,000

Total Claims Reduction

$1.8M

Total Claim Cost Per Episode (21 days) Where people would have gone for care


ROI Case study

2-Time

No ED Visits 1-Time

Visited 3+

11.3% reduction in low intensity ER visits

$1.5M in annualized

savings

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Case study:ED diversion campaign

• Leveraged ED consumer research outcomes and targeted messaging to drive ROI

• Reached 1M members in test segment over a 7-month time period.

• Compared control vs. test population claims data for 6 months post campaign

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BEHAVIORALHEALTH

NUTRITIONURGENT CARE

Transform + Deliver | 8


CARDIOLOGY NEUROLOGY PSYCHIATRYPEDIATRICS

TELESTROKE

WOMEN’SHEALTH

ACUTEBEHAVIORAL

HEALTH

DERMATOLOGY

DIABETES HYPERTENSION

ASTHMA

SMOKINGCESSATION

ACUTEBEHAVIORAL

HEALTH

2nd OPINIONMEDICATION

MANAGEMENTSCHOOL-

BASED CARESLEEP

DISORDERSUROLOGY

SUBSTANCEABUSE

ORTHOPEDICS WOUND CARE PULMONOLOGYCARDIO-

THORACICSIDELINE

CONCUSSION

ROUNDING

MEDICAREADVANTAGE

EMERGENCYDEPARTMENT

OCCUPATIONAL

TEACHING/ VIRTUALROUNDS

BREASTFEEDING SUPPORT

BEHAVIORALHEALTH

URGENT CARE

NUTRITION

Transform + Deliver | 9

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Most Common/Successful Use Cases

Urgent Care Telestroke Scheduled Visits

Acute Behavioral Health Behavioral Health School Health

ED Triage Specialty Consult Retail Health


• Chronic care management

• On-demand inpatient consults

• Home healthcare services

• Post discharge and post surgical follow-up

• Medication consultation/reconciliation

• Contribute physicians to national pool

Other Use Cases

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Baptist AR• Factors that led to urgent care telehealth• Patient population • Telehealth provider supply • Patient engagement efforts

Arkansas• Patient Population – where are the care gaps?• Legislation • Hospital closing vs. expansion

Trends: Baptist AR & Arkansas


Arkansas: Reimbursement Parity

Source: American Telemedicine Association, 2019

This map is not a legal opinion. These laws are subject to change and do not reflect individual plan policies.

Parity Type Coverage & Reimb

Patient SettingTechnologyParameters

No parametersVideo, RPM, Store & forwardNo parameters

Commercial Parity Laws

Parity Type Coverage & Reimb

Patient Setting

TechnologyParameters

No parametersVideo, RPM, Store & forwardNo parameters

Mcaid AR Parity Laws

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Rural communities have limited access to mental healthcare


National

Baptist AR: who uses telehealth?

Baptist Health AR

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How it Works: Components of a telehealth program

Patient Engagement servicesTelehealth-specific marketing services

Operational ServicesImplementations, Integrations, Support

Provider SupplyYour providers, ours, or both

HardwareKiosks, carts, peripheralsMobile, Web

Software PlatformWeb based, your brand (not ours).

Complete package or à-la-carte

SOFTWARE PLATFORM

PATIENT ENGAGEMENT

SERVICES

HARDWARE

YOURTELEHEALTHPROGRAM

OP SERVICES

PROVIDERSUPPLY


How it works: Provider supply

AmWell

Only

Staff Providers

OnlyAmWell +

Staff Providers

27% 50% 23%

Provider staffing model today Provider staffing model future

0% 89% 8%

3% (2 Health Systems) don’t know how they plan to staff their service N=62 Enterprise Health Systems

AmWell

Only

Staff Providers

OnlyAmWell +

Staff Providers

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How it works: visit flow

Office

Telehealth 2.0 : Ongoing Care

Follow UpCare

See Your Patient

MobileKioskWeb

Telehealth 1.0 : On-demand Care

Choose a Doctor

See The Doctor


Considerations

• Most technical problems = poor bandwidth or old equipment

• Web-side manner = Bed-side manner

• Disconnects

• Background

• Lighting

• Tone of voice

• Next steps (treatment plan)

• Prescribing: Understand state and group-specific rules

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Best Practices- Recommending In-Person Care

• Don’t hesitate to refer out (ED, UC, follow-up with PCP or virtual)• Refer out by acuity and type of facility

• Refer to the least acute and costly level of care that is appropriate

• Back to PCP when possible

• Refer ongoing chronic disease management back to the PCP

• Know your limitations• Can’t do full exam (abdomen, auscultation)

• Can’t order labs or radiology


Patient grades all encounters at close (5-star rating system)• Provider Experience• System Experience• Don’t let ratings change your treatment plan

ROI Question: Where would you have gone?• PCP• ER• Urgent Care• Done nothing

Some organizations also use satisfaction score• Sent weekly• More extensive feedback

Final Thought - Patient Satisfaction

Star Rating

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Connectivity and integration

Integrations for Remote Patient MonitoringMobile and web SDKs

Enable integrations with EHRs, and your existing digital assets

Enable single sign-on, quick registration, enrollment, real-time eligibility

APIs The Exchange


[email protected]

Q&A

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Documents

Telehealth: A Primer - Arkansas HFMA. Telehealth - Abraham.pdf2-Time No ED Visits 1-Time Visited 3+ 11.3% reduction in low intensity ER visits $1.5M in annualized savings + & Case