Care anywhere: A framework for a future model of healthcare.

By Dr. Christine Gall, Head of Healthcare Marketing

The concept of “care everywhere” may seem simple in theory but is more complex in practice. The COVID-19 pandemic pushed awareness of healthcare disparities in the U.S. to the forefront. Healthcare institutions needed to quickly rethink how care could be delivered safely outside their brick-and-mortar facilities to reach great numbers of patients with compromised access to care. In response, healthcare organizations and practitioners began leveraging various technologies such as telehealth services to provide care to patients on-demand.

Continued adoption of digital health strategies requires a thorough evaluation of patient outcomes, the review of the impact on the patient and provider experience, and assessment of associated costs compared to traditional health delivery models. The findings from this ongoing analysis must be continually shared with lawmakers and payers to ensure that healthcare reimbursement keeps pace with digital innovation. And it will be important to clearly articulate the value proposition that mobile, virtual, technology-supported care enables; improved access, improved outcomes, reduction in the utilization of costly care alternatives, and decreased overall cost.

The “care anywhere” strategy includes the following:

1. Industry: A shift from fee-for-service and “sick care” to “value-based care” and prevention to improve outcomes. A related driver is the growing shortage of physicians and nurses, which has accelerated significantly since the beginning of the pandemic. Telehealth reimbursement needs to follow this key trend.
   
   
2. Consumer/Patient: Increasing demand from patients with a “consumer mindset” for timely and convenient access to care where and when they want it. Simultaneously, there is increasing comfort and adoption of smartwatches, fitness trackers and other remote patient monitoring devices that give patients greater insight into their health status. These two trends together have the capacity to minimize or prevent illness and injury.
   
   
3. Financial: An unprecedented demand to close the disparities gap by improving access to high-quality healthcare services in a timely manner. During the height of the pandemic, reimbursement for telehealth services was expanded. A number of state and federal-level initiatives are encouraging continued telehealth services, including an August 2022 program from the National Cancer Institute to award $23 million to establish four telehealth Cancer Centers of Excellence. Also, the July Fair Care Act of 2022 expands Medicare coverage to include remote patient monitoring and additional telehealth services. * That said, some funding for telehealth services may end as legislation in response to the pandemic expires. It is important for organizations to lend their voices to bring awareness for the need for permanent telehealth reimbursement.
   
   
4. Clinical: From the clinical perspective, a re-imaged view of primary care delivery that is inclusive of digital options. There are numerous examples of big tech and retail giants investing in digital-first care delivery models, such as Amazon Cares, and Walgreen’s $5.2 billion investment in VillageMD. These non-traditional players must continue to seek highly qualified healthcare leaders to effectively navigate the complex and high-risk healthcare environment.

As non-traditional players continue entering the healthcare delivery space, new levels of collaboration are needed to fully address patient needs at the appropriate price point—at the right time and in the right location.2 Many of the new players have exceptional expertise at managing the consumer journey and meeting the needs of their customers. But healthcare is not the same as the consumer market. Four key challenges to the “care anywhere” model include:

1. Regulatory restrictions on sharing of medical data and associated protections of individual health information. Reliable and secure broadband connectivity is essential to the viability of a responsible data sharing strategy.
   
   
2. Patients want convenience, but they also enjoy face-to-face care. Agile care delivery that promotes seamless transition of care is a growing requirement.
   
   
3. Although efforts are being made to ensure reimbursement parity for remote health monitoring and telehealth visits, there is still a significant gap.
   
   
4. With limited resources, funding for emerging technology and related improvements to the healthcare ecosystem often fall short. And not all providers are early adopters of change so reluctance to embrace technology is a real challenge. Digital literacy and comfort with technology are barriers to adoption of care-anywhere solutions, and often exacerbated in disadvantaged populations.

Dr. Gall’s academic credentials include a Bachelor of Science Degree from the University of Wisconsin-Milwaukee, a Master of Science Degree in Healthcare Management from the Lubar School of Business Administration at the University of Wisconsin-Milwaukee, and a Doctorate Degree in Public Health Leadership from the University of Illinois Chicago. Her Dissertation, funded by the State of Ohio, was on the topic of Mass Casualty Pandemics. Dr. Gall is a Six Sigma Green Belt and has a Certification in Business Analytics from the Wharton School of Business at the University of Pennsylvania.