Virtual visits to ambulatory settings hit record usage during the first wave of the COVID-19 pandemic, increasing 149X in aggregate between March and May, compared to the prior nine-month, pre-pandemic weekly average. The sudden uptake of virtual visits cooled off slightly as the first surge waned, though ambulatory virtual visits were still 77X over the pre-pandemic baseline heading into the final week of May.
Providers relying on telehealth to provide care during the pandemic received good news this week, as President Trump signed an executive order to expand access to telehealth services during the pandemic, which Premier has been advocating for. A new proposed rule would also extend the availability of certain telehealth services after the public health emergency ends.
To understand just how widespread telehealth use has become among ambulatory providers, Premier analyzed InflowHealth, its robust database with volume, operational and revenue data for more than 35,000 ambulatory providers nationwide, to assess changes to ambulatory operations during the first wave of COVID-19. [Download our data-driven report for the full insights.]
The findings were striking: Prior to March 2020, fewer than 2% of InflowHealth providers were using virtual health technologies. By the end of April, that rate had skyrocketed to more than 70%.
Primary care groups, in particular, had a noticeably strong adoption of virtual health visits compared to medical specialty and surgical specialty practices.
While ambulatory providers succeeded in offering high-quality virtual care, the rapid transition raised challenges.
In a webinar Premier hosted in May about navigating post-pandemic realities for medical groups, providers indicated telehealth billing and coding was a top concern during the transition period and post-crisis, followed by integration with technology systems.
Premier has successfully advocated for an expansion of telehealth during the pandemic and is now supporting permanent policy changes to modernize the Medicare telehealth benefit, ensuring more patients have access to these services and that providers are adequately reimbursed for them.
Providers with a stronger foothold in value-based care delivery appear to have had an edge over the competition. In a recent survey Premier conducted, providers in downside-risk alternative payment models (APMs) indicated they had prior experience deploying telehealth in Medicare fee-for-service models via telehealth waivers. Accordingly, more providers in APMs were able to scale existing telehealth capabilities during the crisis (91%) compared to providers who are not in APMs (81%). Ninety-three percent of respondents to the survey cited the telehealth waivers as essentials to make permanent.
With telehealth usage increasing, providers are also making moves to reimagine their office spaces. In Premier’s webinar, respondents indicated the physical safety of their practices for patients and staff was their top concern regarding practice operations. By early June, almost 60 percent of alternate site providers reported they were planning to, or already had, reconfigured their physical spaces to further encourage social distancing.
Behind the environment of safety, the ability to provide important supplies, such as personal protective equipment (PPE), registered as a close second concern for webinar respondents.
As telehealth becomes a larger element of daily care delivery, providers will need to be cognizant of how the downstream effects could reshape their traditional revenue streams.
The influx of virtual visits is changing historical ratios between outpatient visits and downstream services, and leaders will need to align their ramp-up strategies with projected ancillary utilization as well as virtual health platforms as part of their clear back-to-business plan.