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Telehealth: A viable business model in general practices Dr Bastian Seidel

Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

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Page 1: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Telehealth: A viable business model in general practices Dr Bastian Seidel

Page 2: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Overview: in the next 15 minutes…

• Background: how I started in 2011

• The business end: financial incentives

• Has the business model for telehealth failed general practices?

• The VISOR framework

• What does the future hold?

Page 3: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

How it started for me…

Page 4: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Anywhere?

Page 5: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Anywhere in Tasmania…

Page 6: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Huonville and beyond

Page 7: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Business (Medicare) incentive payments

• On board incentive in 2011: $6000

• after review:

•$1600 after the first consultation ($1300 from 2013/2014)

•$3200 after the 10th valid consultation ($2600 from 2013/2014)

• Telehealth service incentive (quarterly): $32-$26

• Extra Telehealth bulk billing incentive: $16-$13

• MBS item numbers: $21.60 (level A)-$134.40 (level D)

Page 8: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Who needs a business case?

Page 9: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

MBS telehealth services in the last 2 ½ years- 3000 specialists signed up

- 6000 GPs signed up

- 55000 patients MBS received

services

Page 10: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

What happened?

(Neufeld)

Page 11: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Has the business model failed general practices?

- Greatest advantage rests with

patients in rural and remote

locations

- Advantages include minimising

the need for travel

- Financial savings will occur

primarily to individuals

- Health services will only

secure gains where they

currently bear the cost of

patient transport

Page 12: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

The ‘business model’ for telehealth

• There is no accepted definition of the term ‘business model’

• ‘Business model’, ‘strategy’, ‘business concept’, ‘revenue model’ and

‘economic’ model are often used interchangeably

• ‘The business model’ has been referred to as:

•Architecture

•Design

•Pattern

•Plan

•Method

•Assumption

•Statement

Page 13: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

The VISOR framework

(Fife & Pereira)

Page 14: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Value

- ‘Willingness to pay’

- Value to patients & practice

- Can be variable!

Page 15: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Interface

The user experience:

- Ease of use

- Simplicity

- Convenience

Page 16: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Service platform

Structural, technical and social

constraints:

- Low compatibility

- Complexity of equipment and

interfaces

- Multiple technical standards

Page 17: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Organizing model

Rules & regulations:

- Standards

- Guidelines on implementation

- Medico-legal aspects

Page 18: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Revenue/cost

Revenue:

- MBS

- Non-MBS

Cost:

- Set-up

- Maintenance

Cost saving:

- Efficiencies

Page 19: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

The bigger picture

(Productivity Commission 2013)

Page 20: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

What does the future hold?

Opportunity to expand the use of

telehealth services

Overall cost to government likely

to be revenue neutral

Patients should only claim MBS

rebates if they have registered

with a GP

Page 21: Telehealth: A viable business model in general practices · 2018-04-02 · Business (Medicare) incentive payments •On board incentive in 2011: $6000 •after review: •$1600 after

Telehealth is changing healthcare!