Successful telehealth business models are a topic of regular discussion in the healthcare industry, and the financial details of telehealth programs, initiatives, and companies are central to program viability and sustainability. Claims and total payments toward telehealth services are rapidly increasing each year; therefore, it is becoming imperative that organizations carefully navigate the regulatory, financial, operational, and technical aspects impacting, and many times determining, the financial health of telehealth programs. The objective of this article is to define and articulate the financial variables and business models that are the lifeblood of today’s successful telehealth programs, and also to provide insights and information to assist organizations in navigating the nuances of telehealth financial modeling, monitoring, and management. The financial and business models surrounding telehealth are unique for a number of reasons, mainly because the calculations and architecture of such models often contain many continuous variables, such as people (clinical providers and patients), geography (rural or metropolitan areas), telehealth governance structure, the service provided, the reimbursement or coverage eligibility, the technology used, the quality of care rendered, and the outcome of the care rendered. In addition, a clear need for a departure from traditional ways of projecting return on investment (ROI) becomes apparent with the layering of additional complexities of restrictive payer requirements, various business models, and the transition from volume to value.

Strong telehealth governance serves as the cornerstone for advancing a telehealth strategy by ensuring that the health system has the intentional leadership infrastructure to compete and excel in this fast-paced and transforming industry. 1 A Conceptual FrameworkEffective governance is the essential first step towards successful management. The former informs the latter to optimize value to the stakeholders. Paraphrasing the Financial Reporting Council, corporate (telehealth) governance should contribute to better company performance by helping a board discharge its duties in the best interests of stakeholders: executive leadership, management, staff, customers, patients, vendors, communities, and regulators, etc.Good governance facilitates efficient, effective, and entrepreneurial management that can deliver value over the longer term. If ignored, the consequences may be vulnerability or poor performance (Financial Reporting Council, 2008).The authors embrace a philosophical argument for governance, that emphasizes active risk management and resource management to ensure alignment between long-and short-term strategies. This is accomplished through leadership, accountability, and responsibility in accord with the organization's mission, vision, and values. Three key functions of telehealth governance are explored here: management, prioritization of services, and achieving return on investment (ROI). In addition, how long it takes to create governance and milestones that define progress over time are addressed. Telehealth Management CapabilityTelehealth management capability provides the organization with timely, thorough, relevant, and accurate information about the telehealth industry. No entity exists in isolation. Accordingly, the state of the telehealth market in which the organization operates, and how its telehealth strategies and programs support and strengthen the organization's overall strategic and financial plans are essential. Simply put, the intent is to support and champion key telehealth stakeholder's decisions.From an implementation perspective, the "telehealth executive champion" and the "telehealth leader" play important roles. Although not governance per se, these positions are critical in discharging governance directives once risks and opportunities are calculated. Leading healthcare organizations commonly select the telehealth executive champion from the following officers:• Chief Information Officer• Chief Technology Officer• Chief Executive Officer• Chief Operating OfficerRegardless of who the telehealth executive champion is, it is imperative that this person ensure telehealth options are evaluated as part of the planning process and ensure appropriate resources are allocated within the organization.The telehealth leader supports the telehealth executive champion. Leading healthcare organizations commonly select this individual from the following personnel:• Senior Vice President, Chief Telehealth Officer The telehealth executive champion and key telehealth stakeholders regularly and sy...

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No abstract available. Editor’s note: This is the first in a series of articles covering technological advancements in home healthcare. Here, the authors provide an overview. Subsequent articles will expand on the details of individual subtopics.