It is no secret that greater patient engagement yields improved health outcomes. For example, the Commonwealth Care Alliance of Massachusetts had more than 51 touchpoints with their members over a 24 month period. This resulted in a 22 percent drop for in-patient admissions, a 14 percent decrease in emergency room visits, and a 5 percent reduction in total cost of care, which their Chief Innovation Officer Dr. John Loughnane highlighted during this year’s Medicaid Managed Care Conference. Other areas of the health system, such as health department tuberculosis programs, have been connecting daily with patients for decades to achieve near perfect rates of treatment completion while achieving cost savings for states. However, until recently, there have been no mechanisms to compensate for this critically important effort.
Reimbursement for virtual communication with patients
The recent creation of ‘virtual communication’ billing codes by the Centers for Medicare & Medicaid Services (CMS) seeks to compensate regular, quick touchpoints with patients. Unlike telehealth or remote patient monitoring codes, new CMS codes G2010 and G0071 reimburse providers for reviewing 5-minutes of recorded photo or video data and communicating back to the patient within 24 hours.
The intention of this new code was clearly outlined by Administrator Seema Verma. At the 2019 CMS Quality Conference she presented her vision for how the agency would empower patients by focusing on results and unleashing innovation to make our health system more accessible, equitable, and efficient. The creation of the virtual communications code in the Medicare fee schedule has set the stage for state-level Medicaid programs, such as California, and commercial insurers, such as United Healthcare and certain Blue Cross Blue Shield plans, to adopt these codes in their fee schedules to improve clinical quality in a cost-effective manner.
Digital health leadership in Mississippi
On March 20, 2019, the Mississippi Telehealth Association convened leaders from across the state to discuss the role telehealth, virtual communications, and remote patient monitoring have in improving care for Mississippians. It is the only state-based, membership-driven telehealth organization in the country with core objectives rooted in creating initiatives to:
- Increase patient adoption of new technology
- Provide greater access to care in rural areas
- Advance patient-centered telehealth policies
- Provide a forum for business to business development
emocha co-presented during a reimbursement break out session with the Mississippi Division of Medicaid at this conference. Approximately 700,000 Medicaid beneficiaries receive care financed by the agency each year and there is a proactive effort to increase telehealth adoption, particularly to serve beneficiaries in rural areas. Given broadband internet limitations in much of the state, livestream communication can be a barrier to care, but asynchronous -- or store-and-forward -- technology can be better utilized to improve care in rural areas.
Improving medication adherence with emocha’s asynchronous video platform is an ideal use case for leveraging new virtual communication codes. The platform has been shown to improve outcomes while reducing costs over prolonged periods of time. emocha can decrease healthcare costs associated with nonadherence that are largely assumed by the state across a number of patient populations.
Furthermore, having a daily touchpoint with patients to improve medication adherence presents the opportunity to proactively intervene on social determinants of health to connect people to services they need, such as transportation or nutritional counseling. Early experiences with Medicaid plans in other states show how emocha works collaboratively with federally qualified health center partners to holistically improve adherence to oral diabetes medication.
“With the evolution and innovation in healthcare today, platforms that can deliver quality, seamless care in a fast and efficient manner is pivotal,” said Ryan Kelly, the Executive Director of the Mississippi Telehealth Association. “Telehealth serves as one of the primary outlets for consistent innovation and growth, and the results show that it is positive for the patient, the provider, and the facilities delivering care. We fully expect telehealth in its many forms to be the future of healthcare that is now beginning to emerge.”
Healthcare continues to be radically redesigned at a rapid pace. Mississippi is leading the way in making care more efficient, equitable, and accessible by engaging with physicians as well as policy, industry, and patient leaders to push innovation forward.