Customized Telehealth Solutions

Another Massachusetts insurer to cover virtual doctor visits

Having a cold, allergies, rash, or urinary tract infection used to mean a visit to the doctor’s office. Now, Harvard Pilgrim Health Care members can video chat with a doctor instead.

Starting July 1, the state’s second-largest commercial insurer will cover telehealth, offering the video chat service through California-based Doctor On Demand and from doctors in the Harvard Pilgrim network that offer telehealth.

Programs like American Well allow patients to connect to doctors via their mobile phones. Harvard Pilgrim will now start covering appointments through Doctor on Demand.

The insurer is the third in the state to cover telehealth services, and shows a growing trend of allowing patients access to doctors through video chats, a far cry from the roadblocks regulations presented just two years ago.

“We believe this service will provide flexibility and value to augment the existing relationships our members have with their primary care physicians,” said Beth Roberts, Harvard Pilgrim’s senior vice president of enterprise sales & marketing, in a release.

The insurer follows in the footsteps of the state’s largest insurer, Blue Cross Blue Shield of Massachusetts, which started covering telehealth Jan. 1. Blue Cross members can connect with doctors in the network that offer telehealth, or can have a virtual doctor’s visit with a physician through Boston-based American Well. Health New England, based in Springfield, was the first health insurer to offer telehealth services in August 2015.

The reasons for telehealth are multipronged. Both insurers said telehealth could help patients in remote areas or with mobility problems can more easily access a doctor. Patients can also access a physician at any time of the day, and don’t have to take time off work to visit a doctor for a minor condition.

Patients with minor issues after hours can also avoid costly trips to the emergency room, improving patient experience and reducing health care spending.

At both insurers, the cost of a telehealth visit is the same as one to a physical doctor. While both insurers cover treatment of medical issues, Blue Cross is also encouraging users with behavioral health problems to utilize telehealth services.

“It’s access, quality and affordability that made us think we should head in this direction,” said Greg LeGrow, senior director of technology engagement solutions for Blue Cross.

Contracting with a national telehealth provider allows all patients access to telehealth, but many patients will be able to see their own doctors.

At Blue Cross, the number of physicians with telehealth capabilities is skyrocketing, going from approximately 200 to upwards of 600, thanks to an undisclosed large delivery system saying they would invest in telehealth for all of its physicians in the coming months.

Harvard Pilgrim is also covering the visit for in-network doctors that offer telehealth services.

source: http://www.bizjournals.com/boston/blog/health-care/2016/06/second-massachusetts-insurer-to-cover-virtual.html

Veterans Health Administration focused on telehealth for veterans’ homes


Looking ahead, the Veterans Health Administration is increasingly focusing on bringing care into veterans’ homes, VA higher-ups said at the mHealth and Telehealth World Conference in Boston.

“I think that the number one thing we see for where telehealth is going in the organization is increasingly into the home and into patients’ daily lives,” said Neil Evans, Chief Officer in the Office of Connected Care at the Veterans Health Administration. “Last year, 282,000 veterans had a clinical video telehealth visit. Only 6,300 of them had those visits into their home. So our telehealth is connecting our medical centers to our remote specialists, but we’re really committed to extending our penetration into our veterans’ daily lives.”

That effort includes not only home telehealth, but remote patient monitoring programs and mobile apps. Until recently, these three technological areas were all administered separately at the VA, Evans said. Now, they’re all organized under the Office of Connected Care.

“We’re developing an app which leverages WebRTC to deliver that video telehealth experience into the home on veterans’ personal devices,” Evans went on. “Likewise we’re expanding the number of veterans we serve through remote patient monitoring through, for example, a mobile text message program we call Annie, based on a two-way text message system that’s been developed at the NHS called Florence, named after Florence Nightingale. It allows us to engage veterans between visits, collect patient-generated data, and provide feedback to reinforce the care plan.”

Dr. Kevin Galpin, acting chief consultant at the VHA Office of Connected Care, said another piece of the VA’s future plans is figuring out how to incorporate family caregivers into veterans’ care via telehealth.

“You have caregivers, you have family members that want to be part of a veteran’s health, but they can’t always be at an appointment, they’re not living in the same state,” Galpin said. “Yet that person is important to them, and would love to attend office visits and be an active part of keeping that person healthy. What we see going forward is being able to invite caregivers not just to existing virtual episodes of care, which would be easier, but to the ones that are currently in-person.”

The VA is also looking into using mobile technology to connect veterans to friends and family for social weight loss or nutrition interventions, or even to do group therapy for PTSD with members of the same unit, who could work through shared experiences together.

Evans said that the VA portal currently has 3.5 million registered users and is accessed 9,000 times a day by veterans. It has processed 72 million prescription requests sincce it was launched 10 years ago. He also said that about 12 percent of VA patients in a given year receive some amount of care through telehealth. Galpin said the VA did 2 million episodes of care through telehealth last year.

Evans said the biggest challenge for the VA is driving provider adoption of telehealth tools, apps, and the patient portal, which he believes will drive patient adoption in turn.

