Innovative Payment Model: Driving the Growth of Telehealth

Nate Gladwell is the Senior Director of Clinical Operations at the University of Utah Health. He has more than ten years of experience within telehealth and digital health space for the University and several national panels, governing boards, and advisory boards. Combining such extensive experience in the healthcare industry, he is currently looking forward to supporting local high-value healthcare. His present job responsibilities at the University of Utah Health include clinical operations for telehealth across an academic medical center with four hospitals and ten ambulatory clinic locations. Additionally, his direct responsibility includes looking after the telehealth contractual relationships with more than 40 hospitals and clinical operations of outreach services geographically spread across six states.

WHAT, ACCORDING TO YOU, ARE SOME OF THE MAJOR PAIN POINTS IN THE DIGITAL HEALTH OR TELEHEALTH MARKET LATELY?

The primary pain point that comes to my mind is the lack of innovations in payment methodologies to incentivize providers—especially those attached and associated with larger health systems. The telehealth industry is growing rapidly, with a vast array of organizations serving on the national and international levels. They typically hire physicians for a shorter time span and offer telehealth services directly to patients. However, during the pandemic, such companies witnessed disruptions in their growth owing to payers flipping the switch to allow local providers and health systems to conduct telehealth and see reimbursement. Companies that were seeing growth prior to COVID saw stagnation because of the better aligned incentives for telehealth within the industry.

"Telehealth has been on a roller coaster ride the last two years. The reality is telehealth is a major aspect of the health care ecosystem. The questions is no longer will it remain, the question is how to enhance the product to meet legacy delivery challenges"

The regulatory landscape is also evolving rapidly, making it essential for physicians to have a comprehensive knowledge of those changes and put into place the right strategies. I believe that the changes from the medical-legal perspective will continue to be a challenge for the growth and adoption of telehealth in the future. 

WHAT ARE SOME OF THE LATEST DEVELOPMENTS THAT HAVE EMERGED IN THE MARKET LATELY?

 In 2021, a comparatively larger investment from equity firms was witnessed in telehealth and digital health. This led to a significant rise in innovations for software-based services within this specific sector. 

Furthermore, due to COVID-19, patients are more attuned to their care management as needs and seeking care providers to meet them where they are instead of going out to seek care Another development that gaining traction in the telehealth and digital health space is AI intervention. As an industry, we still have a long way to go before AI becomes an integral part of a clinician’s everyday practice.

WITH ALL THESE POTENTIAL DISRUPTIONS AND TRANSFORMATIONS HAPPENING, HOW DO YOU ENVISION THE FUTURE OF DIGITAL HEALTH AND TELEHEALTH?

Our present healthcare system is burdened with asymmetry of knowledge. Presently, several healthcare service providers have the majority influence on patient engagement with healthcare system , at least in their own minds. Other industries have already shifted beyond a traditional asymmetrical structure. They have pushed knowledge and decision-making into customers’ hands, and the results are satisfying. Nevertheless, the change has started to occur in the Healthcare sector. Innovators are developing technologies that puts forward information to patients. With such intensive information available online, patients are finding healthier amounts of care decision making before seeing a provider — this is a major shift for the traditional model. Simultaneously, they will be in a better position to manage costs.

WHAT PIECE OF ADVICE DO YOU HAVE FOR YOUR FELLOW AND UPCOMING PROFESSIONALS IN THIS FIELD?

have seen various innovators, leaders, and technologists with some brilliant ideas. However, they get frustrated and agitated when they choose to build on and deploy the concepts within a practical scenario. What leads to such a quandary is the lack of comprehensive knowledge about this specific vertical. Finally, they fail to understand the issue they are addressing and develop incomplete strategies and it leads to failed points of entry into healthcare. Therefore, before striving to bring disruption, a distinct focus on understanding every nook and cranny of the industry is a must. To elaborate, one company has reached heights of success within a short time, as it genuinely understood its market. The company was operating solely on diabetic patients. They considered diabetic patients as individuals looking for a normal life. By doing so, the company caught the pulse of the patients. Thus, with this simple perspective, the company became renowned in the healthcare industry within five years and reached massive patient market – the right insights, the right entry point, and the right deployment model.