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Equit y
R es ea r ch A mer ic a s
|
U nit ed
S ta tes
In
thi s
r eport,
w e
pr ovide
a
r eca p
of
w her e
the
tel ehea lt h
in dus tr y
w a s
pr e - C OVID,
w ha t cha ng ed
dur ing
C OVID,
a nd
wha t
is li k ely
t o
det e r mine
the
pa th
g oing
f o r w a r d. T he
G e n i e
i s
O u t
o f
t he
B o ttl e ,
b u t
t he
J u r y
i s
S ti ll
O u t
o n
th e
M ag n i tu d e
o f
th e
L T Im p l i c at i o n s.
While
it
is
s ti ll
ea r ly
t o
s pecul a te
a bout
li f e
a f ter
C O VID - 19 ,
the
inv es tor ques ti ons
w e
ha ve
f iel ded
m os t
often
over
the
pa s t
1 - 2
m onths
r evolve
a r ound
–
w ha t
the f utur e o f
tel ehea lt h
coul d
look
li k e once
the
pa ndem ic
is ove r ?
T he
phr a s e “ the
g enie
is
out of
the
bott le ”
in
the
c ontex t
of
the
tel ehea lt h
industr y
ha s
come
up
in
every
tel ehea lt h - r ela ted
industr y /e x per t
ca ll
or
m eeti ng
w e
ha ve
hos ted
over
the
pa s t
few
w ee k s .
How ever , the
jur y
is
s ti ll
out
on
the
m a g n it ude
of
L T
implic a ti ons
o f
r ece nt
inc r ea s e s
in
consum er a w a r enes s / a dopti on
&
w hic h
industr y
s ta k eholder s
s ta nd
to
benef it
m os t.
It
w ill
be
up
to poli cy m a k er s ,
pa y or s ,
&
pr ovider s
to
determine
if
the
cha ng es
m a de
to
tel ehea lt h
poli cy
in li g ht
o f
C O VID - 19
outweigh
the
potent ia l
conc er ns ,
if
they
s houl d
r em a in
perm a nentl y ,
&
if tel em edic ine
helps
ena ble
a cc es s ibl e &
qua li ty
hea lt h
ca r e.
Eit her
w a y ,
it
is a lmos t
inevit a ble tha t
the
tel ehea lt h
uti li za ti on
pos t
C O VID - 19
is li k ely
to
s ett le
down
a t
a level
hig her
r e la ti ve to
pr e - C O VID
– w it h
som e i ndus t r y
ex pe r ts
peg g ing
the
f i g ur e a t
25 - 35 %
hi g he r .
P o l i c i e s/ Reg u l at i o n s
P o st - P andemi c W i ll
b e
K e y .
T elehea lt h
is not
new ,
but
r e g ula tor y hur dles
-
m a inl y
how
m uch
hea lt h
ca r e pr ovider s
ca n
be
pa id
f or
t elehea lt h
ver s us
in - per s on visits
-
li m it
w idespr ea d
use.
A s
the
C O VID - 19
pa ndem ic
evolve d,
t he
f ede r a l
g ove r nm ent, m os t
s ta tes,
a nd
m os t
hea lt h
in s ur ance
ca rr ier s
s c r a mbled
to
ex pa nd
a cc es s
to
tel ehea lt h, r em oving
r eg ula tor y
a nd
a dm ini s tr a ti ve
hur dles,
eli mina ti ng
co - p a y s
a nd
cost - s h a r ing ,
a nd even
distr ibut ing
f undin g
to
buil d
out
comm unit ies"
tel em edic ine - r e lated
inf r a s tr uct ur e .
While C MS "
w a iver s
w ill
end
once
the
publi c
em er g enc y
is over ,
la w m a k er s
now
ha ve
a r ea s on
to consider
m or e
perm a nent
r e g ula tor y
cha ng es
g iven
tel ehea l th" s
ef f e ct ive nes s
in
thi s pa ndem ic .
How ever ,
f r om
a
f e der a l
g over nment
per s pect ive,
s om e
of
these
r e g ula ti ons w er e
s et
by
s ta tut e.
A s
a
r es ult ,
C MS
would
not
be
a ble
to
m a k e
s ubs equent
perm a nent cha ng es
thr oug h
a
r e g ula tor y
pr ocess .
