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data-component="mdc-c-module-wrapper" data-module-theme="dark" data-module-background="deep-blue" data-module-category="AnchoredHero" class="ArticleDefault_mck-c-article-default__SfYQE"><style></style><div data-component="mdc-c-background-image" class="mdc-c-bg-image___GJdv1_2734c4f background-image-article-default ArticleDefault_mck-c-article-default__parallax-container__fZ7Iq"></div><div class="ArticleDefault_mck-c-article-default__gradient__Uu21n"></div><div class="ArticleDefault_mck-c-article-default__wrapper-content__XOe9C"><div class="mck-o-container"><div class="mck-o-container--wrapped mck-o-container--mobile-spacing mdc-u-grid mdc-u-grid-col-lg-12"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-col-lg-start-1 mdc-u-grid-col-lg-span-10"><div><h1 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f mdc-u-ts-2 mck-u-animation-slide-down ArticleDefault_mck-c-article-default__heading__bv6rL"><div>Telehealth: A quarter-trillion-dollar post-COVID-19 reality?</div></h1></div><div data-component="mdc-c-description" class="mdc-c-description___SrnQP_2734c4f mdc-u-ts-10 mck-u-animation-blur-in-800 ArticleDefault_mck-c-article-default__description__sjoe9"><div><time datetime="2021-07-09T00:00:00Z">July 9, 2021</time> | Article</div></div></div></div></div></div></div><div class="mck-o-container"><div class="mck-o-container--wrapped mck-o-container--mobile-spacing mdc-u-grid mdc-u-grid-gutter-xxl"><section data-layer-region="article-body-header" class="mdc-u-grid mdc-u-grid-col-md-12 mck-u-animation-blur-in-400 byline-share-container"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-8 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-8 mdc-u-ts-9"><span> </span><span class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j"><a data-component="mdc-c-link" href="/our-people/oleg-bestsennyy" class="mdc-c-link-inline___7DRrt_2734c4f mdc-c-link-inline--secondary___YKoOK_2734c4f"><span class="mdc-c-link__label___Pfqtd_2734c4f">Oleg Bestsennyy</span></a> </span></span><span class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j">Greg Gilbert </span></span><span class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j">Alex Harris<span> </span></span></span><span class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j"><a data-component="mdc-c-link" href="/our-people/jennifer-rost" class="mdc-c-link-inline___7DRrt_2734c4f mdc-c-link-inline--secondary___YKoOK_2734c4f"><span class="mdc-c-link__label___Pfqtd_2734c4f">Jennifer Rost</span></a></span></span></div><div class="mdc-u-grid-col-md-start-8 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-8 mdc-u-grid-col-lg-end-11 ArticleContent_mck-c-article-content__share-tools__kWRRw"></div></section><section class="mdc-u-grid mdc-u-grid-col-md-12 mck-u-animation-blur-in-400"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-11"><div data-component="mdc-c-description" class="mdc-c-description___SrnQP_2734c4f mdc-u-ts-5"><div class="mck-u-links-inline">Strong continued uptake, favorable consumer perception, and tangible investment into this space are all contributing to the continued growth of telehealth in 2021. New analysis indicates telehealth use has increased 38X from the pre-COVID-19 baseline.</div></div></div></section><main data-layer-region="article-body" class="mdc-u-grid mdc-u-grid-gutter-xxl"><div class="mdc-u-grid mdc-u-grid-col-1 mdc-u-grid-col-md-12"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-11"><div class="mdc-o-content-body mck-u-dropcap"><h2>Update: July 9, 2021</h2> <p>Early in the COVID-19 pandemic, telehealth usage surged as consumers and providers sought ways to safely access and deliver healthcare. In April 2020, overall telehealth utilization for office visits and outpatient care was 78 times higher than in February 2020 (Exhibit 1).</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mdc-u-grid mdc-u-grid-gutter-lg mdc-u-grid-col-sm-1 mdc-u-grid--align-start mdc-u-mb-3 GenericItem_mck-c-generic-item__sGwKL"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-gutter-xs GenericItem_mck-c-generic-item__content__gq1m0"><div class="mck-c-eyebrow mdc-u-ts-10"><span> 1</span></div></div></div><div class="mck-u-inline-module-border-top mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg-telehealthrevisited_exhibit1-v2.svgz?cq=50&cpy=Center"/><img alt="Growth in telehealth usage peaked during April 2020 but has since stabilized." src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg-telehealthrevisited_exhibit1-v2.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div>  <p>This step-change, borne out of necessity, was enabled by these factors: 1) increased consumer willingness to use telehealth, 2) increased provider willingness to use telehealth, 3) regulatory changes enabling greater access and reimbursement. During the tragedy of the pandemic, telehealth offered a bridge to care, and now offers a chance to reinvent virtual and hybrid virtual/in-person care models, with a goal of improved healthcare access, outcomes, and affordability.</p> <p>A year ago, we estimated that up to <a href="#may29">$250 billion of US healthcare spend could potentially be shifted to virtual or virtually enabled care</a>. Approaching this potential level of virtual health is not a foregone conclusion. It would likely require sustained consumer and clinician adoption and accelerated redesign of care pathways to incorporate virtual modalities.</p> <p>As of July 2021, we step back to review the progress of telehealth since the initial COVID-19 spike and to assess implications for telehealth and virtual health<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="0199554f-fdab-4e96-844c-ea7d682c7309"><sup class="FootNote_footnotesup__e73z_">1</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="0199554f-fdab-4e96-844c-ea7d682c7309" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">We define virtual health as a range of solutions for healthcare provider-patient interactions to occur outside of in-person visits, including telehealth (video/phone), text-based care, e-triage, and remote monitoring.</span></span></span></a></span> more broadly going forward. Our findings include the following insights:</p> <ul> <li><em>Telehealth utilization has stabilized at levels 38X higher than before the pandemic.</em> After an initial spike to more than 32 percent of office and outpatient visits occurring via telehealth in April 2020, utilization levels have largely stabilized, ranging from 13 to 17 percent across all specialties.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="355f6fd7-f3b5-4015-a101-c31fd19b9e5f"><sup class="FootNote_footnotesup__e73z_">2</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="355f6fd7-f3b5-4015-a101-c31fd19b9e5f" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Compile data set, compile.com.</span></span></span></a></span> This utilization reflects more than two-thirds of what we anticipated as visits that could be virtualized.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="22ec7b6d-35e1-4e0b-93e7-f249dfbbfcd5"><sup class="FootNote_footnotesup__e73z_">3</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="22ec7b6d-35e1-4e0b-93e7-f249dfbbfcd5" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Compile data set, compile.com; Exhibit 2 (of the original article).</span></span></span></a></span></li> <li><em>Similarly, consumer and provider attitudes toward telehealth have improved since the pre-COVID-19 era.</em> Perceptions and usage have dropped slightly since the peak in spring 2020. Some barriers—such as perceptions of technology security—remain to be addressed to sustain consumer and provider virtual health adoption, and models are likely to evolve to optimize hybrid virtual and in-person care delivery.</li> <li><em>Some regulatory changes that facilitated expanded use of telehealth have been made permanent,</em> for example, the Centers for Medicare & Medicaid Services’ expansion of reimbursable telehealth codes for the 2021 physician fee schedule. But uncertainty still exists as to the fate of other services that may lose their waiver status when the public health emergency ends.</li> <li><em>Investment in virtual care and digital health more broadly has skyrocketed,</em> fueling further innovation, with 3X the level of venture capitalist digital health investment in 2020 than it had in 2017.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="2d118b94-e6d2-4b7f-b122-76197c5bc6ae"><sup class="FootNote_footnotesup__e73z_">4</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="2d118b94-e6d2-4b7f-b122-76197c5bc6ae" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Rock Health venture funding database, 2017–21, rockhealth.com.</span></span></span></a></span></li> <li><em>Virtual healthcare models and business models are evolving and proliferating,</em> moving from purely “virtual urgent care” to a range of services enabling longitudinal virtual care, integration of telehealth with other virtual health solutions, and hybrid virtual/in-person care models, with the potential to improve consumer experience/convenience, access, outcomes, and affordability.</li> </ul> <h2>Telehealth uptake</h2> <p>Since the initial spike in April 2020, telehealth adoption overall has approached up to 17 percent of all outpatient/office visit claims with evaluation and management (E&M) services. This utilization has been relatively stable since June 2020.</p> <p>We are also seeing a differential uptake of telehealth depending on specialty, with the highest penetration in psychiatry (50 percent) and substance use treatment (30 percent) (Exhibit 2).</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mdc-u-grid mdc-u-grid-gutter-lg mdc-u-grid-col-sm-1 mdc-u-grid--align-start mdc-u-mb-3 GenericItem_mck-c-generic-item__sGwKL"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-gutter-xs GenericItem_mck-c-generic-item__content__gq1m0"><div class="mck-c-eyebrow mdc-u-ts-10"><span> 2</span></div></div></div><div class="mck-u-inline-module-border-top mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg-telehealthrevisited_exhibit2-v2.svgz?cq=50&cpy=Center"/><img alt="Substantial variation exists in share of telehealth claims across specialities." src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg-telehealthrevisited_exhibit2-v2.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-disruptor1up mck-o-md-center mck-u-inline-module-border-top mck-u-inline-module-border-bottom mck-u-screen-only" data-layer-region="disruptor-1up"><div class="mdc-u-grid mdc-u-grid-gutter-md mdc-u-grid-col-lg-12 mdc-u-grid-col-md-12 "><div class="mdc-u-grid-col-md-span-12"><header data-component="mdc-c-header" class="mdc-c-header"><div class="mdc-c-header__block___i1Lg-_2734c4f"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f"><div>Would you like to learn more about our <a href="/industries/healthcare/how-we-help-clients">Healthcare Systems & Services Practice</a>?</div></h3></div></header></div></div></div> <h2>Consumer and provider perceptions of telehealth</h2> <p>Our consumer research<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="f5f08ff1-67fc-46fb-9097-986590bcfeeb"><sup class="FootNote_footnotesup__e73z_">5</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="f5f08ff1-67fc-46fb-9097-986590bcfeeb" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Jenny Cordina, Eric Levin, and George Stein, “<a href="/industries/healthcare/our-insights/covid-19-consumer-healthcare-insights-what-2021-may-hold">COVID-19 Consumer Healthcare Insights: What 2021 may hold</a>,” June 24, 2021, McKinsey.com.</span></span></span></a></span> shows that consumers continue to view telehealth as an important modality for their future care needs, but—as expected—this view varies widely depending on the type of care. Overall, consumer perception tracks closely to what we believe is possible telehealth uptake by various specialties (Exhibit 3).</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mdc-u-grid mdc-u-grid-gutter-lg mdc-u-grid-col-sm-1 mdc-u-grid--align-start mdc-u-mb-3 GenericItem_mck-c-generic-item__sGwKL"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-gutter-xs GenericItem_mck-c-generic-item__content__gq1m0"><div class="mck-c-eyebrow mdc-u-ts-10"><span> 3</span></div></div></div><div class="mck-u-inline-module-border-top mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg_telehealthrevisited_exhibit3.svgz?cq=50&cpy=Center"/><img alt="Most recent care received utilized telemedicine, with some moderate increases since January." src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg_telehealthrevisited_exhibit3.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div> <p>Around 40 percent of surveyed consumers stated that they believe they will continue to use telehealth going forward—up from 11 percent of consumers using telehealth prior to COVID-19.</p> <p>Moreover, our research shows between 40 and 60 percent of consumers express interest in a set of broader virtual health solutions, such as a “digital front door” or lower-cost virtual-first health plan.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="9ed73da0-c3d6-4dac-a95f-2ae5e4d19803"><sup class="FootNote_footnotesup__e73z_">6</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="9ed73da0-c3d6-4dac-a95f-2ae5e4d19803" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey Consumer Health Insights Survey, June 2021.</span></span></span></a></span> However, a gap has historically existed between consumers’ expressed interest in digital health solutions and actual usage. Continuing to focus on creating a seamless consumer interface, breaking down silos in care provision (across virtual and in-person) with improved data integration and insights, and proactive consumer engagement will all be important to sustaining and growing consumer use of virtual health as the pandemic wanes.</p> <p>On the provider side, 58 percent of physicians continue to view telehealth more favorably now than they did before COVID-19, though perceptions have come down slightly since September 2020 (64 percent of physicians). As of April 2021, 84 percent of physicians were offering virtual visits and 57 percent would prefer to continue offering virtual care. However, 54 percent would not offer virtual care at a 15 percent discount to in-person care.