The Institute for Healthcare Improvement designed the Triple Aim as a vision for transforming the healthcare system to better meet patient needs. The IHI Triple Aim’s goal is to increase the value of healthcare and optimize health system performance by addressing three interrelated objectives: improving the individual experience of care (including quality and satisfaction), improving population health, and reducing the per capita cost of care.
Virtual care is increasing being recognized as a healthcare delivery method which effectively lowers healthcare costs while improving patient experience and overall population health. An emerging opportunity to lower costs is for hospitals to use virtual visits as the core of a cost-effective and outcomes-driven hospital readmissions reduction program.
Hospital readmissions are costly. The Hospital Readmissions Reduction Program (HRRP) tracks hospitals’ 30-day readmission rates for multiple conditions, including heart attack and heart failure, pneumonia, COPD, total joint replacement. If a hospital’s combined readmission scores exceed its target score, which is adjusted for demographic factors, it can be penalized by up to a 3% reduction in its Medicare reimbursement for the year. The HRRP penalties in 2017 (calculated based on three full years of hospital data between 2012 -2015) hit a cumulative of $528M in readmission penalties which was assessed on approximately 1/3 of the hospitals across the nation. Health Plans are not immune from these financial repercussions. Nearly 20% of Medicare patients are readmitted within 30 days. 34% of Medicare patients are readmitted within 90 days and 56% within 1 year. 64% of these patients receive no care between discharge and readmission. Readmissions cost payers approximately $26B annually while $17B is considered avoidable.
There are 4 ways in which virtual visits can lower healthcare costs, specifically related to reducing the risk of readmissions.
- Reduce wait times: Using video-based platforms can help specialists provide better – and faster – care decisions when they are offsite. A virtual consult will reduce providers’ (and patients’) waiting time as they attempt to reach specialists. Specialists can answer the request for the virtual consult from any device – anywhere and at any time – and bring timely patient care to the bedside via video.
- Minimize drive times: Using video-based platforms can help medical staff care for more patients, more often. A virtual visit will reduce travel time and travel costs for care team members and patients. Patients can more conveniently schedule and attend their follow-up care appointments when the timing and location focuses around their lifestyle, post-discharge. Patients will be more engaged; providers will benefit from less no-show’s.
- Maximize staff productivity: Using video-based platforms can help providers redesign staff utilization around patients’ needs. A virtual visit allows medical staff to continuously monitor and respond to patient needs, especially within the critical 30-days post-discharge window. Reporting can identify when patients are more likely to seek follow-up care and department leads can scheduled care team members to best match patients’ preferred timing for follow-up virtual visits. Staff can also be augmented to address the shortfall of providers due to geographical or scheduling constraints.
- Deliver preventative care: Using video-based platforms can help reduce the unnecessary (and expensive) use of emergency room visits and readmissions. Virtual visits can deepen patients’ understanding and ongoing compliance over the initial thirty, sixty or ninety days post-discharge. As providers have the ability to detect patients’ potential issues before an in-person consult is needed, preventative care can be conveniently delivered via video and in-person critical interventions can be minimized.
Virtual visits are critical to bringing care to patients post-discharge and enabling patients to remain comfortably and conveniently at home. By using technology to provide patients with better access to follow-up care, healthcare organizations can optimize their community’s physical and financial health while lowering costs for all stakeholders.