An Argument for Virtual Physical Care

The challenges that surround practitioner recruitment and the ever-impending shortage of Primary Care Physicians continue to plague our underfunded (read: coverage and reimbursement) and overburdened (read: costly and utilized, utilized, utilized) health care system, compounding our necessitated shift towards a focus on preventative medicine and translational chronic care management. Current efforts to expand physician training programs and placement incentives don’t solve the supply/demand gap in the near term. As an industry, we need to rely upon and innovate around existing platforms that improve access, and likely cost and quality. One such solution is telemedicine. Public Service Announcement: I’m a recruiter. If you’ve stumbled upon this article or website by happenstance, allow me to introduce myself. As a retained executive search partner, I focus my efforts on (get ready for the shameless plug) connecting phenomenal senior healthcare executives with what are arguably the most innovative, sexiest and well-backed HIT and healthcare services companies out there today (feel free to pause here and peruse our client list); all of which are solving for a bevy of barriers to access, quality and cost issues in the status quo. My job isn’t always easy, but I’d be lying if I said the attractiveness of these opportunities doesn’t often work in my favor. To clarify, I do not directly work with hospital providers. I recruit strategic and operational executives rather than those charged with the physical delivery of care. As a result, I do not know the first hand difficulties associated with convincing a highly-trained and highly-sought after Doctor of Medicine to settle down in a rural, or even urban for that matter, location to practice their trade. Anecdotally, I know the uneven distribution of physicians is a pain point felt by hospitals and health systems, and consequently the patients they serve, nationwide. For every 100,000 people in a defined region, the minimum number of primary care physicians necessary is 80. Here in our home state of New York, we fall short with an average 72, with some major counties seeing as few as 34 PCPs per population. Without legislation mandating as much, and there have been musings (see NY Senate Bill 577), rural populations suffer from an inability to recruit and retain the primary care and specialist physicians needed to meet the demands of their healthcare needs. Coupled with the expansion of covered lives, retiring baby boomer-era physicians and a population that is increasingly reliant on primary, emergent and long-term care, we’ve got a serious problem on our hands. Fortunately for us, there is a lot of intellectual horsepower and funding currently focused on finding a solution (again, see client list). One such solution that we here at Oxeon are placing our bets on is not a new concept, but one that has benefited from extreme advancements in communication and information technology – telehealth.

A market that has seen relatively stagnant growth in recent decades, telehealth has been highly enabled by the expansion of everyday technology – smart phones, broadband internet access and HIPAA-compliant image sharing. In 2013, the telehealth market in the United States alone stood at $440.6M. According to a recent IHS Technology report, revenues in 2018 will soar to $4.5B, representing a CAGR of roughly 59%. Perhaps a more significant driver than telecommunication modernization alone is the collective push from all key players across the spectrum: the physicians desire to optimize their time with patients and focus more on preventative care, the health systems need to increase their clinician bench, the mandate for payers to care for their members in a translational manner versus the unsustainable episodic approach, and the desire for the patient consumer to have access to quality care in a cost effective and timely manner. As with most verticals within healthcare today, these aligned interests represent a huge opportunity for innovation. One such organization that Oxeon is fortunate enough to work with is the rapidly growing and industry changing MDLIVE.

MDLIVE has built a robust network of physicians, psychiatrists, specialists, mental health counselors and registered nurses that currently spans all 50 states and 5 US territories. Delivering services to a member base of 5M (and growing) and a projected 200,000 clinical visits this year, MDLIVE’s primary mission is to decrease costs and increase access to care for all Americans. MDLIVE currently employs a network of 1,200 clinicians serving 16 health systems, medical groups and ACOs, 250 employers and 14 health plans. For their provider clients, they offer access to tools and technologies that permit secure eVisits from the phone, web or mobile device in secure, real time video telephony. Their enterprise solution affords health systems the ability to tap into an extensive network of providers 24/7/365, thereby enhancing their own clinical abilities and expertise. As a result, these systems improve patient outcomes, gain a greater reach in rural access and community outreach, generate additional revenues, and enhance care coordination.

From the perspective of the patient, telehealth is an affordable (there has been a significant shift in the acceptance of reimbursement) and timely solution for their often urgent and low acuity needs. As an uninsured consumer, imagine having the option to call up or join a videoconference with a Nurse Practitioner or PCP in order to seek care for an upper respiratory issue you thought only a trip to the ED could resolve. As an employee of a large, regional employer, MDLIVE can serve as an alternative to taking a day off work to consult with a physician on a slew of asthma attacks you’ve been having recently. As the health plan for that aforementioned employee, telehealth cuts down on overutilization, often resulting in much lower follow up visit rates than for those seeking physical care.

There are a lot of shifts that need to take place in the current healthcare environment to further align interests around engaging, accessible, and affordable care. MDLIVE has made great strides to support these in offering a solution that really takes into account the future state of sustainable healthcare. The shortage of physicians, specifically within primary care is not solved by companies like MDLIVE alone, but it sure does cauterize the bleeding.