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="773c7c81-3430-4741-9687-b284a26242c7"><sup class="FootNote_footnotesup__e73z_">7</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="773c7c81-3430-4741-9687-b284a26242c7" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey Physician Insights Survey, April 2021.</span></span></span></a></span> Most health systems are closely monitoring reimbursement. Those in bed capacity-constrained environments and value-based care arrangements are looking to understand whether there is scalable volume decanting or cost savings potential at equivalent quality.</p> <h2>Regulatory changes</h2> <p>Some regulatory changes that enabled greater telehealth access during COVID-19 have been made permanent. For example, CMS allowed telehealth coverage for a number of current procedural terminology (CPT) codes permanent in the 2021 physician fee schedule final rule.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="4bf34f74-140d-48c0-9c43-70cd12d495f7"><sup class="FootNote_footnotesup__e73z_">8</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="4bf34f74-140d-48c0-9c43-70cd12d495f7" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Centers for Medicare & Medicaid Services, “CY 2021 Medicare Physician Fee Schedule Final Rule,” effective on January 1, 2021, 85 Fed. Reg. 84472, federalregister.gov.</span></span></span></a></span></p> <p>However, other restrictions on telehealth may return to pre-COVID-19 normal when the public health emergency expires. For example, there were several dozen additional CPT codes that CMS allowed telehealth coverage for on a temporary basis in the 2021 physician fee schedule.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="ca387ed0-f9cf-48b0-b177-e1abd27d7ca8"><sup class="FootNote_footnotesup__e73z_">9</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="ca387ed0-f9cf-48b0-b177-e1abd27d7ca8" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Centers for Medicare & Medicaid Services, “CY 2021 Medicare Physician Fee Schedule Final Rule,” effective on January 1, 2021, 85 Fed. Reg. 84472, federalregister.gov.</span></span></span></a></span> In addition, a waiver for public health emergency allowed telehealth to be provided for Medicare beneficiaries outside of rural areas and from home rather than from a provider’s office. The future of these provisions once the public health emergency ends is not yet clear.</p> <h2>Investor activity</h2> <p>Investment in virtual health continues to accelerate. Per Rock Health’s H1 2021 digital health funding report<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="dac028cf-a149-48c7-aaa7-4d75987402dd"><sup class="FootNote_footnotesup__e73z_">10</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="dac028cf-a149-48c7-aaa7-4d75987402dd" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Adriana Krasniansky et al., “H1 2021 Digital Health Funding: Another Blockbuster Year…In Six Months,” Rock Health, July 2021, rockhealth.com.</span></span></span></a></span> the total venture capital investment into the digital health space in the first half of 2021 totaled $14.7 billion, which is more than all of the investment in 2020 ($14.6 billion) and nearly twice the investment in 2019 ($7.7 billion) (Exhibit 4). This increase would reflect an annualized investment of $25 billion to $30 billion in 2021, if this rate continues. In addition, total revenue of the top 60 virtual health players increased in 2020 to $5.5 billion, from around $3 billion the year before.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="1ee54506-bf6f-44c3-809c-bed795e2b664"><sup class="FootNote_footnotesup__e73z_">11</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="1ee54506-bf6f-44c3-809c-bed795e2b664" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey Virtual Health Vendor Database as of June 2021.</span></span></span></a></span></p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mdc-u-grid mdc-u-grid-gutter-lg mdc-u-grid-col-sm-1 mdc-u-grid--align-start mdc-u-mb-3 GenericItem_mck-c-generic-item__sGwKL"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-gutter-xs GenericItem_mck-c-generic-item__content__gq1m0"><div class="mck-c-eyebrow mdc-u-ts-10"><span> 4</span></div></div></div><div class="mck-u-inline-module-border-top mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg_telehealthrevisited_exhibit4-v2.svgz?cq=50&cpy=Center"/><img alt="Investment in digital health and the revenues of telehealth players almost doubled compared to 2019." src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/20210708/svg_telehealthrevisited_exhibit4-v2.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div> <p>As the investment into virtual health companies continues to grow at record levels, so does the pressure on the companies within the ecosystem to innovate and find winning models that will provide sustainable competitive advantage in this quickly evolving space. This is good news for consumers and patients, as we are likely to continue seeing increased innovation in the virtual care delivery models.</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-disruptor1up mck-o-md-center mck-u-inline-module-border-top mck-u-inline-module-border-bottom mck-u-screen-only" data-layer-region="disruptor-1up"><div class="mdc-u-grid mdc-u-grid-gutter-md mdc-u-grid-col-lg-12 mdc-u-grid-col-md-12 "><div class="mdc-u-grid-col-lg-span-4 mdc-u-grid-col-md-span-5 Disruptor1Up_mck-c-disruptor1up__image___2Gc4"><picture data-component="mdc-c-picture"><img alt="How COVID-19 has changed the way US consumers think about healthcare" src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/how%20covid%2019%20has%20changed%20the%20way%20us%20consumers%20think%20about%20healthcare/standard-1301544015.jpg?cq=50&mh=145&car=16:9&cpy=Center" loading="lazy"/></picture></div><div class="mdc-u-grid-col-lg-span-8 mdc-u-grid-col-md-span-7"><header data-component="mdc-c-header" class="mdc-c-header"><div class="mdc-c-header__block___i1Lg-_2734c4f"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f"><div>How COVID-19 has changed the way US consumers think about healthcare</div></h3></div></header><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_2734c4f mdc-c-link-container--display-column___X0HDD_2734c4f mck-c-disruptor1up__content Disruptor1Up_mck-c-disruptor1up__content--links__VV4lE mdc-u-grid-gutter-md"><a data-component="mdc-c-link" href="/industries/healthcare/our-insights/how-covid-19-has-changed-the-way-us-consumers-think-about-healthcare" class="mdc-c-link-cta___NBQVi_2734c4f"><span class="mdc-c-link__label___Pfqtd_2734c4f">Read the article</span><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mck-link-arrow-right-icon"></span></a></div></div></div></div> <h2>The next chapter of telehealth</h2> <p>Telehealth appears poised to stay a robust option for care. Strong continued uptake, favorable consumer perception, the regulatory environment, and strong investment into this space are all contributing to this rate of adoption.</p> <p>We are observing a quick evolution of the space and innovation beyond the “virtual urgent care” convenience. Innovations around virtual longitudinal care (both primary and specialty), enablement of care at home through remote patient monitoring and self-diagnostics, investment in “digital front doors,” and experimentation with hybrid “online/offline” models will bring new care models for consumers that help achieve healthcare’s “triple aim.”</p> <p>In order to fully realize the potential of virtually enabled care models, both payers and providers should consider these new delivery models part of the core day-to-day value proposition to consumers across three areas:</p> <h3>1. Increasing convenience to receive routine care</h3> <ul> <li><em>Integrating e-triage solutions with virtual visits to create a broader “digital front door”</em> for healthcare that enables consumers to easily get care when they need it, through the most convenient channels, and lowers the cost of care by avoiding unnecessary ED visits</li> <li><em>Integrating care advocacy and telehealth solutions,</em> as evidenced by recent M&A activity with the value proposition to make it easy for consumers to access care and find the best provider for their individual needs</li> <li><em>Experimenting with virtual-first health plans.</em> The number of virtual-first health plans grew from one in 2019 to at least eight in 2020. While these products are still nascent, they offer the potential of lower premiums and greater convenience, in return for seeing a virtual primary care provider as the first point of care. These advantages are attracting increasing attention from employers, brokers, and payers</li> <li><em>Expanding the types of care that can be delivered virtually or near-virtually</em> with innovations in at-home diagnostics/equipment or combining virtual care with at-home nurse visits</li> </ul> <h3>2. Improving access, especially for behavioral health and specialty care</h3> <ul> <li><em>Continuing to expand the range of behavioral health offerings</em> with potential to address <a href="/industries/healthcare/our-insights/a-holistic-approach-to-addressing-the-us-behavioral-health-crisis-in-the-face-of-the-global-covid-19-pandemic">provider shortages in many parts of the country</a>. For example, 56 percent of counties in the United States are without a psychiatrist, 64 percent of counties have a shortage of mental health providers, and 70 percent of counties lack a child psychiatrist.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="644ceeed-cafb-4840-9a26-14207ecb9070"><sup class="FootNote_footnotesup__e73z_">12</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="644ceeed-cafb-4840-9a26-14207ecb9070" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Erica Coe, Lisa Crystal, Kana Enomoto, and Razili Lewis, “<a href="/industries/healthcare/our-insights/a-holistic-approach-to-addressing-the-us-behavioral-health-crisis-in-the-face-of-the-global-covid-19-pandemic">A holistic approach for the US behavioral health crisis during the COVID-19 pandemic</a>,” August 6, 2020, McKinsey.com.</span></span></span></a></span> This kind of access may also be an opportunity to expand community, payer, and provider partnerships</li> <li><em>Expanding access to specialty care capacity,</em> such as <a href="/industries/healthcare/our-insights/covid-19-and-rural-communities-protecting-rural-lives-and-health">in rural areas where many specialties may not be available</a>. Even outside of rural areas, provider-to-provider virtual health can improve experience and quality of care by rapidly getting specialist input</li> </ul> <h3>3. Improving care models and health outcomes, particularly for those with chronic conditions or in need of post-acute care support</h3> <ul> <li><em>Integrating remote monitoring and digital therapeutics with virtual visits, especially in value-based provider arrangements,</em> where incorporating virtual health into their care models could improve patient outcomes and overall performance</li> <li><em>Growing hospital-at-home and post-acute care-at-home models</em></li> </ul> <h2>Remaining challenges to scale</h2> <p>Even with these innovations, challenges remain to be worked through to realize the full potential of virtual care. These challenges include the following items:</p> <ul> <li>The need for better data integration and improved data flows across the various players in the ecosystem, in light of the fast proliferation of point solutions, which are overwhelming consumers, payers, and providers alike</li> <li>The need for better integration of the virtual health-related activities into day-to-day workflows of clinicians, particularly to enable hybrid care models that combine online and in-person care delivery</li> <li>Alignment of incentives for virtual health activities with the broader movement toward value-based care, to break out of the fee-for-service mentality and the worry about reimbursement parity, especially for the virtual health models that aim to reduce total cost of care</li> </ul> <p>Potential exists to improve access, quality, and affordability of healthcare, plus embrace the quarter-trillion dollar economic opportunity represented by telehealth. Collectively, industry leaders have a chance to help consumers and providers improve access and quality through the power of telehealth.</p> <a id="may29"></a> <hr/> <h2>Update: May 29, 2020</h2> <p>COVID-19 has caused a massive acceleration in the use of telehealth. Consumer adoption has skyrocketed, from 11 percent of US consumers using telehealth in 2019 to 46 percent of consumers now using telehealth to replace cancelled healthcare visits.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="e91f57ea-7b94-46f1-bc9b-b056c3f1d37f"><sup class="FootNote_footnotesup__e73z_">13</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="e91f57ea-7b94-46f1-bc9b-b056c3f1d37f" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey COVID-19 Consumer Survey, April 27, 2020.</span></span></span></a></span> Providers have rapidly scaled offerings and are seeing 50 to 175 times<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="aa7dc71a-3e73-4b90-bc5e-6db7a1209671"><sup class="FootNote_footnotesup__e73z_">14</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="aa7dc71a-3e73-4b90-bc5e-6db7a1209671" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Erickson M, “Stanford Medicine increases use of televisits to help prevent spread of coronavirus,” Stanford Medicine, March 30, 2020, med.stanford.edu.</span></span></span></a></span><span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="0952d05f-3e2a-456e-aae8-e8ec06d55ba0"><sup class="FootNote_footnotesup__e73z_">15</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="0952d05f-3e2a-456e-aae8-e8ec06d55ba0" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Palo Alto Medical Foundation, “Video visits and COVID-19 response,” Sutter Health, 2020, sutterhealth.org.</span></span></span></a></span><span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="3211b364-308a-4cae-83f9-1b2a8725aff8"><sup class="FootNote_footnotesup__e73z_">16</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="3211b364-308a-4cae-83f9-1b2a8725aff8" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Beacon Health Options infographic. Beacon’s claims data suggest that compared to April 2019, telehealth sessions increased 5,130 percent in April 2020. (Note: data only include claims paid through May 8, 2020—additional claims for services rendered in April 2020 may be processed at a later date. Additionally, claims for telehealth services may not include a telehealth modifier, and are therefore not included in our telehealth usage calculations.)