A nd ,
tha t
m ea ns
tha t
a ny
s ubs ta nti ve
cha ng e
w ill ha ve
to
g o
thr oug h
the
f o r m a l
r ulema k ing
pr ocess ,
w hic h
coul d
m ea n
it
m a y
not
be
unti l 2022
tha t
b r oa d
new
us es
of
te lehe a lt h
would
be
f or m a ll y
a ll ow ed.
S epa r a tel y ,
w e
do
not s ee
the
us e
of
non - HI PA A - compliant
t echnol og ies
s ta y ing
once
the
pa ndem ic
is
over . T hose
tool s
m ig ht
be
g r ea t
f or
quic k
one - of f
visits
dem a nded
by
the
pa ndem ic ,
but
they don’t
int eg r a te
w ell
w it h
a
hea lt h
s y s tem’s
tel em edic ine
inf r a s tr u c tur e
–
a nd
li k ely
w on’t
be a n
option
w hen
t he
emer g ency
p a ss es
a nd
so m e of
t he
ol d
r ules
a nd
r eg ula ti ons c om e ba ck int o
play .
S epa r a tel y ,
c over a g e
pa r it y
a nd
pa yment
pa r it y
f o r
te l ehea lt h
a cr os s
a ll
insur e r s would
help
inc r ea s e
a cc es s
f or
pa ti ents
a nd
inc entivize
pr ovider s
to
of f er
these
s er vi ces, thoug h
it
w o uld
a lso
inc r ea s e
s pending .
A s
s uch ,
insur e r s
a r e
li k ely
to
pus h
ba ck
on components
tha t
m a k e
up
r eimb ur s em ent,
pos s ibl y
on
inc ludi ng
the
f a ci li ty
f ee
( w hic h
ca n be
a s
hig h
a s
50 %
of
the
tot a l
visit
cost)
in
the
r eimbu r s em ent
of
a
tel ehea lt h
encount e r . Wit h
r es pect
to
in - s tate
li censur e
r equir em ents
f o r
tel ehea lt h, w e
beli eve
s ooner
or
la ter
a ll s ta tes
a r e
li k ely
to
w a ive
thi s
r equir em ent
( 31
s ta tes
a r e
a lr ea dy
pa r t
of
the
Inter s tate Medi ca l
L ic ens ur e C om pact ,
o r
I ML C ) .
Rese ar c h
Anal ysts
Ja il e n d r a S i n g h
212
325
8121
ja ile ndra . s ingh@ c redi t - s uis s e. c om
Je r ma i n e
B r o wn
212
325
8125
jerm a ine. brow n @ c redi t - s uis s e. c om
A d am He u ssn e r
212
325
4727
a da m . heus s ner@ c redit - s uis s e. c om
D IS CLOSU RE
AP P E ND IX
AT
TH E
B ACK
O F
TH IS
REP O RT
CONTA IN S
IMP O RT ANT
D IS CLOSU RE S ,
ANALYST CE RT IFICATIONS, LE G AL
E NTITY
D IS CLOSU RE
AND
TH E
S TA TU S
O F
NON - U S
ANALYSTS.
U S
Discl os ur e :
C r edit
S uiss e does a nd
s eek s
to
do
business Teleh ealt h
Industry Be y ond
th e
P ande mic Hea lt hca r e Technolog y
|
Indus tr y
Pr imer
w it h
compa nies
cover ed
in
it s
r e s ea r ch
r epor t s .
A s
a
r es ult ,
inve s tor s
s hould
be
a w a r e
tha t
the
F ir m
m a y
ha ve
a
conf li ct
of
int e r es t
tha t
coul d
s ta te,
m a ny
hea lt h
insurer s
volunta r il y
a ddr es s ed
tel em edic ine
in
thei r
r es pons e
to
C O VID - 19 ,
f ocusing on
r educi n g
o r
el imi na ti ng
c os t
s ha r in g ,
b r oa den ing
c over a g e of
t elemedici ne
& ex pa nding
in - netwo r k
tel em edic i ne
pr ovider s .
S eve r a l
tel ehea lt h
vendor s
(inc ludi ng
T DO C ) , ha ve
hig hli g hted
tha t
w a iving
co - pa y s
ha ve
ha d
a f a vor a ble
imp a ct
on
tel ehea lt h
uti li za ti on,
& m em ber
s a ti s f a ct ion.
