Roy Schoenberg, M.D., MPH, President & CEO, American Well

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From the ability to immediately connect an individual with a physician based on a smart watch’s 

 to virtual group counseling to aid in our country’s opioid crisis, advancements in technology and new approaches to care are pushing the boundaries of telehealth far beyond a sore throat or rash.

 in 2019, driven by expanding reimbursement measures that are increasingly positioning telehealth as a highly attractive care option for health plans, providers and patients. Supportive 

, coupled with the growing awareness and acceptance of telehealth’s value, have set the stage for big moves in 2020 that will change the paradigm of healthcare.

Given this backdrop—and as shown across a multitude of in-market success cases that span academic medical centers, homes, senior centers, assisted living centers and retail&mdash;many are asking: What’s ahead for telehealth in 2020? How should healthcare leaders prepare? 

Here are six trends we’ll see in the year ahead.

1. Vulnerable populations will take center stage

. To date, many companies offering telehealth have focused heavily on engaging consumers in their 20s, 30s and 40s, as studies show that these consumers possess the tech skills 

 needed to navigate a digital platform. But this isn’t necessarily where telehealth is needed most or where it will provide its most profound impact—and healthcare providers are increasingly becoming aware of this.

As reimbursement continues to expand, providers will be incented to explore new ways for telehealth to facilitate care for more medically complex populations, such as premature newborns, seniors over 65 years old, the chronically ill and individuals in less affluent communities who would benefit from ongoing virtual-care engagement. There’s nothing wrong with focusing on optimizing health for consumers or being “on call” in urgent care situations, but in the year ahead, leading organizations will more broadly deploy telehealth to truly touch and change lives.

The potential of virtual care lies in its ability to to replace in-person visits—for patients living with a serious disease like cancer&mdash;with virtual visits. Applications of telehealth like this are happening in pockets, like at Penn State Health, where 

 use telehealth and remote patient monitoring to improve access to care.

But 2020 will be the year where these pockets expand and care is mobilized in news ways to help our most vulnerable.

2. The blurring of lines across care settings

While in the past Medicare reimbursement for telehealth was typically contingent on the patient’s physical location or the “originating site,” the rules of reimbursement have begun to evolve. In 2019 alone, providers gained the ability to bill Medicare for 

 to diagnose and treat patients with symptoms of acute stroke regardless of where the patient is.

And, geographic restrictions no longer exist when treating 

 (ESRD). This less restrictive, border-free care dynamic continues to pave the way for innovative virtual care use cases, as does having electronic health records (EHRs) embedded with telehealth capabilities. Such positive change empowers and incents healthcare providers and health plans to rethink care delivery and unleashes the potential of the reach and impact that physicians and care teams can have.

3. “Digital First” will change health insurance and plans’ relationship with providers

. Long before the days of parity legislation, the health insurance industry viewed telehealth as a by-necessity-only alternative to in-person visits. Now, we’re seeing the complete opposite: Many payers are viewing telehealth as an effective, and oftentimes preferred, first line of defense for a variety of ailments—from acute flare-ups of inflammatory conditions to symptoms of the flu. As a result, in 2020, one can count on the fact that health plans will increasingly collaborate with providers to broaden telehealth access and use by advancing the following:

Enabling in-network providers to enroll in and participate as part of health plans’ telehealth services and connect with members (their patients) virtually

Providing the technology to support multiway video visits between members, their primary care physicians, specialists and family members or caregivers

Leveraging interprofessional consultations to strengthen referral relationships between primary care physicians and telehealth providers

4. Telehealth peripherals will become an industry

. As telehealth utilization picks up, we’ll also see an influx of “peripheral” services and devices to support it, such that these peripherals will become their very own industry. In the past two years, a variety of devices that complement telehealth, such as biometric scales and technologies for in-home monitoring, have saturated the market.

In 2020, we’ll see deeper integration of many of these devices into physician workflows and care plans, ensuring patients gain the continuity of care needed to manage ongoing or chronic needs. What’s even more exciting is the new types of peripherals entering the market. For example, as more seniors express a desire to age in place, technology developers may roll out more sophisticated devices to meet their needs, such as telemonitoring devices that 

 and respond if a patient has fallen or if there is a sudden, sustained lack of activity.

With an increasing number of successful implementations in market and reimagined pilots continually launching, telehealth is now a proven mode of care. And digital frontrunners are making big bets.

 launched its own virtual care program for employees and their dependents, while CVS Health expanded its telehealth offerings to 26 states. Government is investing big money in telehealth, too, with a 

 proposed by the Federal Communications Commission last July. Recent digital health IPOs like Health Catalyst and Livongo also are a primer for things to come.

In 2020, we’ll see companies, providers and health plans move toward using telehealth not just to increase access to care, but also to deliver improved care—as well as to (depending on the player) increase revenue and/or reduce costs. The bottom line: Telehealth is no longer an academic concept&mdash;there are 275 companies and corporations running telehealth services, with new companies opening daily. We’ll also see virtual care enter its next phase as it becomes a driving force to helping care teams and health plans reimagine and redesign where and how care is delivered.

6. New modes of care delivery and connectedness

. While many consumers are super-connected and own multiple devices, older Americans still tend to gravitate toward traditional media (think newspaper and radio). For these consumers, virtual care makes more sense when it is offered via familiar mediums, such as 

Hospitals, home health agencies and skilled nursing facilities will look for ways to adapt the telehealth experience to devices such as these to bring telehealth into the home in 2020. A home health agency’s ability to conduct check-ins with homebound patients over a television set offers multiple benefits: It can boost engagement, improve medication adherence and support more frequent monitoring of vital signs while enabling clinicians to be more proactive. More importantly, this approach can prevent hospitalizations and adverse events.

On the other end of the spectrum, advances in technology will support tighter integration of telehealth with wearables, empowering consumers to connect with their providers and share vital health stats on the go.  

As consumers, providers and payers increasingly recognize the value of telehealth, collaboration and innovation are critical to embedding virtual care into and across care settings. By building intuitive and out-of-the-box approaches to care delivery alongside telehealth reimbursement momentum, healthcare leaders can design and introduce high-value approaches that strengthen organizations’ ability to attract and retain patients while expanding the reach of the clinical team, controlling costs and improving outcomes.

Roy Schoenberg, M.D., MPH, is president and CEO at American Well. Since its rollout in 2008, American Well has provided telehealth services to more than 200 of the nation’s largest payers, health systems, employers, and retailers. Prior to his work with American Well, Schoenberg was the founder of CareKey and served as CISO of TriZetto following its acquisition of CareKey. In 2013, Schoenberg was appointed to the Federation of State Medical Boards’ task force delivering landmark guidelines for the “Appropriate use of Telehealth in Medical Practice.” Schoenberg is the 2014 recipient of the American Telemedicine Association Industry award for leadership in the field of telemedicine.

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