Becker's Hospital Review

August 2020 Issue of Becker's Hospital Review

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81 81 PRACTICE MANAGEMENT THOUGHT LEADERSHIP Telemedicine as a revenue generator: Big ideas from Beebe Healthcare CEO Dr. David Tam By Laura Dyrda W hen David Tam, MD, joined Lewes, Del.-based Beebe Healthcare as CEO in Febru- ary, one of his top priorities was examin- ing the system's telehealth program and finding ways to optimize it. en the pandemic hit and Dr. Tam's focus on telehealth became even more urgent. CMS and commercial payers li- ed telehealth restrictions during the pan- demic to allow members access to virtual care and to pay the same rates as in-person care. As of June 30, CMS had not yet announced permanent changes to the telehealth program and rolling back some of the benefits is a possibility. But that won't stop many organizations from pursuing their telemedicine initiatives. Here, Dr. Tam discusses Beebe Healthcare's telehealth strategy and where there will be the best opportunities for strategic growth in the coming years. Question: Do you have a plan in place for how you will move forward with telehealth if reimbursement rates drop? Dr. David Tam: We are very grateful that CMS made those changes. I got to this job three months ago, right when the pandemic started, and even then I was looking at where we are at Beebe Healthcare with telemedicine and knew that telemedicine was going to be one of our cornerstones. Even if the CMS rates change back to where they were before, Beebe Healthcare is strategically focusing on continuing to expand our telemedicine functionality for the people of this county. Q: If reimbursement rates are rolled back, the health sys- tem may end up performing a larger percentage of vir- tual visits that would have lower reimbursement rates. Are there ways you are retooling your plan based on that possibility? DT: I think of telemedicine as a revenue generator as well as a service to the community. I also think it will actually improve our ability to get secondary services and therefore enhance our revenue in terms of testing, imaging capability and other ancillary services because we are really talking about increasing our ability to see more patients. We have so many people here that live in the county that may not have transportation or may have language barriers, and that is how telemedicine can really play a significant role to reach out to patients that we have never had a chance to reach out to before and take care of. at will generate secondary revenue in a variety of different ways. is is a way to enhance our revenue generation even if the CMS reimbursement changes back to where they were before. Q: How do you see telehealth expanding further in the future? What do you anticipate you will be able to offer that you don't today? DT: One, I think there is a greater opportunity with the new technical advancements that we have in imagery in terms of optics to look at things like specialty services, with the right platform. Telemedicine isn't just your iPhone or your smartphone; it can be a remote service that allows for better cameras and lighting, you can do things like der- matology or neurology and mental health. ere are a lot of functions that expand the capacity of specialty services, not just primary care. e second thing is that with a robust telemedicine program comes the idea of how to move out with things like lab and imaging into communities where we can provide those services and therefore ex- pand once again to meet the needs of our community and contribute to financial recovery by doing more labs rather than having patients not come to our hospital because they are unable to. Instead, we could have a mobile van go out and draw blood or do other kinds of testing that would generate revenue and take care of patients. e third thing is what I'm really excited about: ere are now models out there for hospital-at-home where you provide inpatient services in limited ways where patients are actually in their home. at's a great opportunity when dealing with a potential pandemic in the future, is how to keep patients from coming into the hospital, or how to keep patients from creating so much patient population that your hospital is inundated. If you can manage an uncomplicated patient at home as an inpatient with the right technology monitoring their vital signs, IVs and having doctors and nurses that are physically there or zoom- ing in, you really have a change in the paradigm of healthcare delivery by moving them simply out of the brick-and-mortar hospital. at is an area where we would love to pursue; in order to do that, we have to get telemedicine out there and people used to telemedicine and have the tech be robust in terms of Wi-Fi and the cloud, and those are things I'm looking forward to doing at Beebe. Q: How are you planning on moving forward with virtual care and telehealth initiatives? DT: e environment is very open to telemedicine. With the corona- virus, I think there are new opportunities for companies, not health- care companies, but other companies looking at remote work and not necessarily being restricted to a metropolitan area. When you start thinking about telemedicine, it's a whole new paradigm in terms of how a community health system like us can partner with other plac- es and perform telemedicine services jointly for things like advanced cancer or immunology or advanced neurosciences. ese are all things that are now open because the population is no longer focused on their specific hospital in Baltimore and only going to one hospital. Now they may want to live somewhere farther away, more like where we are in Delaware, but in telemedicine we can provide the higher level of care that they wouldn't be able to have 10-15 years ago. It's a new paradigm for community healthcare organizations that have struggled because they could not necessarily compete with the health- care organizations in metropolitan areas. Telemedicine allows for re- ally a partnership between rural systems. We're not a small, dispropor- tional critical access hospital, but to be able to partner with other large institutions to talk about what are the things we can do together to provide services at home under a telemedicine umbrella is really excit- ing. e community still needs an emergency room, inpatient bed and a convener, the community health system, to interface with the high specialty services. But it will change the paradigm of what mergers and acquisitions look like in the future to grow large organizations. n

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