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Telehealth is having a moment.
In the midst of the coronavirus pandemic, many people can't, or won't, visit their doctors in person. So, some are making virtual visits, instead.
This could be the future of medicine — or a fad that won't last beyond the current outbreak. The idea that video calls could replace some trips to the doctor's office isn't new, and it never really caught on, until COVID-19 suddenly changed everything.
"We started seeing unprecedented growth — never seen before," said Girish Navani, CEO of Westborough-based eClinicalWorks.
Though Navani's company is a leading maker of medical software, the telehealth platform it introduced several years ago wasn't a big hit. Before the coronavirus pandemic, average daily usage by all clients combined was just 28 hours.
Practically overnight, usage has skyrocketed to about 25,000 hours per day.
"What's even more exciting is not just the growth in usage," Navani said. "The stories that we are hearing every day is that the doctors find this to be very, very convenient, easy, safe. And, on the other side, the patients find it to be extremely convenient."
Navani's company hopes patients and doctors are hooked and that telehealth is here to stay. But getting people to like telehealth is only half the battle.
Until recently, doctors and hospitals had little incentive to offer virtual visits because many health insurers didn't cover them or paid far less than the prices of face-to-face appointments. Like many states, Massachusetts is temporarily requiring equal payments during the pandemic, under an order from Gov. Charlie Baker.
"You talk to almost anybody in the provider community and people on the payer side, and they'll tell you the arrival of the coronavirus and the executive emergency order that we issued on telehealth has brought this into the mainstream in Massachusetts," Baker said at a recent news conference.
A big question is whether insurance companies will continue to cover telehealth at the same rate as in-person care after the pandemic. For now, many are noncommittal.
"At the appropriate time, we will work with all stakeholders — customers, health care providers, and policymakers — on transitioning to a post-COVID-19 environment, with a continued focus on making high-quality health care accessible and affordable," Blue Cross Blue Shield of Massachusetts, the state's largest insurer, said in a statement.
WBUR previously reported that Blue Cross Blue Shield of Massachusetts customers are using telehealth technology about 100 times more than usual.
Harvard Pilgrim said it "will continue to evaluate as the months progress," and Tufts Health Plan said it "will continue to examine reimbursement levels as time goes on." The two insurers plan to merge this year.
AllWays Health Partners said it "will work with state officials and other members of the health care community on appropriate telemedicine policies in a post-COVID-19 environment."
AllWays Vice President Jennifer St. Thomas said in a recent online forum organized by the Massachusetts High Technology Council that telehealth looked like risky business before the coronavirus.
"Health plans have really held back because of the concern over adoption," she said. "Am I going to change my product design just to have it be a flop?"
Adoption is through the roof, at the moment. But, in the long run, telehealth coverage and demand appear to present a chicken-and-egg dilemma: Insurers may need steady demand after the pandemic subsides to make coverage worthwhile. But the demand could depend on continued coverage.
That's because doctors might drop telehealth if asked to accept low insurance payments, and patients may be unwilling to make up the difference, out of pocket.
A compromise may be the key to making the economics of telehealth work in Massachusetts and beyond, according to Dr. Jim Leavitt, whose gastroenterology practice is funded by a Boston private equity firm but has offices in Florida, Alabama, Virginia and Washington state.
"Will it be the same rate as a regular visit? Maybe not," Leavitt said. "If it's 20% of the rate, it's a problem, from a business structure. But if it's 80% [or] 85% of the rate, it's reasonable."
For now, Leavitt's doctors are conducting telehealth visits using software from eClinicalWorks — something they hardly ever did before the spread of COVID-19. If insurance coverage remains at the level Leavitt calls reasonable, after the pandemic, he predicts one-quarter to one-third of his practice's visits could stay virtual.
This segment aired on May 20, 2020.
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