Telehealth Finance Variables and Successful Business Models

Abstract

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.

Telehealth Business Models and Their Components: Systematic Review

“…The papers selected for inclusion in this review were divided into 2 main groups. The first group included 13 studies that presented a new business model or framework [ 1 , 14 , 19 , 23 , 28 - 36 ], and the second group comprised 10 studies that evaluated existing business models or frameworks used in the telehealth industry [ 37 - 46 ]. These studies were published between 2005 and 2020.…”

“…Table 1 presents the 13 studies analyzing a new business model or framework for use in the telehealth industry [ 1 , 14 , 19 , 23 , 28 - 36 ].…”

Development of a Prioritization Model to Compare Emergency Psychiatric Coverage Service Options

“…Important features for an emergency psychiatry service other than ROI include the ability to meet patients' needs, patient centeredness, smooth processes and operations, strategic alignment, and integration of care [24][25]27]. A "Prioritization Model" was created to categorize all features as either a "bene t" or "implementation di culty" and then score each psychiatry service option on how well it aligned with the community hospital's needs.…”

“…A "Prioritization Model" was created to categorize all features as either a "bene t" or "implementation di culty" and then score each psychiatry service option on how well it aligned with the community hospital's needs. The prioritization model builds upon these categories outlined by previous literature [24][25]27] and the results from the qualitative analysis. This model allows for categories to be weighted to re ect how important each feature is: for instance, a category with a weight of 2 is twice as important as another category with a weight of 1.…”

“…In addition, there is a scarcity of research de ning the attributes and outcomes of a successful telehealth business model. None propose an actionable method for selecting a psychiatry service partner based on nancial concerns or other priorities [20][21][22][23]24]. Hospitals implementing an emergency telepsychiatry service have limited resources available to guide their decision-making process.…”