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Telehealth’s Critical Role in the Shift Toward Value-Based Care


Telehealth has exploded in recent months – and most experts believe that it’s here to stay in a post-pandemic world – although to what extent will depend on how payers agree to pay once things return to normal. The shift to value-based care is another reality most healthcare professionals know is coming quickly.  Where these two concepts – telehealth and value-based care – come together is in an ideal world where healthcare can be delivered more efficiently and at a greater value for patients and payers. For healthcare organizations that can make it work, it’s well worth the effort. Successfully utilizing telehealth in the shift to value-based care is a win-win-win that just may give a tiny silver lining to the many challenges facing healthcare organizations right now.

Here are just a few ways telehealth supports the shift to value-based care – and thus, can improve the financial outlook for struggling healthcare systems.

  • Lower Cost per Encounter – Telehealth is less expensive per encounter, averaging $79 per visit compared to the in-office cost of $146. That’s nearly half the cost and now that providers and patients have more experience using virtual visits, they are likely to be far more efficient as well.
  • Improved Outcomes – There are many ways the use of telehealth can improve health outcomes – which is part of the deal for value-based care. Financial quality incentives are offered based on key metrics such as reducing hospital readmissions, reducing spending per beneficiary after a hospital discharge, and more. By using telemedicine to follow-up on recently discharged patients, providers can reduce the need for additional acute care services that may lead to higher costs. Similarly, hospitals that use telemedicine as a back-up for intensive care settings report better outcomes.
  • Cost Avoidance – Patients who get on-demand care when and where they need it from telemedicine are less likely to overutilize urgent care or the emergency department. By using telemedicine during weekends, holidays or after-hours, the costs for higher levels of care are avoided. Finally, remote monitoring (another form of telehealth) in high-risk populations can help reduce emergency department visits and hospital admissions and thereby help avoid higher costs.
  • Early Detection of Clinical Changes – Using telehealth – whether through remote monitoring, wearables, or patient-reported data (i.e. blood pressure, weight, oxygen saturation, etc.) can help providers identify clinical changes in a timely manner – before they escalate into bigger problems. For example, in heart failure patients who take and report their weight daily, providers can often detect fluctuations remotely that may require a simple change in medication that can prevent future decline or hospitalization. Similarly, in patients with cardiac arrhythmia, wearable devices can help providers detect when someone may go into atrial fibrillation and require treatment before a trip to the emergency department is needed.
  • Reduction in Care Gaps – Many accountable care organizations (ACOs) are using telehealth to help provide better care for high-risk patients such as those with chronic conditions and multiple comorbidities. A care adviser (typically a registered nurse) may monitor the patient’s care remotely or carefully review the electronic medical record (EMR) for care gaps such as certain routine screenings, labs or check-ups that are considered best practices. The care adviser can get the needed care scheduled and/or ordered by a physician to close the care gap. This leads to better long-term outcomes and reduces the need for hospitalization, etc.
  • Proactive Care vs Reactive Care – Reactive care, otherwise known as episodic care, almost always comes at a greater cost than preventive care. Telehealth can be used to monitor adherence to a prescribed plan of care (including taking medications as prescribed), compliance with recommended screenings and other preventive health measures – all leading to better outcomes and lower costs that those that come with acute illnesses.

The adoption of telehealth has finally caught on – and while its long-term effect on value is yet to be determined, many believe it has the power to make a significant impact on the shift to value-based care.

GeBBS Healthcare Solutions offers a full spectrum of outsourced medical billing, collections, coding, and telehealth expertise. With the recent challenges of COVID-19, telehealth has gone from a “somewhere in the future” patient care technology to a now technology and immediate adoption has never been more critical – GeBBS diligently works side-by-side with our large client base and industry experts alike to navigate the associated complexities of telehealth. GeBBS’ leadership and SMEs remain at the forefront of change, by continuously monitoring updates and releases and partnering with leading industry experts to transfer and share our knowledge that ensures our clients remain current and compliant in the everchanging world of healthcare. To learn more, visit gebbs.com

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