O P I N I O N
THE SOAPBOX
Stand up. Speak up. It’s your turn.
As the President and CEO of Amoskeag Health, I am writing today to share how telehealth has been instrumental in expanding access to care in our community and improving the financial health of our health center.
Amoskeag Health delivers a vast array of primary care services, from prenatal care and behavioral health to social services, to over 17,000 patients in our region. We are the most diverse health center in New Hampshire, with over 60 languages spoken. Approximately 45 percent of our visits require an interpreter, and we have 12 interpreters on staff.
In response to the pandemic, we had to innovate rapidly. We closed three of our five locations, designating one as a COVID testing facility to isolate the at-risk patients from the patients receiving in-person care. We transitioned many staff to remote working situations and implemented a process to educate our staff and patients on ways to access telehealth services to ensure they would not forego care during the pandemic. We were pleasantly surprised to discover that many of our patients liked telehealth once they got to use it, and to see that our no-show rates for services like behavioral health, substance use disorder treatment, and other services improved drastically!
Telehealth is one of the most prominent solutions we have to replenish some of our lost productivity due to the challenges of transitioning a diverse population to the new and complex world of telemedicine, and to regain some of our loss in patient revenue. (In just two months, Amoskeag experienced a 75 percent decline in in-person visits and 50 percent decline in overall visits, which added up to over $1,100,000 in lost revenue from patient care).
Telehealth mitigates many of the barriers that now exist to return to “the old system”: It allays patient fears of coming into the office, helps us in adhering to CDC guidelines, and reduces the need for personal protective equipment (PPE). Overcoming these obstacles pushes us closer to increasing our volumes of in-person care and returning to normal. As our patients and staff are getting the hang of the new system, it will be critical over the next several months that we are able to be consistent in our delivery of telehealth services, as they were permitted in Governor Sununu’s Emergency Order #8.
Another invaluable aspect of telehealth, is that it helps keep our community safe: It is critical to avoid the danger of transmission among our patients, their families, and our staff (and, again, allows us to reserve our supply of PPE!). For patients who are high risk and must quarantine, telehealth makes it possible for them to receive the care they need without coming into the office and possibly infecting others. It is a tool that enables us to protect our staff and the loved ones they care for who are at high risk.
Right now, the financial stability of our institution is critical to retain. We provide care to over 15% of our community’s residents, and to the most at-risk populations. Our organization operates on a razor-thin margin. We need the health care delivery system to continue to morph to meet the need of the communities we serve. Now and in the future, health centers must be able to rely on reimbursement for telehealth services to provide some stability, and we need a horizon to plan on the future events for our upcoming services. Knowing that telehealth will continue to be a viable option allows us to start planning, designing services, training, and investing accordingly.
Submissions on timely topics are welcome. Send to carolrobidoux@manchesterinklink.com, subject line: The Soapbox
Kris McCraken is President and CEO of Amoskeag Health.
