Local health providers will compete with Cleveland Clinic/American Well’s telehealth service in the near future

• Cleveland Clinic announced Oct. 21 that it has partnered with American Well to provide broad access to comprehensive and high-acuity care services via telehealth.
• In just five years, 50% of outpatient visits will be virtual, according to a Cleveland Clinic press release.
• Annual virtual visits at Cleveland Clinic have grown 68% in 2018 alone, according to the press release.
• HFMA’s Chad Mulvany will discuss examples of disruption like this in HFMA’s Nov. 12 “Fall 2019 Virtual Conference: Industry Trends and Outlook.”

Modern Healthcare is reporting, is reporting, “Cleveland Clinic and Boston-based telehealth company American Well are forming a joint venture digital health company, called The Clinic, to provide broad access to comprehensive and high-acuity care services via telehealth to reach patients nationally and globally, according to a news release.”

“The new company, to be based in Cleveland, will offer virtual care from Cleveland Clinic’s experts through American Well’s digital health technology platform,” the Modern Healthcare piece continued. “Cleveland Clinic has seen a rapid increase in the use of virtual visits to deliver patient care, with the number of annual visits growing by 68% in 2018 alone.

“Telehealth is a key part of its aim to double the number of patients it serves in the next five years, a lofty goal Dr. Tom Mihaljevic, president and CEO of Cleveland Clinic, announced earlier this year. The health system projects that 50% of outpatient visits will be virtual in just five years, according to the release.”  

Takeaway

You’re not just competing with the folks across town for market share (whether they be a local health system or a national player like Optum that employs physicians). As soon as The Clinic is operational, you’re competing with the Cleveland Clinic on both convenience and brand reputation (e.g. perceived quality) for your well-insured PPO business. 

How soon will it happen?

How will you know when this has happened? When you start seeing ads for the service start popping up on popular social media sites and during live broadcast events (e.g. college football games, high-visibility Winter Olympics events) or other broadcast programs (e.g. “This Is Us”).

Who will the service target?

At a minimum, based on the experience of Walmart and others who have deployed center of excellence programs for high-volume/cost procedures, employers will provide this service to their employees as an opportunity to get a second opinion on a diagnosis or a care plan.

Some employers (those who rely on highly skilled labor forces) may include the telehealth service as in-network through national carriers. The initial volume impact probably isn’t going to be significant. However, it will likely grow over time as comfort with receiving care via telehealth increases and more national brands offer similar services. And the loss of “well-insured” business will compound challenges organizations are facing due to deteriorating payer mixes (folks aging into Medicare), payment-rate increases (mostly Medicare and Medicaid) that are not keeping up with input-price inflation, and services shifting to settings that command lower payment rates.  

Obviously, improving quality, particularly in the targeted service lines, is one important step. Another  significant step is understanding how consumer-centric your organization is and increasing those capabilities. 

New HFMA quantitative tool to gauge consumer maturity

HFMA will soon introduce the Consumerism Maturity Model, a concrete, quantitative tool that will enable provider organizations to assess their consumer-centric progress and how much they need to improve. Through a guided self-assessment process, the model gauges a provider’s overall capabilities and identifies specific areas for improvement.

It incorporates the patient-financial-experience building blocks that a growing number of organizations have already adopted and supplements them with relevant revenue cycle metrics from HFMA’s MAP initiative as well as external metrics. Beyond defending your existing market share, improving in these two areas will likely lead to growth.

Not everyone who has a virtual visit with a The Clinic (or other similar service) and requires additional diagnostics or a procedure will want to travel for follow-up care. This should create partnership opportunities in regions where Cleveland Clinic (or other national brands) lack a physical-care delivery presence.