S om e
insurer s
r ecent ly
ex tended
these
co s t
s ha r ing
w a iver s
bey ond thei r
i ni ti a l
dea dli ne
( s om e ex ten ding
th r oug h
y ea r - end ) .
In
2020 ,
the
inc r em enta l
ex pens es inc ur r ed
by
hea lt h
insur e r s
by
w a iving
cost - s ha r ing
f o r
tel ehea lt h
&
corona vir us tests / tr ea tment ,
etc .
is
e x pect e d
to
be
m or e
than
o ff s et
by
t he
benef it
r ela ted
to
the ca ncel la ti on
of
e lec ti ve
s u r g e r ie s
a nd
other
in - per s on
p r ovider / phy s ic ian
visits,
a nd
thus g iving
them
a ddit iona l
f ina nci a l
f l ex ibi li ty .
A ddit iona ll y ,
a s
m or e ho s pit als a nd
phy s ic ia ns
s ta r t to
of f e r
vi r tua l
ca r e
s ervic es
( s om e of
them
e x tendi ng
to
even
on - dem a nd
s ervic es )
to
the i r pa ti ents,
it
r em a ins
to
be
s een
how
the
pa y or
a nd
em ploy er
m a r k et s
f or
tel em edic ine
a r e impa ct ed.
S om e
industr y
consul ta nts
beli eve
i t
ca n
become
co nf us ing
f o r
the
consum er w hen
thei r
em ploy er
( or
pa y or )
a s
w ell
a s
thei r
ow n
phy s ic ian
of f er
tel ehea lt h
s e r vic es . How ever ,
m os t
phy s ic ian
p r a ct ic es
a r e not
g oing
t o
be
a ble
to
o ff er
24 /7
t e lehea lt h
ser vic es . A s
a
r es ult ,
e m ploy e r s
a r e
li k ely
to
cont inue
to
of f er
tel ehea lt h
a s
a
benef it ,
but
a t
s om e point
t ha t
benef it
will
int er s ect
wit h
the
phy s ic ian - of f er ed
vi r tua l
ca r e.
S i z i n g
th e
M arket
O pp o r tu n i t y.
B a s ed
on
our
a na ly s is of
a mbula tor y
visits
da ta
f r om
th e C DC ,
w e es ti m a te
a potent ia l
s y nchr onous
pr ovide r - to - pa ti ent
tel ehea lt h
visits
oppor tuni ty
o f a r ound
330 - 340
mln.
We
ha ve
not
y et
s een
a ny
r eli a ble
da ta
a r ound
how
m a ny
compa r a ble vir tua l
visits
w er e
conduc ted
in
2019 ,
or
w ha t
the
cur r ent
r un - r a te
is .
How ever ,
ba s ed
on our
conver s a ti ons w it h
industr y
s ta k eholder s
a nd
tel ehea lt h
ex per ts,
w e es ti m a te
ther e w er e a r ound
10
m ln
compa r a ble
visits
in
2019 ,
impl y ing
a penetr a ti on
of
less
than
3 %
la s t
y ea r . F ur ther ,
ba s ed
on
our
a na ly s is of
in - per s on
a nd
tel ehea lt h
visit
de ta il s
disc losed
by
Phr ees ia a nd
r es ea r cher s
a t
Ha r va r d
U niv er s it y ,
w e
es ti m a te
r oug hly
~ 32 - 33
m ln
vi r tua l
visits
ha ve a lr ea dy
been
conduc ted
dur ing
C O VID
thr oug h
m id - May .
Inter e s ti ng ly ,
w hil e
in - per s on
visit tr ends ha ve
s een
s om e r ecover y
in
r ecent
w eek s ,
tel ehea lt h
visit
tr ends ha ve
been
r ela ti vel y s ta ble
( a lbei t
below
the
pea k
in
A pr il ) .
N ota bly ,
ou r
a na ly s is
of
both
potent ia l
m a r k et
a nd tot a l
visits
dur ing
C O VID
does n’t
ca ptur e
vir tua l
ca r e
oppor tuni ti es
in
s ever a l
other
m a r k et a r ea s :
a )
s y nchr onous
phy s ic ian - to - phy s ic ian
or
phy s ic ian - to - s pec ia li s t
tel ehea lt h ;
b)
r em ote pa ti ent
m onitorin g
(inc ludi n g
vi r t ua l
hom ...
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