</span></span></span></a></span> the number of patients via telehealth than they did before. Pre-COVID-19, the total annual revenues of US telehealth players were an estimated $3 billion, with the largest vendors focused in the “virtual urgent care” segment: helping consumers get on-demand instant telehealth visits with physicians (most likely, with a physician they have no relationship with).<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="fb4307bb-e646-4b4b-8f5d-2eb9b36dc48a"><sup class="FootNote_footnotesup__e73z_">16</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="fb4307bb-e646-4b4b-8f5d-2eb9b36dc48a" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">Beacon Health Options infographic. Beacon’s claims data suggest that compared to April 2019, telehealth sessions increased 5,130 percent in April 2020. (Note: data only include claims paid through May 8, 2020—additional claims for services rendered in April 2020 may be processed at a later date. Additionally, claims for telehealth services may not include a telehealth modifier, and are therefore not included in our telehealth usage calculations.)</span></span></span></a></span> With the acceleration of consumer and provider adoption of telehealth and extension of telehealth beyond virtual urgent care, <strong>up to $250 billion of current US healthcare spend could potentially be virtualized</strong>.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="f055433b-b524-46e1-be45-45844920759e"><sup class="FootNote_footnotesup__e73z_">18</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="f055433b-b524-46e1-be45-45844920759e" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">See technical appendix.</span></span></span></a></span></p> <div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="lightest-grey" data-module-category="" data-module-gradient-position="bottom-right" class="mck-c-inline-module-container SideBar_mck-c-sidebar__bgimg-wrapper__Qj4Dt mck-o-sm-left-span SideBar_mck-c-sidebar__sidebar-wrapper__Dpjw2 SideBar_mck-c-sidebar__sidebar-wrapper--istablet__IQ6ii mck-u-screen-only mck-c-module-wrapper" data-layer-region="sidebar"><div class="SideBar_mck-c-sidebar__epoAm mck-o-md-center"><div class="SideBar_mck-c-sidebar__share-icons-wrapper__9gB_c"><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_2734c4f mdc-c-link-container--display-column___X0HDD_2734c4f SideBar_mck-c-sidebar__share-icons___eQy6"><div data-component="mdc-c-dropdown-menu" class="mdc-c-drop-down"><button data-component="mdc-c-button" aria-label="" type="button" id="button_id" class="mdc-c-button___U4iY2_2734c4f mdc-c-button--ghost mdc-c-button--size-medium mdc-c-drop-down__rootmenu___yJzvz_2734c4f" aria-expanded="false" aria-haspopup="menu"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mdc-c-icon--default___f-hQM_2734c4f mdc-c-icon--size-md___yi5fA_2734c4f mck-share2-icon"></span></button><div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="white" data-module-category="" class=""></div></div><button data-component="mdc-c-button" aria-label="Expandable Sidebar" type="button" id="button_id" class="mdc-c-button___U4iY2_2734c4f mdc-c-button--ghost mdc-c-button--size-medium SideBar_mck-c-sidebar__toggle-btn__EL8iE" aria-expanded="false" data-layer-event-prefix="UI Item" data-layer-action="click" data-layer-category="sidebar" data-layer-subcategory="open" data-layer-text="open sidebar"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mdc-c-icon--radial___y3csX_2734c4f mdc-c-icon--size-xxl___cL3ZT_2734c4f mck-plus-no-circle-icon"></span></button></div></div><div class="SideBar_mck-c-sidebar__content-outer__UdWCq"><div class="SideBar_mck-c-sidebar__eyebrow__5GSEq"></div><div class="SideBar_mck-c-sidebar__content__raEwe"><h2 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f mdc-u-ts-3 SideBar_mck-c-sidebar__content-heading__NJekY"><div>Disclaimer</div></h2><div class="SideBar_mck-c-sidebar__content-description__4p9iI mdc-u-ts-7"><div class="mdc-o-content-body"><p>These materials are preliminary and non-exhaustive and are being made available on a non-exclusive basis solely for information purposes in response to the urgent need for measures to address the COVID-19 crisis. They reflect general insight and may present potential options for consideration based on currently available information, which is inherently uncertain and subject to change, but do not contain all of the information needed to determine a future course of action. The insights and concepts included in these materials have not been validated or independently verified. References to specific products or organizations are solely for illustration and do not constitute any endorsement or recommendation. These materials do not constitute, and should not be interpreted as, policy, accounting, legal, medical, tax or other regulated advice, or a recommendation on any specific course of action. These materials are not a guarantee of results and cannot be relied upon. Future results may differ materially from any statements of expectation, forecasts or projections. Particularly in light of rapidly evolving conditions, these materials are provided “as is” without any representation or warranty, and all liability is expressly disclaimed for any loss or damage of any kind. The recipient is solely responsible for all of its decisions, use of these materials, and compliance with applicable laws, rules and regulations. Consider seeking advice of legal and other relevant certified/licensed experts prior to taking any specific steps.</p></div></div></div></div></div></div> <p>This shift is not inevitable. It will require new ways of working for a broad set of providers, step-change improvements in information exchange, and broadening access and integration of technology. The potential impact is improved convenience and <a href="/industries/public-sector/our-insights/tracking-public-health-outcomes-across-the-united-states">access to care, better patient outcomes, and a more efficient healthcare system</a>. Healthcare players may consider moves now that support such a shift and improve their future position.</p> <h2>Telehealth has surged under COVID-19</h2> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mdc-u-grid mdc-u-grid-gutter-lg mdc-u-grid-col-sm-1 mdc-u-grid--align-start mdc-u-mb-3 GenericItem_mck-c-generic-item__sGwKL"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-gutter-xs GenericItem_mck-c-generic-item__content__gq1m0"><div class="mck-c-eyebrow mdc-u-ts-10"><span> 1</span></div></div></div><div class="mck-u-inline-module-border-top mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/svg-telehealth-exhibit1-v5.svgz?cq=50&cpy=Center"/><img alt="" src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/svg-telehealth-exhibit1-v5.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div> <p>Many of these dynamics are likely to be in place for at least the next 12 to 18 months, as concerns about COVID-19 remain until a vaccine is widely available. During this period, consumers’ preferences for care access will continue to evolve, and virtual health could become more deeply embedded into the care delivery system.</p> <p>However, challenges remain. Our research indicates providers’ concerns about telehealth include security, workflow integration, effectiveness compared with in-person visits, and the future for reimbursement.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="d8afb064-8a7a-4e89-afa0-75c53e67be61"><sup class="FootNote_footnotesup__e73z_">19</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="d8afb064-8a7a-4e89-afa0-75c53e67be61" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey 2020 Virtual Health Survey.</span></span></span></a></span> Similarly, there is a gap between consumers’ interest in telehealth (76 percent) and actual usage (46 percent). Factors such as lack of awareness of telehealth offerings, education on types of care needs that could be met virtually, and understanding of insurance coverage are some of the drivers of this gap.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="b9c03770-41d2-48b2-a3bd-74756c4e2357"><sup class="FootNote_footnotesup__e73z_">20</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="b9c03770-41d2-48b2-a3bd-74756c4e2357" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey COVID-19 Consumer Survey, April 27, 2020.</span></span></span></a></span></p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-disruptor1up mck-o-md-center mck-u-inline-module-border-top mck-u-inline-module-border-bottom mck-u-screen-only" data-layer-region="disruptor-1up"><div class="mdc-u-grid mdc-u-grid-gutter-md mdc-u-grid-col-lg-12 mdc-u-grid-col-md-12 "><div class="mdc-u-grid-col-md-span-12"><header data-component="mdc-c-header" class="mdc-c-header"><div class="mdc-c-header__block___i1Lg-_2734c4f"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f"><div>Would you like to learn more about our <a href="/industries/healthcare/how-we-help-clients">Healthcare Systems & Services Practice</a>?</div></h3></div></header><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_2734c4f mdc-c-link-container--display-column___X0HDD_2734c4f mck-c-disruptor1up__content Disruptor1Up_mck-c-disruptor1up__content--links__VV4lE mdc-u-grid-gutter-md"><a data-component="mdc-c-link" href="/industries/healthcare/how-we-help-clients/americas/digital-strategy-transformation" class="mdc-c-link-cta___NBQVi_2734c4f"><span class="mdc-c-link__label___Pfqtd_2734c4f">Visit our Digital Strategy & Transformation page</span><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mck-link-arrow-right-icon"></span></a></div></div></div></div> <h2>What is the full potential for telehealth and virtual care?</h2> <p>We identified five models for virtual or virtually enabled non-acute care and analyzed the full potential of healthcare volume and spend that could be delivered this way. These models of virtual care have <em>increasing requirements to engage broader and broader portions of the healthcare delivery system</em>, going from offering one-off urgent visits, to building omnichannel care models that deliver a large portion of office visits virtually or near virtually, to embedding virtual services in home care models. They include:</p> <ol> <li><strong>On-demand virtual urgent care</strong> as an alternative to lower acuity emergency department (ED) visits, urgent care visits, and after-hours consultations. These care needs are the most common telehealth use cases today among payers. This allows a consumer to remotely consult on demand with an unknown provider to address immediate concerns (such as an acute sinusitis) and avoid a trip to the ED or an urgent care center. Such usage could be further scaled to address a larger portion of low acuity visits previously seen in EDs.</li> <li><strong>Virtual office visits</strong> with an established provider for consults that do not require physical exams or concurrent procedures. Such visits can be primary care (such as chronic condition checks, colds, minor skin conditions), behavioral health (such as virtual psychotherapy sessions), and some specialty care (select follow-up visits such as virtual cardiac rehabilitation). An omnichannel care model that fully leverages virtual visits includes a mix of telehealth and in-person care with a consistent set of providers, improving patient convenience, access, and continuity of care. This model also enables clinicians to better manage patients with chronic conditions, with the support of remote patient monitoring, digital therapeutics, and digital coaching, in addition to virtual visits.</li> <li><strong>Near-virtual office visits</strong> extend the opportunity for patients to conveniently access care outside a provider’s office, by combining virtual access to physician consults with “near home” sites for testing and immunizations, such as worksite clinics or retail clinics. For example, a virtual visit of a patient with flu or COVID-like symptoms could be followed up by a trip to a nearby retail clinic for a flu or COVID-19 test, with a subsequent follow-up virtual check-in with the primary care physician to consult on follow-on care.</li> <li><strong>Virtual home health services</strong> leverage virtual visits, remote monitoring, and digital patient engagement tools to enable some of these services to be delivered remotely, such as a portion of an evaluation, patient and care giver education, physical therapy, occupational therapy, and speech therapy. Direct services, such as wound care and assistance with daily living routines, would still occur in person, but virtual home health services could enhance the patient’s and caregiver’s experience, extend the reach of home health providers, and improve connectivity with the broader care team. For example, a physical therapist could conduct virtual sessions with elderly patients at their home to improve their strength, balance, and endurance, and to advise them how to avoid physical hazards to reduce risk of falls.</li> <li><strong>Tech-enabled home medication administration</strong> allows patients to shift receiving some infusible and injectable drugs from the clinic to the home. This shift can happen by leveraging remote monitoring to help manage patients and monitor symptoms, providing self-service tools for patient education (for example, training for self-administration), and providing telehealth oversight of staff (for example, an oncologist overseeing a nurse delivering chemotherapy to a patient at home and monitoring for side effects). This would be coupled with home delivery of the therapeutics.</li> </ol> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mdc-u-grid mdc-u-grid-gutter-lg mdc-u-grid-col-sm-1 mdc-u-grid--align-start mdc-u-mb-3 GenericItem_mck-c-generic-item__sGwKL"><div data-component="mdc-c-content-block" class="mdc-c-content-block___7p6Lu_2734c4f mdc-u-grid-gutter-xs GenericItem_mck-c-generic-item__content__gq1m0"><div class="mck-c-eyebrow mdc-u-ts-10"><span> 2</span></div></div></div><div class="mck-u-inline-module-border-top mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/svg-telehealth-exhibit2-v6.svgz?cq=50&cpy=Center"/><img alt="Approximately 20% of all Medicare, Medicaid, and Commercial OP, office, and home health spend, could potentially be virtualized." src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/telehealth%20a%20quarter%20trillion%20dollar%20post%20covid%2019%20reality/svg-telehealth-exhibit2-v6.