Tag: John Guiliana

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.

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