05.18.2022

Virtual visits: Lingering reluctance, lack of billing keeps agencies from full potential

Two years after the COVID-19 public health emergency loosened Medicare regulations for telehealth, allowing providers more flexibility in the use of virtual visits, few home health and hospice agencies are using telehealth to its full potential.

The two primary obstacles are the inability to bill Medicare for virtual visits and uncertainty about how to effectively use telehealth, according to Laura Wilson, SimiTree’s Clinical Operations Consulting Managing Director.

“Not everyone has jumped on it,” Wilson said. “Nurses are generally reluctant to use what they don’t understand, and without being able to bill for virtual visits, agencies haven’t been willing to prioritize training.”

But Wilson, an avid proponent of telehealth, often changes the minds of agency leaders about the importance of telehealth when she shows them how virtual visits improve outcomes, boost patient satisfaction and help with retention efforts.

With direct care mileage costs spiking this spring in response to rising fuel costs, Wilson has also been able to show agencies how virtual visits can become an integral part of holding down transportation costs.

While the pandemic has presented the opportunity for workers in other industries to experience working from home, clinicians have not had the same opportunity. In many cases, clinicians report higher job satisfaction from being able to work from home one day per week, Wilson said.

One important consideration for agencies in making use of virtual visits or planning weekly work-from-home virtual assessment days for their clinicians is that all virtual visits must be part of the patient’s overall plan of care, she added.

“Virtual visits can’t be used as a substitute for an in-person visit, or just because a clinician doesn’t feel like making home visits that day,” Wilson said. “Planning for virtual visits needs to happen at start of care, and be part of the Plan of Care for that patient, signed off on by the physician as a way to supplement and support in-person visits with greater patient interaction. “

How to conduct remote assessments

Assessment technique differs a bit for a virtual patient assessment, Wilson said. “It’s a bit slower, much more intentional, and the patient becomes a highly involved participant in identifying and reporting sights, smells, sounds,” Wilson said

As a bonus, when a patient learns during the virtual assessment to identify and report wound smells or skin changes on a wound site, the patient is better able to recognize those changes and their significance at other times as well. The result is a patient better able to self-monitor and observe changes that may require prompt attention for fewer problems while healing.

Tools, techniques and documentation

New tools make it easier for clinicians to conduct remote assessments, Wilson said. “We have a variety of tools available now, starting with a stethoscope that can be hooked up to the computer,” she said.

Wilson discussed many of the tools and types of telehealth systems available to agencies during a complimentary webinar on April 25, during which she also covered regulations currently applying to telehealth.

Much of the webinar was devoted to an assessment how-to, including how to train agency staff and some specifics about documentation. “Documentation is an integral part of all we do, and telehealth comes with its own set of documentation requirements,” Wilson said.

Complimentary webinar

View the webinar, “Capitalize on the Changing Market for Telehealth, Telecom & Virtual Visits,” online.

SimiTree can help

SimiTree’s clinical operations experts can help your agency find ways to improve efficiency, increase productivity and operate at peak performance.

We’ll show you how to effectively use telehealth to capture your ROI, address workflow and scheduling issues, and more. Use the form below to reach out to us to begin the conversation about making your agency stronger and healthier overall.

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