Going into 2021, Amwell faces a decidedly different world than it did last year. The telehealth company, which went public in September, will navigate a new set of expectations for virtual care under a new administration.
Most providers saw a surge in virtual visits during the pandemic, and the Boston-based company was no exception. Between January and September, the company saw more than 4.3 million virtual visits, and its revenue was up 78% from the prior year, according to documents filed with the SEC.
Now, with the new Biden Administration, industry groups are watching for future policy changes that could make it easier for patients to receive care in the home and other settings.
Amwell CEO Dr. Roy Schoenberg shared what he’s watching and what’s next for the company in an interview on Wednesday with MedCity News. This interview has been edited for length and clarity.
MedCity: Last year, many people accessed telehealth visits for the first time. What else has changed as you move into the new year?
Schoenberg: Walking into 2020, telehealth was one thing in everyone’s mind. It was the ability to use technology on your phone, on your browser, to quickly get in front of a physician to help you with treatment of the flu, or something really basic.
Coming out of 2020 … everybody’s understanding of what telehealth is has changed fairly dramatically.
Don’t get me wrong, the notion that telehealth can bring convenient access to clinical services, like urgent care and maybe behavioral health remains. It’s not going away. It has incredible value, that’s what we do, that’s what Teladoc does, that’s what Doctor on Demand and some of the others are doing.
But the actual interest and excitement around telehealth has shifted into an area that historically people didn’t think about. How can telehealth operate within the existing relationships between patients and their clinicians? … How can hospitals and delivery networks use telehealth in order to differently envelope the patients they care for regularly, the cancer patients, the heart failure patients, the hypertension patients, those that require frequent interaction with the healthcare system?
MedCity: What is needed for that to continue to grow in the future, such as reimbursement changes or adoption by providers?
Schoenberg: There’s no question that some of the elements that were historically challenging for telehealth will continue to be a part. Reimbursement policy is going to continue to be there — that’s never going to go away.
We have advanced probably a decade in our understanding of how to pay for telehealth in just one year, so we’re in a much better place than we ever were. … Yet when you start using telehealth as a new way in which healthcare relationships take place, there are new pieces to the puzzle that now have to be aligned. It’s not only the payment structure that has to change.
It’s also a new understanding of what is the frequency in which healthcare and a patient need to interact in a world where we can actually check up on their phone for a couple of minutes. How do we change the way we look at how we support cancer patients at home who are living for sometimes months and years with the realities of chemotherapy? How do we reimagine our availability as healthcare professionals to them on a daily basis when they struggle with that condition?
MedCity: Have you gotten any indication of what will be the Biden Administration’s approach to telehealth?
Schoenberg: Many of the folks that are involved or have been brought into the workforces of the administration are people we know or who are very involved in policymaking, thinking, and the taskforces about telehealth that were convened in 2020.
I’m very encouraged by some of the picks that were made and some of the statements that were made about how we can modernize care delivery, and how we should for example recognize the home as a point of care, as a place where healthcare can happen.
MedCity: What policy changes are you watching for?
Schoenberg: There are things that are almost self-evident: recognizing the home as a valid place of care … changing some of the Medicare rules around reimbursement, changing HIPAA rules to accommodate the fact that care is rendered outside facilities and hospitals. Those things I think are not only needed but are also anticipated.
The part that I would say is more aspirational and incredibly important is that notion around state licensure. … The Internet doesn’t stop at the state line. Nothing that we do over online services drops dead when it gets to the state border. Yet in healthcare it does. Because a clinician cannot deliver services to patients who happen to be 10 miles across the border in another state, which absolutely makes no sense.
We have got to create an exception to state licensure when it comes to telehealth-based services. That’s not an easy thing to do.
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