Column: CVS ‘video visits’ represent a genuine improvement to the healthcare system
Video healthcare, or “telehealth,” is taking a big step toward the mainstream as pharmacy giant CVS Health rolls out internet access to its MinuteClinic treatment facilities in California and a handful of other states.
This is a big deal, representing a smart use of technology to make healthcare more accessible, especially for relatively minor medical issues — which can turn into major concerns if not addressed early.
It’s also the latest example of the private sector stepping up and reforming the U.S. healthcare system as political leaders remain unwilling or unable to make bold moves in protecting the well-being of Americans.
“Technology like this has been around for years, but it’s largely been on the fringes, mostly for specialty medicine,” said Stuart Altman, a professor of national health policy at Brandeis University. “The fact that a CVS MinuteClinic would start using it shows a real coming-of-age.”
The question in my mind is why for-profit companies have to be on the forefront of healthcare innovation. Why isn’t this something that Medicare, Medicaid and Veterans Affairs are out front on, reducing costs, improving service and stretching taxpayer dollars?
I’ll get back to that.
First, props to CVS for recognizing a need and coming up with a solution.
The basic idea is that as an alternative to visiting a MinuteClinic in a CVS drugstore, where wait times can run hours, people would be able to access a nurse practitioner or physician assistant on their mobile device via the CVS Pharmacy app.
“A video visit can be used to care for patients ages two years and up who are seeking treatment for a minor illness, minor injury or a skin condition,” CVS says.
“Each patient will complete a health questionnaire, then be matched to a board-certified healthcare provider licensed in their state, who will review the completed questionnaire with the patient’s medical history and proceed with the video-enabled visit.”
Obviously this isn’t preferable for more complex health problems. But for modest issues or simple questions, this can be a highly effective way of meeting the needs of millions of people while taking pressure off other facets of the healthcare system.
Accessing MinuteClinic online costs $59, payable by credit or debit card. Insurance can’t be used, but a CVS spokeswoman told me the company is “actively working to seek insurance coverage for this service in the future.”
Altman, a former federal health official, said affordable telehealth should be very attractive to people with no health insurance, or with skimpy coverage.
“Previously, your baby might be crying and perhaps you wouldn’t do anything, or you’d go to the ER,” he said. “Now you’ll be able to speak with a professional who can answer your questions.”
That’s a potential game changer. Trips to the emergency room, especially by the uninsured, represent the absolute costliest way of delivering treatment — a cost shared by all policyholders. Any reduction in ER visits represents big savings.
Just as important, affordable and accessible preventive care is the way little medical problems are kept from becoming big ones. Services like CVS’ thus can make the overall healthcare system more efficient.
“For people with chronic conditions like diabetes, little things can snowball out of control very quickly,” said Chad Meyerhoefer, a healthcare economist at Lehigh University. “This is great for something like that.”
He said telehealth “has a lot of potential to help the Medicare population” by allowing seniors to manage the various issues that can arise with the aging process from the comfort of home.
Yet what are the chances Medicare — let alone Medicaid or the VA — will adopt or support something as smart and cutting-edge as this? Pretty much zilch, I’d say.
If for no other reason, conservative politicians would fight such a move as an expansion of the healthcare bureaucracy and another step down the slippery slope of government-run, socialized medicine.
“Private-sector initiatives like this are an important part of the U.S. healthcare landscape, and offer the opportunity to test out new and innovative ideas in a wide variety of settings,” said Laurence Baker, a professor of health research and policy at Stanford University.
Politicians and public health officials leave it to businesses to fix our healthcare problems, but then they seldom act on the ideas. Or if they do, they don’t follow through.
For example, many companies offer so-called wellness programs to keep employees healthy. The Affordable Care Act included such programs as essential benefits.
The Trump administration, however, is pushing skimpier health plans that, among other things, don’t include wellness and preventive medicine.
Many businesses try to lower insurance costs by banding together and creating a larger risk pool. This is precisely the idea behind the single-payer healthcare systems of most other developed countries, which result in much lower medical costs and much better health outcomes.
Yet the United States won’t even consider a similar Medicare-for-all program. Instead, the country remains wedded to its fractured, inefficient, for-profit approach to healthcare.
And even though companies like CVS deserve respect for moving in the right direction, let’s not forget that their motivation is anything but altruistic. It’s to make a buck.
CVS is expanding its horizons as Amazon slowly but steadily moves into the online pharmacy business, threatening to dominate the landscape just as it has done in every industry it’s entered. MinuteClinic video visits are good for patients, but they’re also good for shareholders.
The missed opportunity here is building on CVS’ innovation and applying it throughout the healthcare system. Our laissez faire lawmakers would rather reel from healthcare crisis to crisis.
That’s not just foolish. It’s sick.