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div>  <p>Our claims-based analysis suggests that approximately 20 percent of all emergency room visits could potentially be avoided via virtual urgent care offerings, 24 percent of healthcare office visits and outpatient volume could be delivered virtually, and an additional 9 percent “near-virtually.” Furthermore, up to 35 percent of regular home health attendant services could be virtualized, and 2 percent of all outpatient volume could be shifted to the home setting, with tech-enabled medication administration. Overall, these changes add up to $250 billion in healthcare spend in 2020 that could be shifted to virtual or near-virtual care, or 20 percent of all office, outpatient, and home health spend across Medicare, Medicaid, and commercially insured populations.</p> <div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="lightest-grey" data-module-category="" data-module-gradient-position="bottom-right" class="mck-c-inline-module-container SideBar_mck-c-sidebar__bgimg-wrapper__Qj4Dt mck-o-sm-left-span SideBar_mck-c-sidebar__sidebar-wrapper__Dpjw2 SideBar_mck-c-sidebar__sidebar-wrapper--istablet__IQ6ii mck-u-screen-only mck-c-module-wrapper" data-layer-region="sidebar"><div class="SideBar_mck-c-sidebar__epoAm mck-o-md-center"><div class="SideBar_mck-c-sidebar__share-icons-wrapper__9gB_c"><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_2734c4f mdc-c-link-container--display-column___X0HDD_2734c4f SideBar_mck-c-sidebar__share-icons___eQy6"><div data-component="mdc-c-dropdown-menu" class="mdc-c-drop-down"><button data-component="mdc-c-button" aria-label="" type="button" id="button_id" class="mdc-c-button___U4iY2_2734c4f mdc-c-button--ghost mdc-c-button--size-medium mdc-c-drop-down__rootmenu___yJzvz_2734c4f" aria-expanded="false" aria-haspopup="menu"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mdc-c-icon--default___f-hQM_2734c4f mdc-c-icon--size-md___yi5fA_2734c4f mck-share2-icon"></span></button><div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="white" data-module-category="" class=""></div></div><button data-component="mdc-c-button" aria-label="Expandable Sidebar" type="button" id="button_id" class="mdc-c-button___U4iY2_2734c4f mdc-c-button--ghost mdc-c-button--size-medium SideBar_mck-c-sidebar__toggle-btn__EL8iE" aria-expanded="false" data-layer-event-prefix="UI Item" data-layer-action="click" data-layer-category="sidebar" data-layer-subcategory="open" data-layer-text="open sidebar"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mdc-c-icon--radial___y3csX_2734c4f mdc-c-icon--size-xxl___cL3ZT_2734c4f mck-plus-no-circle-icon"></span></button></div></div><div class="SideBar_mck-c-sidebar__content-outer__UdWCq"><div class="SideBar_mck-c-sidebar__eyebrow__5GSEq"></div><div class="SideBar_mck-c-sidebar__content__raEwe"><h2 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f mdc-u-ts-3 SideBar_mck-c-sidebar__content-heading__NJekY"><div>What changes need to happen to realize the full potential of telehealth?</div></h2><div class="SideBar_mck-c-sidebar__content-description__4p9iI mdc-u-ts-7"><div class="mdc-o-content-body"><p>This value will not happen without concerted efforts by healthcare stakeholders, innovations in care models, adoption of new technologies, and supporting infrastructure.</p> <ol> <li><strong>Scale the use of virtual urgent care.</strong> This change will require building out flexible provider networks to address the shortages and long wait times that consumers experienced during the initial escalation of telehealth demand. Sustaining and growing patient use also will likely require active, personalized patient engagement, by both providers and payers, to ensure a positive experience with telehealth. Integration with e-triage/symptom solutions (by either provider or payer) can make the patient experience even more seamless and can leverage artificial intelligence (AI) to guide patients to the most appropriate care. Finally, the ability to access patients’ medical records and make post-encounter additions may be needed to enable care integration.</li> <li><strong>Scale the use of fully virtual office visits.</strong> This change would require going beyond on-demand visits with an unknown provider and embedding virtual health in the “brick and mortar” healthcare system. Telehealth solutions will likely need to be easier to embed in provider workflows and address security concerns, both of which have been raised by providers as limiting factors to telehealth adoption.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="926378f3-3439-4d57-b294-3251a5cc365f"><sup class="FootNote_footnotesup__e73z_">1</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="926378f3-3439-4d57-b294-3251a5cc365f" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey 2020 Virtual Health Survey.</span></span></span></a></span> Capabilities are needed to allow for more seamless information exchange and sufficiently rich clinical data to be transferred among providers and between providers and patients (for example, ensuring all providers caring for a complex patient have access to the clinical record and can update it based on virtual visits, plus leveraging AI and natural language processes to capture notes in easily sharable forms). In addition, retail diagnostic kits (for example, home pulse oximeters, blood pressure machines) must be widely available, so patients can take basic measurements at home and enable a broader set of care to be delivered virtually. Providers should have a clear end-to-end value proposition for integrating telehealth into their service delivery model (for example, incorporating the value from patient attraction and retention and operating model efficiency, in addition to reimbursement for visits). Payers should also have a clear view of potential outcomes and total cost of care impact (for example, by population and care journey) to inform decisions on provider engagement strategies and reimbursement.</li> <li><strong>Integrate “near virtual” office visits into the care continuum.</strong> These near-virtual visits will have requirements similar to fully virtual office visits, and scale up the availability of “near-home” sites of care (for example, workplace and retail clinics). They would be integrated into provider networks and delivery system footprints, and optimize care protocols to guide patients to these sites. Even further data integration will likely be needed. This may include patient data shared across platforms outside of a single health system and patient tools (for example, comprehensive personal health records applications, care navigation tools) that allow patients to manage their care across providers.</li> <li><strong>Virtualize home care services.</strong> This change would likely require increased access to and use of remote monitoring devices, tailored to specific clinical conditions (such as remote continuous glucose monitoring sensors for people with diabetes or remote heartbeat monitors and blood pressure monitors for people with cardiovascular conditions). Providers may be required to integrate use of such devices into care plans. Payers may need to offer reimbursement, and solutions may need to enable integrated access between, for example, primary care physicians, care managers, and at-home caregivers. These services could also require the deployment of supportive patient engagement tools (for example, digital coaching, care plan navigation tools), tailored to patients’ needs and integrated with communication channels to providers, care managers, and others involved in their care.</li> <li><strong>Tech-enabled home medication administration.</strong> This change will have requirements similar to virtualized home care services, as well as tailored digital tools to support monitoring and care delivery (for example, medication adherence tools), and virtual access to pharmacist consults.</li> </ol></div></div></div></div></div></div> <p>Scaling telehealth does more than alleviate patient and provider concerns over the next 12 to 18 months until a COVID-19 vaccine is available. Telehealth can increase <strong>access to necessary care</strong> in areas with shortages, such as behavioral health, <strong>improve the patient experience</strong>, and <strong>improve health outcomes</strong>. Fundamentally, the integration of fully virtual and near-virtual health solutions brings care closer to home, increasing the convenience for patients to access care when they need it and the likelihood that they will take the right steps to manage their care. These solutions can also make healthcare <strong>more efficient</strong>; evidence prior to COVID-19 shows that telehealth solutions deployed for chronic populations can improve total cost of care by 2 to 3 percent.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="f4eb6681-e2c5-42c4-aa24-6c88077e6455"><sup class="FootNote_footnotesup__e73z_">21</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="f4eb6681-e2c5-42c4-aa24-6c88077e6455" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">McKinsey 2019 Digital Healthcare Value Opportunity Assessment.</span></span></span></a></span> The actual opportunity is likely greater once stakeholders embed telehealth as the new normal (for example, driven by improved abilities to manage chronic patients, potential increases in provider productivity).</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-disruptor1up mck-o-md-center mck-u-inline-module-border-top mck-u-inline-module-border-bottom mck-u-screen-only" data-layer-region="disruptor-1up"><div class="mdc-u-grid mdc-u-grid-gutter-md mdc-u-grid-col-lg-12 mdc-u-grid-col-md-12 "><div class="mdc-u-grid-col-lg-span-4 mdc-u-grid-col-md-span-5 Disruptor1Up_mck-c-disruptor1up__image___2Gc4"><picture data-component="mdc-c-picture"><img alt="From wartime to peacetime: Five stages for healthcare institutions in the battle against COVID-19" src="/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/from%20wartime%20to%20peacetime%20five%20stages%20for%20healthcare%20institutions%20in%20the%20battle%20against%20covid%2019/standard-wartime-peactime.jpg?cq=50&mh=145&car=16:9&cpy=Center" loading="lazy"/></picture></div><div class="mdc-u-grid-col-lg-span-8 mdc-u-grid-col-md-span-7"><header data-component="mdc-c-header" class="mdc-c-header"><div class="mdc-c-header__block___i1Lg-_2734c4f"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f"><div>From “wartime” to “peacetime”: Five stages for healthcare institutions in the battle against COVID-19</div></h3></div></header><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_2734c4f mdc-c-link-container--display-column___X0HDD_2734c4f mck-c-disruptor1up__content Disruptor1Up_mck-c-disruptor1up__content--links__VV4lE mdc-u-grid-gutter-md"><a data-component="mdc-c-link" href="/industries/healthcare/our-insights/from-wartime-to-peacetime-five-stages-for-healthcare-institutions-in-the-battle-against-covid-19" class="mdc-c-link-cta___NBQVi_2734c4f"><span class="mdc-c-link__label___Pfqtd_2734c4f">Read the article</span><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mck-link-arrow-right-icon"></span></a></div></div></div></div> <h2>What actions should healthcare stakeholders take in the near term to shape this opportunity?</h2> <p>Actions payers could consider:</p> <ol> <li><strong>Define a value-backed virtual health roadmap,</strong> taking a data-driven view to prioritize interventions that will improve outcomes for priority populations, and develop strategies to digitally enable end-to-care care journeys.</li> <li><strong>Optimize provider networks and accelerate value-based contracting to incentivize telehealth.</strong> Define approaches (beyond the immediate COVID-19 response measures) to reimbursement and covered services, embed in contracting, and optimize networks and value-based models to include virtual health. Align incentives for using telehealth, particularly for chronic patients, with the shift to risk-based payment models.</li> <li><strong>Build virtual health into new product designs</strong> to meet changing consumer preferences and demand for lower-cost plans. This new design may include virtual-first networks, digital front-door features (for example, e-triage), seamless “plug and play” capabilities to offer innovative digital solutions, and benefit coverage for at-home diagnostic kits.</li> <li><strong>Integrate virtual health into the care delivery approach.</strong> Given the significant disruptions to providers, payers are reassessing their role in care delivery—from ownership of care delivery assets, value-based contracting, or anything in between. Consider options in virtual health (for example, platforms, digital-first providers) as a critical element of this approach.</li> <li><strong>Reinforce the technology and analytics foundation</strong> that will be required to achieve the full potential of virtual health.</li> </ol> <p>Actions health systems could consider:</p> <ol> <li><strong>Accelerate development of an overall consumer-integrated “front door.”</strong> Consider what the integrated product will initially cover beyond what currently exists and integrate with what may have been put in place in response to COVID-19 (for example, e-triage, scheduling, clinic visits, record access).</li> <li><strong>Segment the patient populations (for example, with specific chronic disease) and specialties</strong> whose remote interactions could be scaled with home-based diagnostics and equipment.</li> <li><strong>Build the capabilities and incentives of the provider workforce to support virtual care</strong> (for example, workflow design, centralized scheduling, and continuing education); align benefit structure to drive adoption in line with health system and/or physician practice economics.</li> <li><strong>Measure the value of virtual care by quantifying clinical outcomes,</strong> access improvement, and patient/provider satisfaction to drive advocacy and contracting for continued expanded coverage. Include the potential value from telehealth when contracting with payers for risk models to manage chronic patients.