"Health-care reform, a ballooning and aging population and a shortage of available family physicians may be a perfect storm that could blow the doors open for telehealth to go mainstream."

-- Brian Heaton, GovTech 

Despite recent fiascos in our nation's capitol, the Affordable Care Act is taking root. And regardless of where you fall politically, there is one thing that is clear: the ACA may really boost telemedicine. We've been keeping our eye on the regulatory side of things, so here is our rundown... 

6 reasons the Affordable Care Act makes telemedicine (even more) crucial:

1. High demand. It's estimated that the healthcare system will see an influx of more than 30 million newly insured patients. Those patients' needs may be best met with a combination of telemedicine and conventional solutions. 
2. Provider shortage. The ACA's provisions increase demand while not addressing the provider shortage (particularly of primary care doctors), making telemedicine-based visits are care coordination crucial. 
3. Better reimbursement and funding. The bill provides several explicit provisions increasing funding and easing reimbursements for telehealth.  
4. Need for medical home and meaningful use. It's not enough to use EMRs, as we all know -- it has to be meaningful use.
5. Shared cost and outcomes-driven models. A focus on outcomes (rather than treatments) and a shared cost model means that the care coordination, collaboration, and savings that telemedicine can provide will be crucial for hospital systems and providers. As Dr. Brian Rosenfeld, Chief Medical Officer at Philips Healthcare, said, "Telehealth offers the opportunity to provide the access, quality and cost that will be necessary to increase prevention and leverage our current workforce."
6. Technology is less of a barrier. Although this factor isn't directly related to the ACA, it is a trend happening at the same time. Every year, technology -- broadband, collaboration platforms, cameras, computers -- get a little more widespread and a little easier to use. For instance, every doctor has the tools for using iClickCare in their office, and most have it in their pocket.

A recent New York Times article highlights hospitals featuring luxury amenities like organic meals, swanky lobbies, and posh rooms. In fact, the article even shows a number of hospital and hotel interiors and dares you to guess which is which. The hospitals featured are part of a larger trend in which the "Disney experience" is a common phrase among hospital adminstrators. 

“We found that patient demand correlates much better to amenities than quality of care,” said Dr. John Romley, a research professor at the Leonard D. Schaeffer Center for Health Policy and Economics of the University of Southern California.

But in an age when 50% of providers are burned out and we know patient satisfaction starts with provider satisfaction, are luxury hospital approaches sustainable? Posh hospitals might improve demand, but do they improve patient satisfaction -- or more importantly -- outcomes?

As we know from sources like this New York Times article, providers need many of the same things that lead to patient satisfaction. Both patients and providers need more time in the exam room, better communication, simpler regulations, less rush, and more authentic interaction. So while Haagen-Dazs in waiting rooms might improve demand, we wonder whether it will ultimately also take away from the very things that make patients -- and providers -- happy and well. 

Just another reason we're grateful for the long-term, win-win thinking of our ClickCare community and customers. 

Could telemedicine without video conferencing simplify your life? Take a look:

New compensation structures start with the best of intentions: keep costs down and patients healthy. But healthcare providers can become a casualty on the road to lower costs.

So, is your pay system causing provider burnout? The short answer is: probably.

Exhibit 1: Pay for volume.
Volume-related incentives were the compensation fad of the last decade. However, since provider burnout is exacerbated by feeling disconnected to patients and not having enough time to spend with them, this short-sighted policy contributes to many frustrated providers. As Dr. Robert Centor said at the Medscape Roundtable, "Too often the current finances of medicine force physicians to spend inadequate time with patients… I would argue that our payment system, especially for outpatient internists and family physicians, is a leading cause of burnout." 

Exhibit 2: Pay for performance.
A recent New York Times article shows how the Affordable Care Act is prompting hospitals to link provider pay with performance (measured by patient outcomes, cost containment, and patient satisfaction.) It sounds like a plan that makes sense, but physicians tend to resent this time of micro-level intervention in how they care for patients. And some point out that they're held responsible for things they can't influence (like whether a hospital floor is clean.) In fact, experts say that this plan of "carrots for doctors" is unlikely to work, even outside of physician considerations. 

What works?
There is no doubt that healthcare has to be more accountable and costs need to come down. But when it comes to designing a compensation plan that works, healthcare provider needs have to be front and center. The big problem with igorning provider needs and stressing them out? Well, it doesn't work. Patient satisfaction starts with happy healthcare providers. And research shows that doctors with lower incomes, more debt, and less savings tend to be more burned out than their peers. So if your compensation structure is burning out your providers, it's very possible that you're gouging patient outcomes and even elevating costs at the same time.

Compensation is a headache, but coding doesn't have to be. Get our free guide to ICD-10: