“Understanding the value of virtual care is vital to inform decision making that facilitates the shift to digitally enabled care models that blend the best features of in-person care with those of virtual care,” AMA Board Member Jack Resneck Jr., MD, said in a press release.
“The AMA’s framework fills a critical need to inclusively define and measure the various benefits generated by virtual care as decision makers design new care models, prioritize investments, and determine appropriate coverage and payment policies in the future,” he added.
With the coronavirus pandemic creating a surge in telehealth programs and virtual care appointments, AMA officials say it is crucial for healthcare providers to understand how these platforms can improve care outcomes and reduce waste and expenses beyond the pandemic. They need to know how to value these services when the emergency ends and new policies take effect.
According to the organization, healthcare providers, payers and policymakers are often making financial virtual care decisions based on outdated, over-generalized telehealth strategies that fail to consider the values of virtual care and don’t account for unique environmental factors.
The AMA’s Return on Health initiative aims to update that decision-making process, so that connected health programs can be sustained and scaled upwards.
The initiative will frame the value of virtual care in seven categories: clinical outcomes, quality and safety, access to care, patient and family experience, clinician experience, financial and operational impact, and health equity. Programs should be measured against all of these categories to ensure they’re being valued properly.
The framework also breaks out environmental factors that impact these value streams, such as practice type, payment arrangements, patient population, clinical use cases and virtual care modalities. With this, the AMA wants the industry to acknowledge that different organizations have different demands that mold their approach to virtual care, therefore ensuring that no two organizations end up with the same outcomes.
The Return on Health initiative includes real world examples and case studies that use the new framework to determine the value of virtual care. By bringing in physician voices, AMA officials say they are using clinical evidence to influence payers’ decisions.
Virtual care and telehealth use significantly increased during the pandemic due to social distancing measures and stay-at-home orders. To establish a post-pandemic telehealth strategy, healthcare practices need to keep in mind their patients’ accommodations and needs. In order for payers to continue to provide adequate coverage and funds for these programs, the AMA says, they’ll need to be aware of the full benefits, which can be found using the framework.
The AMA’s initiative can also be used when asking the question of how much telehealth is enough? Instead of trying to find one conclusive, positive way that telehealth affects everyone, providers and payers can assess its value by using the framework presented and considering all value streams and environmental factors.