Direct to Consumer Strategies

ePoster Presentations

EP-160 - The Value Proposition Initiative: ATA's New Collaborative Research Effort

Monday, April 30
4:45 PM - 5:00 PM
Location: Education Zone, Booth 2416, Screen 3

Objectives:
The American Telemedicine Association is the voice of the telemedicine industry. In this role, ATA engages in ongoing efforts to communicate the value of telemedicine to various stakeholders, including patients, health care systems, payers, providers, policy makers, and communities. ATA must also demonstrate value to its members, including development of implementation of novel collaborations with members that promote telehealth to external stakeholders. In 2017, ATA launched the Value Proposition Initiative (VPI). The VPI is an ambitious, far-reaching, and multi-pronged collaborative strategy in which ATA works with members to optimize ATA’s ability to communicate telemedicine’s value to external stakeholders. This presentation describes initial efforts to develop the “VPI Use Case Library,” one of several activities that ATA is launching under the VPI umbrella.

Methods:
The VPI Use Case Library concept was introduced to ATA Platinum Members in the Summer of 2017, and it received considerable support. Platinum members were asked which aspects of telemedicine should be prioritized in the Use Case Library, and it was agreed that use cases highlighting the value of telemedicine in terms of its financial impact and cost to health systems and payers should be targeted first. ATA Platinum Members were then asked to work with a consultant to generate content for the Use Case Library with an initial focus on financial impact and cost. Three ATA member organizations—Mercy Virtual, Avera Health, and CHI Franciscan Health—were early collaborators in this effort. These organizations identified a point of contact who worked with ATA’s consultant to generate content for specific use cases. Use case content includes epidemiologic data that frames the use case in a public health/public policy context, as well non-public financial, cost, and other data provided by the member that demonstrate the value of telemedicine for health systems and payers. Each use case can be thought of as a “book” in the VPI Use Case Library, and the Library can be thought of as a resource for ATA’s membership and the larger telemedicine community. The first VPI use cases on financial/cost issues for systems and payers were finalized in late 2017.

Results:
Mercy Health developed a use case highlighting the value of telemedicine for Medicare Advantage, Avera Health developed a use case on the value of telemedicine in rural emergency departments, and CHI Franciscan developed a use case on use of telemedicine in direct-to-consumer chronic care management for high risk diabetes patients. Mercy Health’s application of telemedicine in high risk Medicare Advantage patients resulted in a 50% decline in the rate of hospital admissions and a 35% decrease in the rate of emergency department visit in the first month of the program, and sustained declines since that time. Avera Health’s eEmergency program showed that from 2009-2014, 1,175 avoided transfers were attributed to tele-emergency, with an estimated savings of $4.5 million in avoided patient transportation costs. Tele-emergency also increased hospital revenue through local ED service provision and increased inpatient admissions resulting from avoided transfers to other hospitals. The 9,048 tele-ED encounters in 85 hospitals resulted in $542,880 in additional revenue to study hospitals. Related work from Avera showed that critical access hospitals that provided tele-ED services saved Medicare $25,222 per hospital per year. CHI Franciscan conducted a six-month study on direct-to-consumer telemedicine management of high risk people with type two diabetes. In addition to marked improvements in guideline-based outcome metrics, claims data for the high-risk diabetic intervention group were compared with an equivalent control group. Monthly charges and payments were analyzed for both groups and included all participating payers with varying rates. Charge savings were 45% lower for the intervention group (intervention group $1,338 patient/month vs. control group $2,434 patient/month). Payment savings were also 36.3% lower ($374/patient/month vs. control $587/patient/month respectively).

Conclusions:
ATA’s Value Proposition Initiative is a set of inter-related activities focused on the goal of better communicating the value of telemedicine to external stakeholders. The VPI leverages the knowledge and experience of ATA members to develop use cases and other communication vehicles that can effectively demonstrate how telemedicine can improve health and health care in the United States and beyond. The Use Case Library, a key effort under the VPI umbrella, is actively developing content that will be accessible to ATA members and the larger telemedicine community. In addition to addressing the value of telemedicine in terms of its financial and cost impacts, ATA expects this library to cover additional topics, including access to care, patient and provider experience, effectiveness, and quality.

Amanda Bell

eCARE Quality & Innovation Officer
Avera eCARE

Mandy Bell is the eCARE Quality & Innovation Officer at Avera Health in Sioux Falls, SD and works with each of the Avera’s eCARE telemedicine teams to demonstrate performance outcomes. Mandy specializes in new service line launches and also leads public policy efforts related to Avera’s telehealth programs. She serves as Avera's principal investigator on eEmergency related research programs and assisted with several peer-reviewed manuscripts. Mandy has a Masters in Healthcare Administration from the University of Minnesota.

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Matt Levi

Director, Virtual Health Services
Catholic Health Initiatives

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Helaine Resnick

President
Resnick Chodorow & Associates

Helaine Resnick, PhD, MPH is President of Resnick, Chodorow, and Associates. She holds a bachelor’s degree in history from Tufts University, a master's degree in health policy from Yale University, and a PhD in epidemiology from the University of Michigan. Dr. Resnick completed a 3-year post-doctoral fellowship in epidemiology at the National Institutes of Health. She has published 120 book chapters, journal articles, and technical reports on various health-related topics. Dr. Resnick is experienced with analysis and reporting of large public health data sets, longitudinal studies, and patient registries. She has served as the principal investigator on numerous grants and contracts, and as a co-principal investigator, senior consultant, and advisor on many others. Her efforts have been supported by numerous agencies including the NIH, CMS, AHRQ, ASPE, DoD, DoL, and AoA. She has been an invited speaker at various meetings both domestically and abroad. Dr. Resnick has worked in both non-profit and academic settings and has served in leadership positions in both settings. In addition to her consulting practice, Dr. Resnick holds an adjunct appointment at the University of Maryland School of Medicine.

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Gary Raju

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