Rural agency markets telemedicine to MCOs
Payers interested in cost savings
Home telemedicine may seem like futuristic technology to some private duty providers. But one agency is already using the system to attract managed care business, and payers are excited about the cost savings.
Kansas Care in Salina purchased and leased machines from American TeleCare of Eden Prairie, MN, last November and is now providing home telemedicine services to managed care organizations, says Amy Howard, executive vice president. "[MCOs] are extremely receptive because it’s about half the cost of an on-site visit of traditional care."
Kansas Care, a home care agency that covers 36 rural counties, got into telemedicine as a way to improve access to care. "I didn’t want clinicians driving for hours to hand someone one pill. I think nurses need to be at the patient’s bedside, not drivers sitting in traffic."
Weather also can keep patients from getting the proper care. "What if patient X had to go to the doctor when it was snowing? How is he or she going to get there in a snowstorm? How is he or she going to be monitored?" she asks. "[Telemedicine] allows someone to be in his or her home. It is not meant to replace a doctor or a nurse visit on-site. It is an adjunct to established care."
An example of savings
Howard says she tells payers that home telemedicine will allow the agency to medically manage patients at a distance, and it will drive down the cost of the care.
She gives the example of a client who needed a course of IV antibiotics. The course of antibiotics constituted 35 visits, but the client only had 20 visits for the benefit year on his managed care plan. The managed care organization also said the client could handle his own antibiotic treatment, but the patient was anxious about doing something wrong.
Kansas Care was off the case after four visits: one on-site and three telemedicine. "We foster a teach-and-release philosophy. With telemedicine, we can do patient teaching, patient management, and return demonstrations with the patient."
The visits decreased the client’s anxiety level and taught him how to manage the port, Howard says. "One morning he called panic-stricken and said, I can’t connect this.’ The nurse flicked the button [on the machine] so she could see him. We walked him through it."
The end result: cost savings for the payer and sensitivity to the subscriber who may need those additional visits down the road. "The managed care organization thinks you’re a star because you are driving health care costs down."
Home telemedicine also encourages clients to take charge of their own care, Howard says.
For example, a client with a leg wound might not dress the leg on days of on-site visits because "the nurse will do it," Howard says. "However, if you’re going to be on the screen and the nurse is going to watch you dress your own leg, there is an expectation level that you need to know how to do this yourself. And if you know how to do this yourself, the less care you are going to require and the less it will cost."
Setting up telemedicine services in your agency may help attract managed care business, but the setup costs can be substantial. "It is a substantial investment and commitment on an agency’s part," says Howard. Kansas Care now has 12 machines. (To see how others can handle the technology for you, see related story, below.)
Kansas Care was encouraged in its path toward telemedicine by Medicaid. "Telemedicine is a reimbursable service by Medicaid in Kansas, and in California and Minnesota," she explains.
Even without the Medicaid reimbursement, Howard says the services still would be worth the start-up cost. "It is a saleable feature to an insurance company," she says. "I think it can make a difference in the covered lives of an insurance company’s subscribers. I have not had an insurance company turn us away yet."
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