July 21, 2020

“Hey Wilshire: What Does the Future Hold for Telehealth?”

Rebecca Haymaker

Telehealth has been a roller coaster ride over the last 4 months. While it has been around for years, adoption and daily use has been limited due to reimbursement and other challenges. However, in March and April we saw steep increases as health systems paused elective care and closed clinics. Telehealth services expanded more in those two months than we have seen over the last ten years. Collectively we worked together to rapidly expand telephone and video-based telehealth services. But as clinics started to re-open, the focus on telehealth began to wane. Many reasons have been given, the most common being expansion of in-person care and uncertainty about long-term reimbursement.

While health systems are working to define the long-term vision for telehealth, one thing remains – patients want telehealth. We all saw and experienced the benefits – time savings, removal of transportation and childcare barriers, effective treatment, and clinician satisfaction. Read more about telehealth benefits and guidelines from the CDC here.

So how do we find that sustainable sweet spot for telehealth services? Wilshire has a few ideas.

  1. Modify Your Clinic Access Workflows
  • Work with clinicians to define acceptable use cases for telehealth services
  • Modify your schedules to allow for dedicated video visit slots
  • Incorporate telehealth options into your decision trees
  • Make decisions trees available for patient self-scheduling
  • Incorporate telehealth flags into your follow-up orders workflow


  1. Update Your Pre-registration Processes to Support Telehealth Services
  • Consider dedicated telehealth pre-registration workqueues
  • Leverage electronic check-in for self-registration
  • Monitor patient out of pocket to accurately communicate expectations up front


  1. Work with Contracting and Finance on the Long-Term Financial Plan
  • Continue payer outreach to understand short and long-term reimbursement
  • Incorporate telehealth services into contract negotiations
  • Lobby for telehealth service coverage and parity
  • Complete financial modeling based on operational workflows and reimbursement

The last step is the most critical in building a sustainable model. You need to find the percentage split of telehealth to in-person services to achieve and maintain your financial targets. Getting to an actual percentage, be it 15% or 25% is critical to designing a balanced approach to telehealth well into the future. This can only be done through collaboration of physicians, clinic operations, revenue cycle, revenue integrity, contracting, and finance. Consider re-calibrating every quarter as CMS, state Medicaid programs, and commercial payers evolve their requirements and reimbursement models.

Consider us your personal Epic revenue cycle assistants. Next time you have a question, e-mail or call us and say, “Hey Wilshire”. At The Wilshire Group we have Patient Access, Revenue Integrity, and Revenue Cycle experts ready to help you with your long-term telehealth strategy. Learn more about our telehealth and other strategic solutions here. Start planning now to design a fiscally responsible approach to telehealth services. Contact Rebecca Haymaker at r.haymaker@thewilshiregroup.net if you are interested in learning more.

Rebecca Haymaker

Vice President, Revenue Cycle Services

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