</li> <li><strong>Consider strategies and rationale to go beyond “telehealth”/clinic visit replacement</strong> to drive growth in new markets and populations and scale other applications (for example, teleICU, post-acute care integration).</li> </ol> <p>Actions investors and health services and technology firms could consider:</p> <ol> <li><strong>Develop scenarios on how virtual health will evolve and when,</strong> including how usage evolved post-COVID-19, based on expected consumer preferences, reimbursement, CMS, and other regulations.</li> <li><strong>Assess impact across virtual health solution/service types,</strong> developing a view of the opportunity for each solution/service type, including expected consumer/provider adoption, impact (for example, to outcomes, experience, affordability), and reimbursement.</li> <li><strong>Develop potential options</strong> and define investment strategies based on the expected virtual health future (for example, combinations of existing players/platforms, linkages between in-person and virtual care offerings) and create sustainable value.</li> <li><strong>Identify the assets and capabilities to implement these options,</strong> including specific assets or capabilities to best enable the play, and business models that will deliver attractive returns.</li> <li><strong>Execute, execute, execute.</strong> The next normal will rapidly take hold, and those that can best anticipate its impact will create disproportionate value. Don’t underestimate the potential of network effect.</li> </ol> <hr/> <div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="lightest-grey" data-module-category="" data-module-gradient-position="bottom-right" class="mck-c-inline-module-container SideBar_mck-c-sidebar__bgimg-wrapper__Qj4Dt mck-o-sm-left-span SideBar_mck-c-sidebar__sidebar-wrapper__Dpjw2 SideBar_mck-c-sidebar__sidebar-wrapper--istablet__IQ6ii mck-u-screen-only mck-c-module-wrapper" data-layer-region="sidebar"><div class="SideBar_mck-c-sidebar__epoAm mck-o-md-center"><div class="SideBar_mck-c-sidebar__share-icons-wrapper__9gB_c"><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_2734c4f mdc-c-link-container--display-column___X0HDD_2734c4f SideBar_mck-c-sidebar__share-icons___eQy6"><div data-component="mdc-c-dropdown-menu" class="mdc-c-drop-down"><button data-component="mdc-c-button" aria-label="" type="button" id="button_id" class="mdc-c-button___U4iY2_2734c4f mdc-c-button--ghost mdc-c-button--size-medium mdc-c-drop-down__rootmenu___yJzvz_2734c4f" aria-expanded="false" aria-haspopup="menu"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mdc-c-icon--default___f-hQM_2734c4f mdc-c-icon--size-md___yi5fA_2734c4f mck-share2-icon"></span></button><div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="white" data-module-category="" class=""></div></div><button data-component="mdc-c-button" aria-label="Expandable Sidebar" type="button" id="button_id" class="mdc-c-button___U4iY2_2734c4f mdc-c-button--ghost mdc-c-button--size-medium SideBar_mck-c-sidebar__toggle-btn__EL8iE" aria-expanded="false" data-layer-event-prefix="UI Item" data-layer-action="click" data-layer-category="sidebar" data-layer-subcategory="open" data-layer-text="open sidebar"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_2734c4f mdc-c-icon--radial___y3csX_2734c4f mdc-c-icon--size-xxl___cL3ZT_2734c4f mck-plus-no-circle-icon"></span></button></div></div><div class="SideBar_mck-c-sidebar__content-outer__UdWCq"><div class="SideBar_mck-c-sidebar__eyebrow__5GSEq"></div><div class="SideBar_mck-c-sidebar__content__raEwe"><h2 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f mdc-u-ts-3 SideBar_mck-c-sidebar__content-heading__NJekY"><div>Technical Appendix</div></h2><div class="SideBar_mck-c-sidebar__content-description__4p9iI mdc-u-ts-7"><div class="mdc-o-content-body"><p>Our analysis looked at 2018 claims data representative for Medicare, commercial, and Medicaid lines of business.</p> <h3>Emergency rooms and virtual care</h3> <p>We analyzed the emergency room visits and associated primary diagnoses. Using the NYU Wagner ED visit classification<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="bd634658-7313-4a3e-84b2-86e3c615cef2"><sup class="FootNote_footnotesup__e73z_">1</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="bd634658-7313-4a3e-84b2-86e3c615cef2" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">“Faculty & research,” NYU Wagner, wagner.nyu.edu.</span></span></span></a></span> research on various categories of the visits, we split the visits into those with non-emergent status (a big portion of which could be highly avoidable if proper self-triage and virtual urgent care tools could be available at people’s disposal) versus those that are higher emergency in nature, and are unlikely to be avoided using virtual urgent care. We assigned probabilities of potential to divert each category of these visits via a virtual urgent care offering.</p> <h3>Outpatient hospital and office visits</h3> <p>We filtered for visits that have evaluation and management procedure codes and analyzed individual claims to determine whether other additional services and procedures occurred during the visit (for example, administration of infusible/injectable drugs, blood draws, immunizations, physical therapy). We categorized the opportunities:</p> <ul> <li>Virtual office visits: a visit included only evaluation and management and no other procedures</li> <li>Near-virtual office visits: a visit included blood draws/lab tests and administration of immunizations/vaccinations</li> <li>Tech-enabled home medication administration: the visit included administration of drugs in a clinic/outpatient setting (for example, administration of “J-code” infusible/injectable drugs). We included only a portion of the spend associated with these procedures, using our estimates of what portion of the procedure spend could be saved by shifting administration of these drugs from outpatient to home settings</li> <li>Other: all other visits</li> </ul> <p>We conducted clinical reviews to further categorize the various kinds of procedures into high, medium, and low probability of being virtual.</p> <h3>Home health attendant services</h3> <p>We filtered for visits and services occurring in a home setting, and looked at what types of services were rendered during such visits:</p> <ul> <li>Direct nursing and attendant services (such as wound care, assistance with daily living routines, administration of IV) which are much less likely to be delivered virtually—if at all</li> <li>Services that can potentially be delivered virtually (such as evaluation, general assessment, patient and caregiver education, physical therapy, occupational therapy and speech therapy)</li> </ul> <p>For services that did not involve direct nursing or attendant services, we conducted clinical reviews to further categorize them into high, medium, and low ability to virtualize.</p> <p>After conducting these analyses for each of the commercial, Medicare, and Medicaid data sets, we scaled and projected the spend and utilization to represent national 2020 spend figures, using CMS National Health Expenditure projections.<span class="FootNote_footnote-holder__tjRqy"><a aria-label="footnote" href="javascript:void(0);" class="FootNote_footnote-wrapper__AIRwL undefined FootNote_inactive__VZfCp" aria-describedby="8807095e-0cb0-43f9-b2b8-3b093c3ff3b6"><sup class="FootNote_footnotesup__e73z_">2</sup><span class="FootNote_notch-wrapper__b_5NS"><span class="FootNote_notch__omKtY"></span></span><span class="FootNote_tooltip__QtrbA mdc-u-mt-2"><span class="FootNote_footnote-content__r2OVl"><span id="8807095e-0cb0-43f9-b2b8-3b093c3ff3b6" aria-hidden="true" data-module-theme="light" class="FootNote_footnote-text__VjKgO mck-u-links-inline">“NHE fact sheet,” Centers for Medicare & Medicaid Services, last modified March 24, 2020, cms.gov.</span></span></span></a></span></p></div></div></div></div></div></div> <p>The window to act is now. The current crisis has demonstrated the relevance of telehealth and created an opening to modernize the care delivery system. This modernization will be achieved by embedding telehealth in the care continuum at scale. A $3 billion revenue market has the potential to grow to $250 billion. The seeds for success will be sown in the next few months during the COVID-19 crisis. Healthcare systems that come out ahead will be those who act decisively, invest to build capabilities at scale, work hard to rewire the care delivery model, and deliver distinctive high-quality care to consumers.</p></div><div class="container-placeholder"></div></div></div><div class="mdc-u-grid mdc-u-grid-gutter-xl"><section role="contentinfo" data-layer-region="article-about-authors" class="mdc-u-grid mdc-u-grid-col-md-12 AboutAuthor_mck-c-about-author__nRJzu"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-11"><h5 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_2734c4f mdc-c-heading--title___5qyOB_2734c4f mdc-c-heading--border___K8dj3_2734c4f mdc-u-align-center"></h5><div data-component="mdc-c-description" class="mdc-c-description___SrnQP_2734c4f mdc-u-ts-8 mck-u-links-inline mck-u-links-inline--secondary mdc-u-mt-5"><div><p><strong>Oleg Bestsennyy</strong> is a partner in McKinsey’s New York office. <strong><a href="/sitecore/service/notfound.aspx?item=web%3a%7b72951f4b-ea7e-4ac6-a815-6c4f8de76338%7d%40en">Greg Gilbert</a></strong>, <strong><a href="/sitecore/service/notfound.aspx?item=web%3a%7b87907fe6-cb7d-4294-8aa7-05e25f4ab6a3%7d%40en">Alex Harris</a></strong>, and <strong>Jennifer Rost</strong> are partners in the Washington, DC, office.</p> <p>The authors would like to thank Yuqi Shi, Rafael Mora, Katarina Pregelj, Jenny Cordina, Eric Bochtler, Eric Levin, Isaac Swaiman, Jennifer Fowkes, Annie Kurdziel, Rustin Fakheri, Rafael Mora, Shubham Singhal, Andrew Gendreau, Tiago Moura, and Kana Enomoto for their contributions to this article.</p> <p>This article was edited by Elizabeth Newman, an executive editor in the Chicago office.</p></div></div></div></section><section class="mdc-u-grid mdc-u-grid-col-md-12 mck-u-screen-only"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-5 mdc-u-grid-col-lg-end-9"><h5 data-component="mdc-c-heading" 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type="application/json">{"props":{"pageProps":{"locale":"en","dictionary":{},"sitecoreContext":{"route":{"name":"Telehealth A quarter trillion dollar post COVID 19 reality","displayName":"Telehealth A quarter trillion dollar post COVID 19 reality","fields":null,"databaseName":"web","deviceId":"fe5d7fdf-89c0-4d99-9aa3-b5fbd009c9f3","itemId":"d8974509-3bcc-4439-a706-64f450972af2","itemLanguage":"en","itemVersion":3,"layoutId":"ae753eb4-a035-40b4-83bf-4b4438df6742","templateId":"683910db-02ba-40ba-92e7-726c880160a9","templateName":"ArticleJSS","placeholders":{"jss-main":[{"uid":"232bb7e9-289f-492d-a916-2b6185e44a84","componentName":"ArticleTemplate","dataSource":"","fields":{"data":{"articleTemplate":{"title":{"jsonValue":{"value":"Telehealth: A quarter-trillion-dollar post-COVID-19 reality?"}},"sEOTitle":{"value":"Telehealth: A post-COVID-19 reality?"},"description":{"jsonValue":{"value":"Strong continued uptake, favorable consumer perception, and tangible investment into this space are all contributing to the continued growth of telehealth in 2021. New analysis indicates telehealth use has increased 38X from the pre-COVID-19 baseline."}},"sEODescription":{"value":"Telehealth has helped expand access to care for patients restricted from seeing their doctors. Actions taken today will determine if its full potential is realized after the crisis is over."},"displayDate":{"jsonValue":{"value":"2021-07-09T00:00:00Z"}},"body":{"value":"\u003ch2\u003eUpdate: July 9, 2021\u003c/h2\u003e\n\u003cp\u003eEarly in the COVID-19 pandemic, telehealth usage surged as consumers and providers sought ways to safely access and deliver healthcare. In April 2020, overall telehealth utilization for office visits and outpatient care was 78 times higher than in February 2020 (Exhibit 1).\u003c/p\u003e\n[[exhibit 202107081]]\n[[MostPopularArticles 5]]\n\u003cp\u003eThis step-change, borne out of necessity, was enabled by these factors: 1) increased consumer willingness to use telehealth, 2) increased provider willingness to use telehealth, 3) regulatory changes enabling greater access and reimbursement. During the tragedy of the pandemic, telehealth offered a bridge to care, and now offers a chance to reinvent virtual and hybrid virtual/in-person care models, with a goal of improved healthcare access, outcomes, and affordability.\u003c/p\u003e\n\u003cp\u003eA year ago, we estimated that up to \u003ca href=\"#may29\"\u003e$250 billion of US healthcare spend could potentially be shifted to virtual or virtually enabled care\u003c/a\u003e. Approaching this potential level of virtual health is not a foregone conclusion. It would likely require sustained consumer and clinician adoption and accelerated redesign of care pathways to incorporate virtual modalities.\u003c/p\u003e\n\u003cp\u003eAs of July 2021, we step back to review the progress of telehealth since the initial COVID-19 spike and to assess implications for telehealth and virtual health[[footnote 1]] more broadly going forward. Our findings include the following insights:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cem\u003eTelehealth utilization has stabilized at levels 38X higher than before the pandemic.\u003c/em\u003e After an initial spike to more than 32 percent of office and outpatient visits occurring via telehealth in April 2020, utilization levels have largely stabilized, ranging from 13 to 17 percent across all specialties.[[footnote 2]] This utilization reflects more than two-thirds of what we anticipated as visits that could be virtualized.[[footnote 3]]\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eSimilarly, consumer and provider attitudes toward telehealth have improved since the pre-COVID-19 era.\u003c/em\u003e Perceptions and usage have dropped slightly since the peak in spring 2020. Some barriers\u0026mdash;such as perceptions of technology security\u0026mdash;remain to be addressed to sustain consumer and provider virtual health adoption, and models are likely to evolve to optimize hybrid virtual and in-person care delivery.