Can Telehealth Enable New Care Management Strategies In Value-Based Payment Models?

VSSL Director Dr. Joshua Liao thinks so. In a blog article published in Health Affairs, Dr. Liao and collaborator Amol Navathe argued that "policymakers should capitalize on the fact that telehealth provides an opportunity to fundamentally rethink care delivery under APMs, enabling novel solutions that have remained untested to date."

The authors make the point that "this potential for new strategies is particularly critical for interventions such as care management—widely popular and adopted by any providers in APMs, but unfortunately associated with variable impact due to historical care delivery limitations."

Drs. Liao and Navathe highlighted a number of potential issues with traditional care management strategies to use “hotspotting” to target population outliers:

1. Variation in program design and activities, functions, and goals

2. Costliness to create and maintain

3. Inherent involvement of “miss rates” (not all patients that are targeted will have intervenable needs that can be addressed with existing tools care management tools)

4. Success being predicated on the difficult task of achieving large improvements among a small number of patients

5. Risk that a focus on managing outliers may unintentionally siphon attention and resources away from other patients, thereby undercutting the true goal of APMs—to manage health across entire populations

The authors then argued that "telehealth offers a way around those challenges", in particular that "by leveraging technology, APM participants can go beyond super-utilizer management and extend population health management interventions to a wider range of their populations."

Read the article here and Dr. Liao's work here.