Telehealth at Kaiser Permanente

Transcription

1 Telehealth at Kaiser Permanente Keavney Klein, Senior Counsel February 6, 2018 AcademyHealth National Health Policy Conference 0 February 7, Kaiser Foundation 2016 Health Plan, Kaiser Inc. Foundation Health Plan, Inc. All Rights Reserved.

2 Convenient, personalized, seamlessly integrated I need care. Medical record Nurse Surgeon Your doctor Specialist Wellness coach 1 February 7, Kaiser Foundation Health Plan, Inc.

3 Video a faster path to face-to-face care What it is: Routine and urgent primary care, dermatology, follow-up care, and more Watch: Video Visits: Not Just for Millennials! Being able to sit in my own home and have a visit (with my doctor) and talk about (my health) is a good thing. Kaiser Permanente member, February 7, Kaiser Foundation Health Plan, Inc.

4 Phone appointments a convenient way to get routine care What it is: Scheduled primary and specialist visits, wellness coaching, and more What it includes: Primary care appointments Specialty care appointments Scheduled follow-up care and specialist consults Wellness Coaching by Phone rest It s much easier than having to juggle schedules with the of the family to go into the doctor s office. Kaiser Permanente member, February 7, Kaiser Foundation Health Plan, Inc.

5 Doctor-to-doctor consult a lifesaving innovation What it is: Doctors can consult with one another by phone or video, or in some cases, secure text messaging What it includes: Primary to specialist Emergency care Burn care Stroke care Radiology and more Video consults save precious time by bringing a remote specialist into the room When I was in medical school, stroke was barely treatable. Now we have stroke neurologists seeing virtually every stroke patient the moment they hit the emergency room. It s allowed us much more accurate diagnosis and much faster treatment than almost Kaiser Permanente doctor, 2016 anywhere else in the world. 4 February 7, Kaiser Foundation Health Plan, Inc.

6 a core channel for staying connected What it is: An easy way for members to get care and questions answered by their care team What it offers: Convenience Members can their doctors offices any time of day and get a response within 48 hours. Many hear back within 24 hours or sooner. Consultations members can attach photos for a provider to review my I took a photo of a rash on my arm and sent it in. My doctor looked at photo and was able to tell me what to pay attention to. 5 February 7, Kaiser Foundation Health Plan, Inc. Kaiser Permanente member, 2016

7 kp.org a hub for health management What it offers: What it is: A single portal for connecting with Kaiser Permanente doctors and care providers Scheduling and changing routine appointments Checking most lab results Refilling most prescriptions Making personal action plans for ongoing care * Managing a family member s care Getting timely reminders for screenings and more * Ask your sales and account manager about availability in your region. the I love that I scheduled my doctor appointment online and by time I got home, I saw my lab results. 6 February 7, Kaiser Foundation Health Plan, Inc. Kaiser Permanente member, 2016

8 By the numbers Phone 39.9 million phone calls between members and care providers in % of touches took place by phone in 2016 Source: Core Value Metrics Report, Kaiser Permanente, million Secure touches by members in % of touches took place via in 2016 Source: Core Value Metrics Report, Kaiser Permanente, kp.org 5.1 million appointments requested in million 70% lab tests viewed in 2016 Source: Kaiser Permanente Digital Metrics, 2017 Video 85,000 Source: Kaiser Permanente internal data 21.8 million prescriptions filled online in 2016 of members registered completed video visits in 2016 Doctor-to-doctor connection 50% Source: Kaiser Permanente internal data. faster diagnosis-to-treatment times for stroke patients with telestroke program 7 February 7, Kaiser Foundation Health Plan, Inc.

9 Delivering the right care in the right setting More telehealth touches than in-person visits since 2012 Outpatient touches All regions Office visits Secure Telephone 35% 34% 33% 33% 33% 17% 19% 21% 23% 25% 48% 47% 46% 44% 42% 58% Electronic health record-enabled telehealth touches M 99.6M 105M 112.7M 122M Total touches Source: Core Value Metrics Report, Kaiser Permanente, February 7, Kaiser Foundation Health Plan, Inc.

10 Beyond convenience to care transformation At Kaiser Permanente, telehealth is part of our commitment to innovate, advance care, and transform the member experience. Accelerates the care process Increases quality of care Helps manage the cost of care 9 February 7, Kaiser Foundation Health Plan, Inc.

11 Telehealth policy A primary barrier to adoption and expansion of telehealth: Medicare payment policy Original Medicare has strict limitations on coverage of telehealth Real-time audio/video Rural/health professional shortage areas Certain types of practitioners Specific CPT/HCPCS services Fee-for-service requirements do apply to Medicare Advantage unless a supplemental benefit is in place Requires use of rebate dollars or additional member premium Medicare Advantage risk adjustment does not recognize telehealth as part of encounter data 10 February 7, Kaiser Foundation Health Plan, Inc.

12 Telehealth policy Highlights from recent federal telehealth policy activity: Congress CHRONIC Care Act of 2017 (passed Senate) Medicare Advantage plans may include additional telehealth benefits in bids Allow ACOs to treat home as originating site Flexibility in provision of telestroke services End-stage renal disease beneficiaries may receive visits via telehealth Medicare Part B Improvement Act of 2017 (passed House) Includes ESRD provision Increasing Telehealth Access in Medicare (ITAM) Act (reported by House Ways & Means Committee) Includes Medicare Advantage additional telehealth benefits provision Continuing Resolution? 11 February 7, Kaiser Foundation Health Plan, Inc.

13 Telehealth policy Highlights from recent federal telehealth policy activity: Centers for Medicare & Medicaid Services Recent change in policy to allow rural-like census tracts to be included in the geographic areas where telehealth is permitted Year-to-year expansion of list of services eligible for telehealth ACO flexibility (for ACOs sharing two-sided risk) MedPAC Report on telehealth due March 15, 2018 (mandated by 21 st Century Cures Act) The telehealth services for which payment can be made under Medicare Parts A and B The telehealth services for which payment can be made under private health insurance plans Ways in which telehealth services covered under private insurance plans might be incorporated into the Medicare fee-for-service program (including recommendations) 12 February 7, Kaiser Foundation Health Plan, Inc.

14 Thank you 13 February 7, Kaiser Foundation Health Plan, Inc.