Is healthcare on the way to ‘telehealth at-scale?’ We checked in with American Well’s Danielle Russella, President & GM of Health Plan Solutions, to rumor-check the buzz we’ve been hearing about “digital-first health plans” and what that means for the future of health plan coverage for telehealth services. From provider uptake and payment parity to patient awareness and utilization, Danielle weighs in on the state-of-play of telehealth/health plan relations and how digital health seems to finally becoming part of payer strategy talks within the C-suite. At American Well, that’s meant more growth in last 2 years than in the previous 8 years, says Danielle. Is that why we’re hearing those IPO rumors? Tune in to find out if there’s any merit to that chatter.
After the longwinded-ness of last episode, Jessica DaMassa runs a tight ship today. Lantern’s demise, GSK & 23andme’s huge deal, yet another big chunk of change for American Well, and what was going on at #GoogleNext18 with Google Cloud in health –all asked by Jessica and answered by me, in under the 2 minute wire–Matthew Holt
Jessica DaMassa asks me about the American Well mega funding round, Cerner investing in Lumeris, and the new NHS England app. Which naturally descends into a conversation about England’s chances in the world cup semi-final tomorrow!–Matthew Holt
Last week Avizia, where I’ve been the Chief Medical Officer since 2014, was acquired by American Well (AmWell). From my perspective, the merger made perfect sense. Avizia has been focused on chronically and acutely ill patients—those more directly attached to a hospital system. AmWell, on the other hand, has been the dominant solution for community-based care; it’s an online consultation service for folks who might otherwise have gone to an urgent care for problems like fever, headache, or a sore throat. Combining these entities provides a solution that spans the spectrum of care, which aligns with the needs of many healthcare systems. Issues related to patient access and satisfaction (think: less acute, community-based care) are top-of-mind for many administrators. However, with 80% of the dollars going to 20 % of the population, managing the continuum for the chronically ill (which is more in line with the mission of Avizia) is imperative to provide better care at a lower cost.
The merger also marks a predictable milestone in the common transition pattern for big ideas (internet, aeronautics, GPS, etc.)—from the military, to academia, to scalable business.
Telemedicine started as a military-run effort. NASA, concerned that astronaut healthcare issues would cause mission failures, was the first organization to devote significant funding to telemedicine research. Early ATA meetings were opened with military-sponsored presentations featuring the Telemedicine & Advanced Technology Research Center, a branch of the Army.
Next came academia. Millions of dollars in grant money were offered, but academics were no longer focused on the health of astronauts. Instead, the goal was providing care at a distance—to the citizens of Rural America. Many early leaders of the ATA came from the universities that built and deployed this technology.
CMS recently unveiled a massive regulatory overhaul of Medicaid managed care requirements. Despite the fact that it’s being called a “mega-reg,” and taking some heat for its 1400+ page size, there’s certainly some interesting reading contained within, particularly for the telehealth community.
It’s all about network adequacy standards.
Health plans are regulated by states or CMS and measured based on their ability to demonstrate the adequacy of their in-network providers. How many are there? What’s the availability by specialty? Do consumers understand which providers are in-network? What does access look like in terms of wait times and distance? Answering these questions are the key to meeting the standard.
In an exclusive interview with Matthew Holt, American Well President and CEO Roy Schoenberg, MD shrugs off the threat of emerging competitors, predicts that United Healthcare will own a telehealth company within the next 12 months, and reveals that his company has “turned the corner” in terms of generating revenue from telehealth services. Schoenberg also shares details of the company’s recently announced integration with Apple HealthKit and the growing use of scheduled telehealth visits to treat chronically ill patients.
Our friends over at American Well have two announcements today. First, they’re releasing what they call Online Care Insight, which is essentially the integration of care guidelines into their online care system. We saw a glimpse into this at the Health 2.0 Hawaii chapter meeting last March (sorry if you weren’t there!). Essentially this is a decision support service that helps physicians figure out if the online visit in front of them is appropriate for online care, and then offers clinical decision support during the visit (such as medication reminders, gaps in care, and other alerts)
The second piece of news is that American Well and Optum Health will be combining the American Well online visit service with Optum’s eSync care management platform. eSync basically integrates the data analytics portion with care management, so that a plan or employer can figure out who’s got what dread disease and reach out to them using a series of different contacts. Usually this means email, or nurse or health coach call. Now an online physician visit is part of that continuum.
(Optum Health is a subsidiary of United HealthGroup, and eSync was introduced at a sponsored Deep Dive at the recent Health 2.0 Meets Ix conference. FD Both American Well and Optum have sponsored the Health 2.0 Conference).
Obviously given United’s scale & Optum’s reach into the self-funded employer market this is big news for American Well and online care. The press release also says that the service will be available to individual consumers. I assume that this means that some part of United’s multi-state physician network will be on the system, and that there’ll be an option for consumers who are not in a United plan to access it. If it does mean that, then when this is launched the American Well service will essentially be available nationwide. But that’s my early morning speculation. I’ll try to track down someone from American Well to get more accurate details.