Acknowledging The Price of Avoidable Health Expenses: Strategies To Lower Such Spending

John Guiliana

By John Guiliana, DPM, MS, medical director of podiatry, ModMed.

The flaws in our healthcare system that have bloated the cost of care to nearly one-fifth of the United States gross domestic product are too numerous to list. However, as a physician, I would like to highlight some issues from a clinical perspective, especially the value of preventive care.

Physicians and care providers wield tremendous power to drive down the cost of healthcare. They can champion a higher standard of care while limiting avoidable medical expenses. One overall strategy is stressing wellness and prevention to keep people out of doctors’ offices and hospitals. But we can’t do it alone.

Both providers and payers need to act. When it comes to completely rethinking traditional reimbursement models, payers need to be on board.

Among the best practices is a more “hands-on approach” to preventive care, taking full advantage of technologies that already exist. Incorporating these technologies effectively can include creating more digital “touchpoints” with patients to keep them engaged in their own care. Greater patient involvement can also help them make more informed decisions and decrease time wasted through staff-assisted scheduling and data entry.

Furthermore, patient engagement tools can cut unnecessary spending by increasing efficiency. The potential also exists for greater patient engagement to translate to marked improvements in patient outcomes.

At the same time, practices that leverage these technologies successfully could also see lower costs.

A call to recognize telehealth’s role

When medical technologies become routine in a practice setting, they can also help with routine care – such as a patient’s annual or bi-annual in-person visit. These regular wellness visits, for example, can be elevated through more frequent interactions between physicians and their patients, including telehealth services. In fact, efforts to expand telehealth services out of necessity during the COVID-19 pandemic are translating to enhanced accessibility to physicians for patients.

On top of the increased convenience provided by telehealth platforms, patients trusted and appreciated the ability to interact with physicians via digital technologies during the pandemic, a March 2021 study revealed. Out of 368 patients surveyed, 47% said they were “very satisfied’ with the virtual health visit and another 35% were ‘satisfied.”

At the same time, payer models need to reflect the increasing popularity of telehealth services. In other words, payers need to catch up and increase reimbursement for appointments that include telehealth consultations.

In that sense, payers will be critical to improving preventive care as well. It is pretty simple. Without fair reimbursement, telehealth has no chance of remaining viable for providers.

On a positive note, the Centers for Medicare and Medicaid Services (CMS) expanded coverage for telehealth services during COVID-19. What will happen after the pandemic subsides remains unknown, so more permanent legislation is needed to continue virtual health care coverage.

Technology to the rescue

Research supports the role of preventive care to lower spending on health care costs. For example, such interventions in podiatry patients with diabetes could save commercial insurers an estimated $2 billion every year in spending, a Thomson Reuters Healthcare study reveals.

Podiatry serves as a prime example. Significant money can be saved in my specialty by physicians working directly with payers on the cadence of care, as well as on increasing the touchpoints between providers and patients. These tactics can work whether the clinical interaction remains in-person or happens virtually on a digital platform.

Walk the walk

By combining emerging tracking tools with telehealth and in-person visits, physicians can gain a clearer view of their patients’ health than ever before. Such insight also can increase chances of early detection and treatment of any clinical condition, thereby minimizing the risk of treating more advanced disease.

Generally, treating patients later in the course of a disease costs more, so here is another example where preventive medicine can play an important role.

Wearable technology can help. Smart insoles that allow podiatrists to track their patients remotely, for example, are already on the market today. These and other wearable devices have become increasingly ubiquitous in recent years.

Fitbit alone counted more than 31 million active users in 2020, according to a 2021 report on the company’s revenue and usage statistics. At the same time, Fitbit is compiling tons of data providers could mine for patient monitoring and on the value of preventive measures, including healthier lifestyles and regular physical activity.

The time is now

Reigning in spending through preventive care can make a difference. It will take a concerted effort by providers and payers to drive this change in a meaningful way. Furthermore, the more technologies such as telehealth services, patient engagement tools, and wearable health- tracking devices are incorporated in these strategies, the closer we can get to increasing efficiency and lowering costs at the same time.


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