\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eSome regulatory changes that facilitated expanded use of telehealth have been made permanent,\u003c/em\u003e for example, the Centers for Medicare \u0026amp; Medicaid Services\u0026rsquo; expansion of reimbursable telehealth codes for the 2021 physician fee schedule. But uncertainty still exists as to the fate of other services that may lose their waiver status when the public health emergency ends.\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eInvestment in virtual care and digital health more broadly has skyrocketed,\u003c/em\u003e fueling further innovation, with 3X the level of venture capitalist digital health investment in 2020 than it had in 2017.[[footnote 4]]\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eVirtual healthcare models and business models are evolving and proliferating,\u003c/em\u003e moving from purely \u0026ldquo;virtual urgent care\u0026rdquo; to a range of services enabling longitudinal virtual care, integration of telehealth with other virtual health solutions, and hybrid virtual/in-person care models, with the potential to improve consumer experience/convenience, access, outcomes, and affordability.\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003eTelehealth uptake\u003c/h2\u003e\n\u003cp\u003eSince the initial spike in April 2020, telehealth adoption overall has approached up to 17 percent of all outpatient/office visit claims with evaluation and management (E\u0026amp;M) services. This utilization has been relatively stable since June 2020.\u003c/p\u003e\n\u003cp\u003eWe are also seeing a differential uptake of telehealth depending on specialty, with the highest penetration in psychiatry (50 percent) and substance use treatment (30 percent) (Exhibit 2).\u003c/p\u003e\n[[exhibit 202107082]]\n[[disruptor1up 20210708learnmore]]\n\u003ch2\u003eConsumer and provider perceptions of telehealth\u003c/h2\u003e\n\u003cp\u003eOur consumer research[[footnote 5]] shows that consumers continue to view telehealth as an important modality for their future care needs, but\u0026mdash;as expected\u0026mdash;this view varies widely depending on the type of care. Overall, consumer perception tracks closely to what we believe is possible telehealth uptake by various specialties (Exhibit 3).\u003c/p\u003e\n[[exhibit 202107083]]\n\u003cp\u003eAround 40 percent of surveyed consumers stated that they believe they will continue to use telehealth going forward\u0026mdash;up from 11 percent of consumers using telehealth prior to COVID-19.\u003c/p\u003e\n\u003cp\u003eMoreover, our research shows between 40 and 60 percent of consumers express interest in a set of broader virtual health solutions, such as a \u0026ldquo;digital front door\u0026rdquo; or lower-cost virtual-first health plan.[[footnote 6]] However, a gap has historically existed between consumers\u0026rsquo; expressed interest in digital health solutions and actual usage. Continuing to focus on creating a seamless consumer interface, breaking down silos in care provision (across virtual and in-person) with improved data integration and insights, and proactive consumer engagement will all be important to sustaining and growing consumer use of virtual health as the pandemic wanes.\u003c/p\u003e\n\u003cp\u003eOn the provider side, 58 percent of physicians continue to view telehealth more favorably now than they did before COVID-19, though perceptions have come down slightly since September 2020 (64 percent of physicians). As of April 2021, 84 percent of physicians were offering virtual visits and 57 percent would prefer to continue offering virtual care. However, 54 percent would not offer virtual care at a 15 percent discount to in-person care.[[footnote 7]] Most health systems are closely monitoring reimbursement. Those in bed capacity-constrained environments and value-based care arrangements are looking to understand whether there is scalable volume decanting or cost savings potential at equivalent quality.\u003c/p\u003e\n\u003ch2\u003eRegulatory changes\u003c/h2\u003e\n\u003cp\u003eSome regulatory changes that enabled greater telehealth access during COVID-19 have been made permanent. For example, CMS allowed telehealth coverage for a number of current procedural terminology (CPT) codes permanent in the 2021 physician fee schedule final rule.[[footnote 8]]\u003c/p\u003e\n\u003cp\u003eHowever, other restrictions on telehealth may return to pre-COVID-19 normal when the public health emergency expires. For example, there were several dozen additional CPT codes that CMS allowed telehealth coverage for on a temporary basis in the 2021 physician fee schedule.[[footnote 9]] In addition, a waiver for public health emergency allowed telehealth to be provided for Medicare beneficiaries outside of rural areas and from home rather than from a provider\u0026rsquo;s office. The future of these provisions once the public health emergency ends is not yet clear.\u003c/p\u003e\n\u003ch2\u003eInvestor activity\u003c/h2\u003e\n\u003cp\u003eInvestment in virtual health continues to accelerate. Per Rock Health\u0026rsquo;s H1 2021 digital health funding report[[footnote 10]] the total venture capital investment into the digital health space in the first half of 2021 totaled $14.7 billion, which is more than all of the investment in 2020 ($14.6 billion) and nearly twice the investment in 2019 ($7.7 billion) (Exhibit 4). This increase would reflect an annualized investment of $25 billion to $30 billion in 2021, if this rate continues. In addition, total revenue of the top 60 virtual health players increased in 2020 to $5.5 billion, from around $3 billion the year before.[[footnote 11]]\u003c/p\u003e\n[[exhibit 202107084]]\n\u003cp\u003eAs the investment into virtual health companies continues to grow at record levels, so does the pressure on the companies within the ecosystem to innovate and find winning models that will provide sustainable competitive advantage in this quickly evolving space. This is good news for consumers and patients, as we are likely to continue seeing increased innovation in the virtual care delivery models.\u003c/p\u003e\n[[disruptor1up 20210708readnext]]\n\u003ch2\u003eThe next chapter of telehealth\u003c/h2\u003e\n\u003cp\u003eTelehealth appears poised to stay a robust option for care. Strong continued uptake, favorable consumer perception, the regulatory environment, and strong investment into this space are all contributing to this rate of adoption.\u003c/p\u003e\n\u003cp\u003eWe are observing a quick evolution of the space and innovation beyond the \u0026ldquo;virtual urgent care\u0026rdquo; convenience. Innovations around virtual longitudinal care (both primary and specialty), enablement of care at home through remote patient monitoring and self-diagnostics, investment in \u0026ldquo;digital front doors,\u0026rdquo; and experimentation with hybrid \u0026ldquo;online/offline\u0026rdquo; models will bring new care models for consumers that help achieve healthcare\u0026rsquo;s \u0026ldquo;triple aim.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eIn order to fully realize the potential of virtually enabled care models, both payers and providers should consider these new delivery models part of the core day-to-day value proposition to consumers across three areas:\u003c/p\u003e\n\u003ch3\u003e1. Increasing convenience to receive routine care\u003c/h3\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cem\u003eIntegrating e-triage solutions with virtual visits to create a broader \u0026ldquo;digital front door\u0026rdquo;\u003c/em\u003e for healthcare that enables consumers to easily get care when they need it, through the most convenient channels, and lowers the cost of care by avoiding unnecessary ED visits\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eIntegrating care advocacy and telehealth solutions,\u003c/em\u003e as evidenced by recent M\u0026amp;A activity with the value proposition to make it easy for consumers to access care and find the best provider for their individual needs\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eExperimenting with virtual-first health plans.\u003c/em\u003e The number of virtual-first health plans grew from one in 2019 to at least eight in 2020. While these products are still nascent, they offer the potential of lower premiums and greater convenience, in return for seeing a virtual primary care provider as the first point of care. These advantages are attracting increasing attention from employers, brokers, and payers\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eExpanding the types of care that can be delivered virtually or near-virtually\u003c/em\u003e with innovations in at-home diagnostics/equipment or combining virtual care with at-home nurse visits\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch3\u003e2. Improving access, especially for behavioral health and specialty care\u003c/h3\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cem\u003eContinuing to expand the range of behavioral health offerings\u003c/em\u003e with potential to address \u003ca href=\"/industries/healthcare/our-insights/a-holistic-approach-to-addressing-the-us-behavioral-health-crisis-in-the-face-of-the-global-covid-19-pandemic\"\u003eprovider shortages in many parts of the country\u003c/a\u003e. For example, 56 percent of counties in the United States are without a psychiatrist, 64 percent of counties have a shortage of mental health providers, and 70 percent of counties lack a child psychiatrist.[[footnote 12]] This kind of access may also be an opportunity to expand community, payer, and provider partnerships\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eExpanding access to specialty care capacity,\u003c/em\u003e such as \u003ca href=\"/industries/healthcare/our-insights/covid-19-and-rural-communities-protecting-rural-lives-and-health\"\u003ein rural areas where many specialties may not be available\u003c/a\u003e. Even outside of rural areas, provider-to-provider virtual health can improve experience and quality of care by rapidly getting specialist input\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch3\u003e3. Improving care models and health outcomes, particularly for those with chronic conditions or in need of post-acute care support\u003c/h3\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cem\u003eIntegrating remote monitoring and digital therapeutics with virtual visits, especially in value-based provider arrangements,\u003c/em\u003e where incorporating virtual health into their care models could improve patient outcomes and overall performance\u003c/li\u003e\n \u003cli\u003e\u003cem\u003eGrowing hospital-at-home and post-acute care-at-home models\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003eRemaining challenges to scale\u003c/h2\u003e\n\u003cp\u003eEven with these innovations, challenges remain to be worked through to realize the full potential of virtual care. These challenges include the following items:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThe need for better data integration and improved data flows across the various players in the ecosystem, in light of the fast proliferation of point solutions, which are overwhelming consumers, payers, and providers alike\u003c/li\u003e\n \u003cli\u003eThe need for better integration of the virtual health-related activities into day-to-day workflows of clinicians, particularly to enable hybrid care models that combine online and in-person care delivery\u003c/li\u003e\n \u003cli\u003eAlignment of incentives for virtual health activities with the broader movement toward value-based care, to break out of the fee-for-service mentality and the worry about reimbursement parity, especially for the virtual health models that aim to reduce total cost of care\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003ePotential exists to improve access, quality, and affordability of healthcare, plus embrace the quarter-trillion dollar economic opportunity represented by telehealth. Collectively, industry leaders have a chance to help consumers and providers improve access and quality through the power of telehealth.\u003c/p\u003e\n\u003ca id=\"may29\"\u003e\u003c/a\u003e\n\u003chr /\u003e\n\u003ch2\u003eUpdate: May 29, 2020\u003c/h2\u003e\n\u003cp\u003eCOVID-19 has caused a massive acceleration in the use of telehealth. Consumer adoption has skyrocketed, from 11 percent of US consumers using telehealth in 2019 to 46 percent of consumers now using telehealth to replace cancelled healthcare visits.[[footnote 13]] Providers have rapidly scaled offerings and are seeing 50 to 175 times[[footnote 14]][[footnote 15]][[footnote 16]] the number of patients via telehealth than they did before. Pre-COVID-19, the total annual revenues of US telehealth players were an estimated $3 billion, with the largest vendors focused in the \u0026ldquo;virtual urgent care\u0026rdquo; segment: helping consumers get on-demand instant telehealth visits with physicians (most likely, with a physician they have no relationship with).[[footnote 16]] With the acceleration of consumer and provider adoption of telehealth and extension of telehealth beyond virtual urgent care, \u003cstrong\u003eup to $250 billion of current US healthcare spend could potentially be virtualized\u003c/strong\u003e.[[footnote 18]]\u003c/p\u003e\n[[sidebar 1]]\n\u003cp\u003eThis shift is not inevitable. It will require new ways of working for a broad set of providers, step-change improvements in information exchange, and broadening access and integration of technology. The potential impact is improved convenience and \u003ca href=\"/industries/public-sector/our-insights/tracking-public-health-outcomes-across-the-united-states\"\u003eaccess to care, better patient outcomes, and a more efficient healthcare system\u003c/a\u003e. Healthcare players may consider moves now that support such a shift and improve their future position.\u003c/p\u003e\n\u003ch2\u003eTelehealth has surged under COVID-19\u003c/h2\u003e\n[[exhibit 1]]\n\u003cp\u003eMany of these dynamics are likely to be in place for at least the next 12 to 18 months, as concerns about COVID-19 remain until a vaccine is widely available. During this period, consumers\u0026rsquo; preferences for care access will continue to evolve, and virtual health could become more deeply embedded into the care delivery system.