“How do you encourage adoption and integration of these tools into the actual delivery of healthcare on the front lines?” Evans said. “How do we make sure telehealth is an intrinsic part of our core operations and not just a bolted add-on to the healthcare system? As our use of the portal has increased and we bring more apps online, how do we help our providers understand that this technology exists, understand how to use it, and bring on some that are slower to adopt? Because we know that when the healthcare team recommends a portal, apps, or telehealth, patient adoption and trust increases tremendously.”

source: http://mobihealthnews.com/content/veterans-health-administration-more-focused-bringing-telehealth-veterans-homes | By: Jonah Comstock

Walgreens Is Launching a New Mental Health Platform

It’s about raising awareness, reducing stigma, and helping patients.

Walgreens launched a new mental health initiative Tuesday that aims to help connect more people with mental health resources in the community, maintain better adherence to important drug therapies, and screen millions of people for various mental health conditions.

The drug store chain is teaming up with Mental Health America (MHA), a community-based nonprofit organization dedicated to addressing the needs of people with mental health concerns, to offer a new online portal dedicated to providing screenings and information on conditions as diverse as anxiety, depression, obsessive compulsive disorder, and schizophrenia. The site will connect to MHA’s free, scientifically-based screenings to allow people to anonymously rate their conditions. Walgreens WAG 0.00% and MHA aim to screen 3 million people by the end of 2017.

The launch aligns with the start of Mental Health Month in May, which is dedicated to bringing attention to issues that affect about one-in-four Americans each year. Mental health conditions affect more people than heart disease or diabetes. On top of that, nearly half of those affected may never seek treatment, and for those that do, adherence to sometimes life-saving medications can be as low as 50%, says Walgreens CMO Harry Leider.

“Nearly 25% of our customer base is coming in every day battling a mental health condition, and many don’t even know it,” says Leider. “It’s a huge opportunity to serve our customers. It’s an opportunity where we can do good and do well at the same time.”

The Walgreens team had been working on a mental health initiative for nearly two years, trying to find the best approach to help connect customers the right resources, according to Leider. A series of elements came together to make now the right time to launch. First, MHA’s online resources and screenings are a vital element. Second, Walgreens is now able to tie in MDLIVE’s Breakthrough service, which can provide behavioral telehealth services for patients to access help faster and easier in some cases. In some communities, there’s a shortage of mental health providers and patients can wait six weeks or more to see somebody.

The initiative also gives Walgreens an important touchpoint with payers, providers, and patients: drug adherence. Medications for many mental health conditions, like depression, can take four weeks or longer to start working. Many patients end up stopping using the drug before it even has a chance to work, which could be life-threatening in some cases. Walgreens is now educating its pharmacists and nurse practitioners to work with these patients to educate them on how best to manage side effects and what to expect to better increase chances that a patient will remain adherent.

“Supporting patients with treatments sounds mundane but it’s incredibly important,” says Leider. “It’s a triple win. It helps patients get better, helps our bottom line, and ultimately helps lower medical costs for payers.”

source: http://fortune.com/2016/05/10/walgreens-mental-health | By: Laura Lorenzetti

Medicaid pays for live telehealth in most states but lack of definition creates confusion

Dive Brief:

  • The Center for Connected Health Policy released its annual guide on state telehealth laws and reimbursement policies, which found several telehealth trends in 2015.
  • While some states are expanding telehealth reimbursement, others are placing more limits and restrictions on telehealth delivered services, the report stated.
  • The survey specified 11 telehealth-related policy areas ranging from the definition of the word telehealth/telemedicine to various reimbursements, consent issues, and online prescribing.

Dive Insight:
The most predominant reimbursed form of telehealth is live video. The District of Columbia and 47 states provided reimbursement for live video in Medicaid fee-for-service last year.

According to the report, each state has its own definition of telehealth and how it is regulated, which creates confusion for telehealth participants. Alabama, New Jersey, and Rhode Island still lack a definition for telehealth/telemedicine.

Only five state Medicaid programs – Alaska, Illinois, Minnesota, Mississippi, and Washington – reimbursed for live video in Medicaid fee-for-service, store-and-forward delivered services, as well as remote patient monitoring (RPM) last year, although with certain limitations.

Only 16 states have some form of reimbursement for RPM in Medicaid programs, the report found.

Some of the other key findings in the report include:

  • 47 states have some type of reimbursement for telehealth in their public program but Massachusetts, Rhode Island and Utah do not have a definitive reimbursement policy.
  • 29 states have some form of informed consent requirement.
  • Nine state medical boards issue special licenses or certificates for telehealth.

Over the 2016 legislative session, 44 states have introduced more than 150 telehealth-related pieces of legislation. Many of the bills address different aspects of reimbursement in regards to private payers and Medicaid. Many states have proposed legislation for adoption of the Federation of State Medical Board’s model language for an Interstate Medical Licensure Compact.

source: http://www.healthcaredive.com/news/medicaid-pays-for-live-telehealth-in-most-states-but-lack-of-definition-cre/417862 | By: Nina Flanagan