Juan J Andino1, Peris R Castaneda2, Parth K Shah1, Chad Ellimoottil1,3. 1. Department of Urology, Michigan Medicine. 2. University of Michigan Medical School. 3. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.
Abstract
INTRODUCTION: Telehealth is gaining more attention in multiple specialties, including urology. Video visits in particular have shown high satisfaction and cost-saving for patients. However, there has been little investigation into how video visits compare to traditional clinic visits on measures of clinical efficiency and reimbursement. METHODS: Our dataset included 250 video visits of established patients at Michigan Medicine Department of Urology and 250 in-person clinic visits with the same providers completed between July 2016 and July 2017. Information on visit completion and cancellation rates; cycle time (time from check in to check out); reimbursement; and patient out-of-pocket expenses was collected using the electronic medical record and billing data. RESULTS: Completion rates were similar between video and clinic visits (58% versus 61%, respectively; p=0.24). Average cycle time for video visits was significantly shorter compared to clinic visits (24 min vs 80 min, respectively; p<0.01). Neither average commercial payer reimbursement (p=0.21) nor average out-of-pocket expense (p=0.22) was statistically different between video and traditional visits. More video visits than clinic visits were billed as level 3 encounters (85% and 63%, respectively, p=0.002). CONCLUSIONS: Our study demonstrates that video visits have the potential to reduce the time patients spend on follow-up care without negatively impacting reimbursement rates. However, these visits could reduce average billing levels. These findings suggest that the incorporation of video visits into practice may be more efficient for patients but may also reduce billing levels.
INTRODUCTION: Telehealth is gaining more attention in multiple specialties, including urology. Video visits in particular have shown high satisfaction and cost-saving for patients. However, there has been little investigation into how video visits compare to traditional clinic visits on measures of clinical efficiency and reimbursement. METHODS: Our dataset included 250 video visits of established patients at Michigan Medicine Department of Urology and 250 in-person clinic visits with the same providers completed between July 2016 and July 2017. Information on visit completion and cancellation rates; cycle time (time from check in to check out); reimbursement; and patient out-of-pocket expenses was collected using the electronic medical record and billing data. RESULTS: Completion rates were similar between video and clinic visits (58% versus 61%, respectively; p=0.24). Average cycle time for video visits was significantly shorter compared to clinic visits (24 min vs 80 min, respectively; p<0.01). Neither average commercial payer reimbursement (p=0.21) nor average out-of-pocket expense (p=0.22) was statistically different between video and traditional visits. More video visits than clinic visits were billed as level 3 encounters (85% and 63%, respectively, p=0.002). CONCLUSIONS: Our study demonstrates that video visits have the potential to reduce the time patients spend on follow-up care without negatively impacting reimbursement rates. However, these visits could reduce average billing levels. These findings suggest that the incorporation of video visits into practice may be more efficient for patients but may also reduce billing levels.
Entities:
Keywords:
practice patterns; reimbursement; telehealth; telemedicine
Authors: Neil S Fleming; Edmund R Becker; Steven D Culler; Dunlei Cheng; Russell McCorkle; Briget da Graca; David J Ballard Journal: Health Serv Res Date: 2013-12-21 Impact factor: 3.402
Authors: Boyd R Viers; Deborah J Lightner; Marcelino E Rivera; Matthew K Tollefson; Stephen A Boorjian; R Jeffrey Karnes; R Houston Thompson; Daniel A O'Neil; Rachel L Hamilton; Matthew R Gardner; Mary Bundrick; Sarah M Jenkins; Sandhya Pruthi; Igor Frank; Matthew T Gettman Journal: Eur Urol Date: 2015-04-18 Impact factor: 20.096
Authors: Daniel J Scott; Eva Labro; Colin T Penrose; Michael P Bolognesi; Samuel S Wellman; Richard C Mather Journal: J Bone Joint Surg Am Date: 2018-09-19 Impact factor: 5.284
Authors: Julia B Finkelstein; Dylan Cahill; Michael P Kurtz; Julie Campbell; Caitlin Schumann; Briony K Varda; Rosemary Grant; Kate Humphrey; Heather Meyers; Caleb P Nelson; Carlos R Estrada Journal: J Urol Date: 2019-06-07 Impact factor: 7.450
Authors: Sera-Melisa Thomas; Maya M Jeyaraman; Maya Jeyaraman; William G Hodge; Cindy Hutnik; John Costella; Monali S Malvankar-Mehta Journal: PLoS One Date: 2014-12-05 Impact factor: 3.240