\u003c/p\u003e\n\u003cp\u003eHowever, challenges remain. Our research indicates providers\u0026rsquo; concerns about telehealth include security, workflow integration, effectiveness compared with in-person visits, and the future for reimbursement.[[footnote 19]] Similarly, there is a gap between consumers\u0026rsquo; interest in telehealth (76 percent) and actual usage (46 percent). Factors such as lack of awareness of telehealth offerings, education on types of care needs that could be met virtually, and understanding of insurance coverage are some of the drivers of this gap.[[footnote 20]]\u003c/p\u003e\n[[disruptor1up learnmore]]\n\u003ch2\u003eWhat is the full potential for telehealth and virtual care?\u003c/h2\u003e\n\u003cp\u003eWe identified five models for virtual or virtually enabled non-acute care and analyzed the full potential of healthcare volume and spend that could be delivered this way. These models of virtual care have \u003cem\u003eincreasing requirements to engage broader and broader portions of the healthcare delivery system\u003c/em\u003e, going from offering one-off urgent visits, to building omnichannel care models that deliver a large portion of office visits virtually or near virtually, to embedding virtual services in home care models. They include:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003e\u003cstrong\u003eOn-demand virtual urgent care\u003c/strong\u003e as an alternative to lower acuity emergency department (ED) visits, urgent care visits, and after-hours consultations. These care needs are the most common telehealth use cases today among payers. This allows a consumer to remotely consult on demand with an unknown provider to address immediate concerns (such as an acute sinusitis) and avoid a trip to the ED or an urgent care center. Such usage could be further scaled to address a larger portion of low acuity visits previously seen in EDs.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eVirtual office visits\u003c/strong\u003e with an established provider for consults that do not require physical exams or concurrent procedures. Such visits can be primary care (such as chronic condition checks, colds, minor skin conditions), behavioral health (such as virtual psychotherapy sessions), and some specialty care (select follow-up visits such as virtual cardiac rehabilitation). An omnichannel care model that fully leverages virtual visits includes a mix of telehealth and in-person care with a consistent set of providers, improving patient convenience, access, and continuity of care. This model also enables clinicians to better manage patients with chronic conditions, with the support of remote patient monitoring, digital therapeutics, and digital coaching, in addition to virtual visits.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eNear-virtual office visits\u003c/strong\u003e extend the opportunity for patients to conveniently access care outside a provider\u0026rsquo;s office, by combining virtual access to physician consults with \u0026ldquo;near home\u0026rdquo; sites for testing and immunizations, such as worksite clinics or retail clinics. For example, a virtual visit of a patient with flu or COVID-like symptoms could be followed up by a trip to a nearby retail clinic for a flu or COVID-19 test, with a subsequent follow-up virtual check-in with the primary care physician to consult on follow-on care.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eVirtual home health services\u003c/strong\u003e leverage virtual visits, remote monitoring, and digital patient engagement tools to enable some of these services to be delivered remotely, such as a portion of an evaluation, patient and care giver education, physical therapy, occupational therapy, and speech therapy. Direct services, such as wound care and assistance with daily living routines, would still occur in person, but virtual home health services could enhance the patient\u0026rsquo;s and caregiver\u0026rsquo;s experience, extend the reach of home health providers, and improve connectivity with the broader care team. For example, a physical therapist could conduct virtual sessions with elderly patients at their home to improve their strength, balance, and endurance, and to advise them how to avoid physical hazards to reduce risk of falls.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eTech-enabled home medication administration\u003c/strong\u003e allows patients to shift receiving some infusible and injectable drugs from the clinic to the home. This shift can happen by leveraging remote monitoring to help manage patients and monitor symptoms, providing self-service tools for patient education (for example, training for self-administration), and providing telehealth oversight of staff (for example, an oncologist overseeing a nurse delivering chemotherapy to a patient at home and monitoring for side effects). This would be coupled with home delivery of the therapeutics.\u003c/li\u003e\n\u003c/ol\u003e\n[[exhibit 2]]\n[[ceros covid]]\n\u003cp\u003eOur claims-based analysis suggests that approximately 20 percent of all emergency room visits could potentially be avoided via virtual urgent care offerings, 24 percent of healthcare office visits and outpatient volume could be delivered virtually, and an additional 9 percent \u0026ldquo;near-virtually.\u0026rdquo; Furthermore, up to 35 percent of regular home health attendant services could be virtualized, and 2 percent of all outpatient volume could be shifted to the home setting, with tech-enabled medication administration. Overall, these changes add up to $250 billion in healthcare spend in 2020 that could be shifted to virtual or near-virtual care, or 20 percent of all office, outpatient, and home health spend across Medicare, Medicaid, and commercially insured populations.\u003c/p\u003e\n[[sidebar 2]]\n\u003cp\u003eScaling telehealth does more than alleviate patient and provider concerns over the next 12 to 18 months until a COVID-19 vaccine is available. Telehealth can increase \u003cstrong\u003eaccess to necessary care\u003c/strong\u003e in areas with shortages, such as behavioral health, \u003cstrong\u003eimprove the patient experience\u003c/strong\u003e, and \u003cstrong\u003eimprove health outcomes\u003c/strong\u003e. Fundamentally, the integration of fully virtual and near-virtual health solutions brings care closer to home, increasing the convenience for patients to access care when they need it and the likelihood that they will take the right steps to manage their care. These solutions can also make healthcare \u003cstrong\u003emore efficient\u003c/strong\u003e; evidence prior to COVID-19 shows that telehealth solutions deployed for chronic populations can improve total cost of care by 2 to 3 percent.[[footnote 21]] The actual opportunity is likely greater once stakeholders embed telehealth as the new normal (for example, driven by improved abilities to manage chronic patients, potential increases in provider productivity).\u003c/p\u003e\n[[disruptor1up readnext]]\n\u003ch2\u003eWhat actions should healthcare stakeholders take in the near term to shape this opportunity?\u003c/h2\u003e\n\u003cp\u003eActions payers could consider:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003e\u003cstrong\u003eDefine a value-backed virtual health roadmap,\u003c/strong\u003e taking a data-driven view to prioritize interventions that will improve outcomes for priority populations, and develop strategies to digitally enable end-to-care care journeys.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eOptimize provider networks and accelerate value-based contracting to incentivize telehealth.\u003c/strong\u003e Define approaches (beyond the immediate COVID-19 response measures) to reimbursement and covered services, embed in contracting, and optimize networks and value-based models to include virtual health. Align incentives for using telehealth, particularly for chronic patients, with the shift to risk-based payment models.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eBuild virtual health into new product designs\u003c/strong\u003e to meet changing consumer preferences and demand for lower-cost plans. This new design may include virtual-first networks, digital front-door features (for example, e-triage), seamless \u0026ldquo;plug and play\u0026rdquo; capabilities to offer innovative digital solutions, and benefit coverage for at-home diagnostic kits.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIntegrate virtual health into the care delivery approach.\u003c/strong\u003e Given the significant disruptions to providers, payers are reassessing their role in care delivery\u0026mdash;from ownership of care delivery assets, value-based contracting, or anything in between. Consider options in virtual health (for example, platforms, digital-first providers) as a critical element of this approach.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eReinforce the technology and analytics foundation\u003c/strong\u003e that will be required to achieve the full potential of virtual health.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eActions health systems could consider:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003e\u003cstrong\u003eAccelerate development of an overall consumer-integrated \u0026ldquo;front door.\u0026rdquo;\u003c/strong\u003e Consider what the integrated product will initially cover beyond what currently exists and integrate with what may have been put in place in response to COVID-19 (for example, e-triage, scheduling, clinic visits, record access).\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSegment the patient populations (for example, with specific chronic disease) and specialties\u003c/strong\u003e whose remote interactions could be scaled with home-based diagnostics and equipment.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eBuild the capabilities and incentives of the provider workforce to support virtual care\u003c/strong\u003e (for example, workflow design, centralized scheduling, and continuing education); align benefit structure to drive adoption in line with health system and/or physician practice economics.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eMeasure the value of virtual care by quantifying clinical outcomes,\u003c/strong\u003e access improvement, and patient/provider satisfaction to drive advocacy and contracting for continued expanded coverage. Include the potential value from telehealth when contracting with payers for risk models to manage chronic patients.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eConsider strategies and rationale to go beyond \u0026ldquo;telehealth\u0026rdquo;/clinic visit replacement\u003c/strong\u003e to drive growth in new markets and populations and scale other applications (for example, teleICU, post-acute care integration).\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eActions investors and health services and technology firms could consider:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003e\u003cstrong\u003eDevelop scenarios on how virtual health will evolve and when,\u003c/strong\u003e including how usage evolved post-COVID-19, based on expected consumer preferences, reimbursement, CMS, and other regulations.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAssess impact across virtual health solution/service types,\u003c/strong\u003e developing a view of the opportunity for each solution/service type, including expected consumer/provider adoption, impact (for example, to outcomes, experience, affordability), and reimbursement.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eDevelop potential options\u003c/strong\u003e and define investment strategies based on the expected virtual health future (for example, combinations of existing players/platforms, linkages between in-person and virtual care offerings) and create sustainable value.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIdentify the assets and capabilities to implement these options,\u003c/strong\u003e including specific assets or capabilities to best enable the play, and business models that will deliver attractive returns.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eExecute, execute, execute.\u003c/strong\u003e The next normal will rapidly take hold, and those that can best anticipate its impact will create disproportionate value. Don\u0026rsquo;t underestimate the potential of network effect.\u003c/li\u003e\n\u003c/ol\u003e\n\u003chr /\u003e\n[[sidebar 3]]\n\u003cp\u003eThe window to act is now. The current crisis has demonstrated the relevance of telehealth and created an opening to modernize the care delivery system. This modernization will be achieved by embedding telehealth in the care continuum at scale. A $3 billion revenue market has the potential to grow to $250 billion. The seeds for success will be sown in the next few months during the COVID-19 crisis. Healthcare systems that come out ahead will be those who act decisively, invest to build capabilities at scale, work hard to rewire the care delivery model, and deliver distinctive high-quality care to consumers.\u003c/p\u003e"},"isFullScreenInteractive":{"boolValue":false},"hideStickySocialShareBar":{"boolValue":false},"desktopID":{"value":""},"mobileID":{"value":""},"desktopURL":{"value":""},"mobileURL":{"value":""},"desktopPaddingPercentage":{"value":""},"mobilePaddingPercentage":{"value":""},"desktopOverrideHeight":{"value":""},"mobileOverrideHeight":{"value":""},"cerosOembedURL":{"value":""},"cerosRenderMode":{"targetItem":null},"cerosBackgroundColor":{"targetItem":null},"hideByLine":{"boolValue":false},"tableOfContentsTitle":{"value":"TABLE OF CONTENTS"},"accessStatus":{"targetItem":{"key":{"value":"RegisteredUsers"},"value":{"value":"Registered Users"}}},"articleType":{"targetItem":{"displayName":"Article"}},"hasSpecialReport":{"boolValue":false},"contentType":{"targetItem":{"displayName":"Article"}},"sourcePublication":{"targetItem":null},"externalPublication":{"value":""},"mobileReady":{"boolValue":true},"forClientsOnly":{"boolValue":false},"excludeFromClientLink":{"boolValue":false},"originalPublishDate":{"jsonValue":{"value":"2020-05-29T00:00:00Z"}},"footnotes":{"value":"\u003col\u003e\n \u003cli\u003eWe define virtual health as a range of solutions for healthcare provider-patient interactions to occur outside of in-person visits, including telehealth (video/phone), text-based care, e-triage, and remote monitoring.