Saldanha is chief innovation officer of a health system.
The public health emergency, declared in 2020 as a result of the COVID pandemic, fostered the creation of waivers and exemptions that allowed for the widespread use of digital health, including telemedicine and remote patient monitoring. With the public health emergency ending earlier this year, many of these waivers and exemptions are gradually winding down, thereby putting pressure on early adopters of digital health at health systems around the nation.
Additionally, funding for U.S.-based digital health startups has seen a major decline over the last couple of years, from $29.3 billion in 2021 down to $15.3 billion in 2022. The latest digital health funding report shows declining confidence in digital health startups.
Yet, the need for digital health is not over.
It is crucial to continue to invest in digital health to align with changes in consumer choices, patient expectations, advances in technology, and a growing clinical workforce that uses digital tools. We should not wait for another public health emergency to advance access to and use of digital health.
Digital Health Saves Lives
According to a Commonwealth Fund report published in 2020, the U.S. spends nearly twice as much on healthcare as a share of its economy compared to other wealthy countries. Given this vast expenditure, it is even more critical to choose and implement the best mode of care delivery — and digital health helps make the system more efficient, effective, and accessible.
According to the CDC, 37% of adults used telemedicine in 2021. More women used telemedicine than men. People in large metropolitan areas used telemedicine in greater numbers than areas with decreased urbanization. Patients are clearly using technology to improve their access to care; expanding, rather than restricting, telehealth can help advance access even more.
In a 2022 report from the American Medical Association, 93% of physicians said that digital health is important. The report also revealed that the increased correlation between digital tools and clinical data in electronic health records greatly enhanced care delivery and reduced physician burnout.
UnitedHealth Group, the largest private health insurance company in the U.S., states that telehealth is a scalable digital health solution that will permanently increase access to behavioral healthcare. For UnitedHealth Group, telehealth enabled 26% of outpatient behavioral health visits among commercially insured patients.
Digital health also plays an essential role in timely identification of health risks. Uncontrolled hypertension is a major risk factor for stroke, cardiovascular disease, and other ailments. Early identification of patients at risk for hypertension can lead to effective and personalized treatments. Risk stratification for cardiovascular disease is greatly enhanced by digital health techniques as more data is being collected via remote patient monitoring and the use of clinical data in electronic health records.
Simply put, digital health saves lives.
Breaking Down Barriers to Use
Yet, among many health insurance companies, there is continued skepticism towards digital health. Some insurers have expressed a desire to see more outcomes data before they reimburse digital health. Meanwhile, UnitedHealth Group has announced that it will offer telehealth with no out-of-pocket expenses for its members. This is a positive boost for digital health from the insurers’ side. This trend needs to catch on among the other insurers.
During the public health emergency, the Centers for Medicare & Medicaid Services (CMS) allowed reimbursement of audio-only telehealth services and remote patient monitoring services for a patient for as little as 2 days a month. Now that the public health emergency has ended, CMS will discontinue reimbursing audio-only telehealth, and will only reimburse remote patient monitoring for existing patients and only if data is collected for at least 16 days a month. Unfortunately, CMS has not announced any clear pathways for reimbursement for broader digital health solutions. This is a serious bottleneck for digital health adoption and growth in the U.S.
According to McKinsey, digital health can provide health insurance companies (payers) increased efficiency, improved healthcare value, improved member experience, and optimized data quality. Policymakers, hospital administrators, healthcare providers, insurance companies, and all healthcare stakeholders need to focus more on pilot programs and funding involving digital health.
The federal government can make a huge impact by extending waivers and exemptions for digital health. Private insurers need to accelerate reimbursement for digital health.
This must not be an end but the beginning.
Anil Saldanha is the chief innovation officer at Rush University System for Health in Chicago, and a public voices fellow with The OpEd Project.
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