Value (Business Strategy and Financial Management)
EP-149 - Secondary Cost Savings Associated with School Telehealth
Sunday, April 29
4:25 PM - 4:40 PM
Location: Education Zone, Booth 2416, Screen 5
Introduction: the economic impact of telemedicine is not well understood. From a medical perspective, technology can be more expensive than return revenue or observed cost savings, resulting in negative financial returns. The outcome of the telemedicine is linked to financial sustainability through potential reductions in being treated at more expensive hospital settings, but the efficacy of volume reductions associated with telemedicine is also not well understood.
Methods: Different satisfaction surveys were developed for caregivers and nurses, and deployed across the 2015-2016 and 2016-2017 academic school years. Caregivers received surveys on a quarterly basis if their child was seen in the school telehealth visit, and nurses were given surveys twice per school year. Questions topics with financial impacts included sources of alternative care, school absence, travel costs, and work time saved.
Results: In all, 8,765 students were seen through the school telehealth program between October, 2014 and June 30, 2017. Ninety-seven school telehealth sites are currently active, expanding from 26 schools in the 2014-2015 school year to 57 schools in the 2015-2016 school year, and to 97 schools in the 2016-2017 school year. Throughout these visits, 349 caregivers responded, and 161 nurses responded to the surveys.
Thirty-six percent of the nurses surveyed responded that they strongly believed that the child would have visited an ED or Urgent Care Center if they had not been seen through the school telehealth visit. This equates to approximately 3,155 patients being highly likely to utilize these services. With a cost difference of approximately $1,215 between the ED and the school telehealth service, and approximately $106 between Urgent Care and the school telehealth service, this program potentially provides over $2 million in cost savings.
Forty-three percent of nurses responded strongly believed the school telehealth program reduced illness-related absenteeism, with another thirty-eight percent somewhat agreeing. Furthermore, another forty-three percent strongly believed the child would have left school without the school telehealth program.
On the other hand, over three-quarters of caregivers reported that the child would have missed at least a half of a school day without the telemedicine program. Based on responses, the school telehealth program may have averted over 12,000 illness-related absence days from more than 6,000 student contacts. At an average reimbursable rate of $9,559 per student for the State of Texas (in 2015), or a $53.11 per day reimbursement, this equates to over $650,000 saved to school districts in absences averted.
Transportation costs are yet another aspect of cost savings provided to the caregivers. By applying a $0.55 reimbursable rate to the distance brackets, the school telehealth program potentially saves upwards of $100,000 in travel costs. The average midrange cost for caregivers traveling at least 1 mile is almost $10.00.
Conclusion: This analysis was not exact in determining reimbursement, but looked to assess the potential cost savings due to the school telehealth program. This study shows significant cost savings across several different mechanisms including cost of care, travel, school absences averted, and potentially mitigating lost wages.
- Discuss and identify carious avenues of exploring cost-savings opportunities found within a school telehealth program
- Discuss the potential indirect cost savings of school telehealth programs as a subsection of determining overall value for this and similar programs
- Discuss and identify challenges of determining cost savings, and determine the next steps in more accurately assessing cost savings