\u003c/li\u003e\n \u003cli\u003eCompile data set, compile.com.\u003c/li\u003e\n \u003cli\u003eCompile data set, compile.com; Exhibit 2 (of the original article).\u003c/li\u003e\n \u003cli\u003eRock Health venture funding database, 2017\u0026ndash;21, rockhealth.com.\u003c/li\u003e\n \u003cli\u003eJenny Cordina, Eric Levin, and George Stein, \u0026ldquo;\u003ca href=\"/industries/healthcare/our-insights/covid-19-consumer-healthcare-insights-what-2021-may-hold\"\u003eCOVID-19 Consumer Healthcare Insights: What 2021 may hold\u003c/a\u003e,\u0026rdquo; June 24, 2021, McKinsey.com.\u003c/li\u003e\n \u003cli\u003eMcKinsey Consumer Health Insights Survey, June 2021.\u003c/li\u003e\n \u003cli\u003eMcKinsey Physician Insights Survey, April 2021.\u003c/li\u003e\n \u003cli\u003eCenters for Medicare \u0026amp; Medicaid Services, \u0026ldquo;CY 2021 Medicare Physician Fee Schedule Final Rule,\u0026rdquo; effective on January 1, 2021, 85 Fed. Reg. 84472, federalregister.gov.\u003c/li\u003e\n \u003cli\u003eCenters for Medicare \u0026amp; Medicaid Services, \u0026ldquo;CY 2021 Medicare Physician Fee Schedule Final Rule,\u0026rdquo; effective on January 1, 2021, 85 Fed. Reg. 84472, federalregister.gov.\u003c/li\u003e\n \u003cli\u003eAdriana Krasniansky et al., \u0026ldquo;H1 2021 Digital Health Funding: Another Blockbuster Year\u0026hellip;In Six Months,\u0026rdquo; Rock Health, July 2021, rockhealth.com.\u003c/li\u003e\n \u003cli\u003eMcKinsey Virtual Health Vendor Database as of June 2021.\u003c/li\u003e\n \u003cli\u003eErica Coe, Lisa Crystal, Kana Enomoto, and Razili Lewis, \u0026ldquo;\u003ca href=\"/industries/healthcare/our-insights/a-holistic-approach-to-addressing-the-us-behavioral-health-crisis-in-the-face-of-the-global-covid-19-pandemic\"\u003eA holistic approach for the US behavioral health crisis during the COVID-19 pandemic\u003c/a\u003e,\u0026rdquo; August 6, 2020, McKinsey.com.\u003c/li\u003e\n \u003cli\u003eMcKinsey COVID-19 Consumer Survey, April 27, 2020.\u003c/li\u003e\n \u003cli\u003eErickson M, \u0026ldquo;Stanford Medicine increases use of televisits to help prevent spread of coronavirus,\u0026rdquo; Stanford Medicine, March 30, 2020, med.stanford.edu.\u003c/li\u003e\n \u003cli\u003ePalo Alto Medical Foundation, \u0026ldquo;Video visits and COVID-19 response,\u0026rdquo; Sutter Health, 2020, sutterhealth.org.\u003c/li\u003e\n \u003cli\u003eBeacon Health Options infographic. Beacon\u0026rsquo;s claims data suggest that compared to April 2019, telehealth sessions increased 5,130 percent in April 2020. (Note: data only include claims paid through May 8, 2020\u0026mdash;additional claims for services rendered in April 2020 may be processed at a later date. Additionally, claims for telehealth services may not include a telehealth modifier, and are therefore not included in our telehealth usage calculations.)\u003c/li\u003e\n \u003cli\u003eMcKinsey scan of telehealth and digital care vendors. Vendor revenues only partially include physician billings (in situations where vendor only charges a monthly usage fee or a portion of the physician fee); total spend including all physician billings for virtual visits is likely to be higher than $3 billion.\u003c/li\u003e\n \u003cli\u003eSee technical appendix.\u003c/li\u003e\n \u003cli\u003eMcKinsey 2020 Virtual Health Survey.\u003c/li\u003e\n \u003cli\u003eMcKinsey COVID-19 Consumer Survey, April 27, 2020.\u003c/li\u003e\n \u003cli\u003eMcKinsey 2019 Digital Healthcare Value Opportunity Assessment.\u003c/li\u003e\n\u003c/ol\u003e"},"contributoryPractice":{"targetItems":[{"displayName":"Healthcare"},{"displayName":"SHaPE"}]},"aboutTheAuthors":{"value":"\u003cp\u003e\u003cstrong\u003eOleg Bestsennyy\u003c/strong\u003e is a partner in McKinsey\u0026rsquo;s New York office. \u003cstrong\u003e\u003ca href=\"/sitecore/service/notfound.aspx?item=web%3a%7b72951f4b-ea7e-4ac6-a815-6c4f8de76338%7d%40en\"\u003eGreg Gilbert\u003c/a\u003e\u003c/strong\u003e, \u003cstrong\u003e\u003ca href=\"/sitecore/service/notfound.aspx?item=web%3a%7b87907fe6-cb7d-4294-8aa7-05e25f4ab6a3%7d%40en\"\u003eAlex Harris\u003c/a\u003e\u003c/strong\u003e, and \u003cstrong\u003eJennifer Rost\u003c/strong\u003e are partners in the Washington, DC, office.\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Yuqi Shi, Rafael Mora, Katarina Pregelj, Jenny Cordina, Eric Bochtler, Eric Levin, Isaac Swaiman, Jennifer Fowkes, Annie Kurdziel, Rustin Fakheri, Rafael Mora, Shubham Singhal, Andrew Gendreau, Tiago Moura, and Kana Enomoto for their contributions to this article.\u003c/p\u003e\n\u003cp\u003eThis article was edited by Elizabeth Newman, an executive editor in the Chicago office.\u003c/p\u003e"},"authors":{"targetItems":[{"template":{"id":"3FBABDB63A094F68B1F8E1BBE1BA124E","name":"Author"},"id":"DFDE988C60A04E3C9497DB256EC7561A","name":"Oleg Bestsennyy","authorTitle":{"value":"Oleg Bestsennyy"},"description":{"value":""},"thumbnailImage":{"alt":"","src":null},"profile":{"targetItems":[{"standardImage":{"src":"/~/media/mckinsey/our people/oleg bestsennyy/oleg_bestsennyy_profile_1536x1152.jpg","alt":""},"emailLinks":{"value":"Oleg_Bestsennyy@mckinsey.com"},"linkedInUrl":{"value":"https://www.linkedin.com/in/obestsennyy"},"description":{"value":"Supports leading healthcare organizations on designing and deploying the next-generation models of care using advanced analytics and new digital technologies"},"locations":{"targetItems":[{"name":"New York","displayName":"New York"}]},"firmTitle":{"value":"Partner"},"thumbnailImage":{"alt":"","src":"/~/media/mckinsey/our people/oleg bestsennyy/oleg_bestsennyy_headshot_988x741.jpg"},"url":{"path":"/our-people/oleg-bestsennyy"}}]}},{"template":{"id":"3FBABDB63A094F68B1F8E1BBE1BA124E","name":"Author"},"id":"EF26F36277E74737AB1975CC662ADDAC","name":"Greg Gilbert","authorTitle":{"value":"Greg Gilbert"},"description":{"value":""},"thumbnailImage":{"alt":"","src":null},"profile":{"targetItems":[]}},{"template":{"id":"3FBABDB63A094F68B1F8E1BBE1BA124E","name":"Author"},"id":"A16928FEB334434697FB1CDC9FC7ACAE","name":"Alex Harris","authorTitle":{"value":"Alex Harris"},"description":{"value":""},"thumbnailImage":{"alt":"","src":null},"profile":{"targetItems":[]}},{"template":{"id":"3FBABDB63A094F68B1F8E1BBE1BA124E","name":"Author"},"id":"6C88DBEA215E4B539592F1C7B6EA5AAB","name":"Jennifer Rost","authorTitle":{"value":"Jennifer Rost"},"description":{"value":""},"thumbnailImage":{"alt":"","src":null},"profile":{"targetItems":[{"standardImage":{"src":"/~/media/mckinsey/our people/jennifer rost/jennifer rost - 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They reflect general insight and may present potential options for consideration based on currently available information, which is inherently uncertain and subject to change, but do not contain all of the information needed to determine a future course of action. The insights and concepts included in these materials have not been validated or independently verified. References to specific products or organizations are solely for illustration and do not constitute any endorsement or recommendation. These materials do not constitute, and should not be interpreted as, policy, accounting, legal, medical, tax or other regulated advice, or a recommendation on any specific course of action. These materials are not a guarantee of results and cannot be relied upon. Future results may differ materially from any statements of expectation, forecasts or projections. 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Sustaining and growing patient use also will likely require active, personalized patient engagement, by both providers and payers, to ensure a positive experience with telehealth. Integration with e-triage/symptom solutions (by either provider or payer) can make the patient experience even more seamless and can leverage artificial intelligence (AI) to guide patients to the most appropriate care. Finally, the ability to access patients\u0026rsquo; medical records and make post-encounter additions may be needed to enable care integration.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eScale the use of fully virtual office visits.\u003c/strong\u003e This change would require going beyond on-demand visits with an unknown provider and embedding virtual health in the \u0026ldquo;brick and mortar\u0026rdquo; healthcare system. Telehealth solutions will likely need to be easier to embed in provider workflows and address security concerns, both of which have been raised by providers as limiting factors to telehealth adoption.[[footnote 1]] Capabilities are needed to allow for more seamless information exchange and sufficiently rich clinical data to be transferred among providers and between providers and patients (for example, ensuring all providers caring for a complex patient have access to the clinical record and can update it based on virtual visits, plus leveraging AI and natural language processes to capture notes in easily sharable forms). In addition, retail diagnostic kits (for example, home pulse oximeters, blood pressure machines) must be widely available, so patients can take basic measurements at home and enable a broader set of care to be delivered virtually. Providers should have a clear end-to-end value proposition for integrating telehealth into their service delivery model (for example, incorporating the value from patient attraction and retention and operating model efficiency, in addition to reimbursement for visits). Payers should also have a clear view of potential outcomes and total cost of care impact (for example, by population and care journey) to inform decisions on provider engagement strategies and reimbursement.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIntegrate \u0026ldquo;near virtual\u0026rdquo; office visits into the care continuum.\u003c/strong\u003e These near-virtual visits will have requirements similar to fully virtual office visits, and scale up the availability of \u0026ldquo;near-home\u0026rdquo; sites of care (for example, workplace and retail clinics). They would be integrated into provider networks and delivery system footprints, and optimize care protocols to guide patients to these sites. Even further data integration will likely be needed. This may include patient data shared across platforms outside of a single health system and patient tools (for example, comprehensive personal health records applications, care navigation tools) that allow patients to manage their care across providers.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eVirtualize home care services.\u003c/strong\u003e This change would likely require increased access to and use of remote monitoring devices, tailored to specific clinical conditions (such as remote continuous glucose monitoring sensors for people with diabetes or remote heartbeat monitors and blood pressure monitors for people with cardiovascular conditions). Providers may be required to integrate use of such devices into care plans. Payers may need to offer reimbursement, and solutions may need to enable integrated access between, for example, primary care physicians, care managers, and at-home caregivers. These services could also require the deployment of supportive patient engagement tools (for example, digital coaching, care plan navigation tools), tailored to patients\u0026rsquo; needs and integrated with communication channels to providers, care managers, and others involved in their care.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eTech-enabled home medication administration.\u003c/strong\u003e This change will have requirements similar to virtualized home care services, as well as tailored digital tools to support monitoring and care delivery (for example, medication adherence tools), and virtual access to pharmacist consults.\u003c/li\u003e\n\u003c/ol\u003e"}},"aboutTheAuthors":{"jsonValue":{"value":""}},"headline":{"jsonValue":{"value":"What changes need to happen to realize the full potential of telehealth?"}},"footnotes":{"value":"\u003col\u003e\n \u003cli\u003eMcKinsey 2020 Virtual Health Survey.\u003c/li\u003e\n\u003c/ol\u003e"},"showShareTools":{"boolValue":true},"backgroundColor":{"targetItem":{"key":{"value":"Lightest Grey"},"value":{"value":"lightest-grey"}}},"gradientDirection":{"targetItem":{"key":{"value":"Bottom Right"},"value":{"value":"bottom-right"}}},"renderMode":{"targetItem":{"key":{"value":"Collapsible"},"value":{"value":"default"}}},"isAboutAuthor":{"boolValue":false},"background":{"targetItem":null},"image":{"src":null,"alt":""}},{"mediaID":{"value":"3"},"description":{"jsonValue":{"value":"\u003cp\u003eOur analysis looked at 2018 claims data representative for Medicare, commercial, and Medicaid lines of business.\u003c/p\u003e\n\n\u003ch3\u003eEmergency rooms and virtual care\u003c/h3\u003e\n\n\u003cp\u003eWe analyzed the emergency room visits and associated primary diagnoses. Using the NYU Wagner ED visit classification[[footnote 1]] research on various categories of the visits, we split the visits into those with non-emergent status (a big portion of which could be highly avoidable if proper self-triage and virtual urgent care tools could be available at people\u0026rsquo;s disposal) versus those that are higher emergency in nature, and are unlikely to be avoided using virtual urgent care. We assigned probabilities of potential to divert each category of these visits via a virtual urgent care offering.\u003c/p\u003e\n\n\u003ch3\u003eOutpatient hospital and office visits\u003c/h3\u003e\n\n\u003cp\u003eWe filtered for visits that have evaluation and management procedure codes and analyzed individual claims to determine whether other additional services and procedures occurred during the visit (for example, administration of infusible/injectable drugs, blood draws, immunizations, physical therapy). We categorized the opportunities:\u003c/p\u003e\n\n\u003cul\u003e\n \u003cli\u003eVirtual office visits: a visit included only evaluation and management and no other procedures\u003c/li\u003e\n \u003cli\u003eNear-virtual office visits: a visit included blood draws/lab tests and administration of immunizations/vaccinations\u003c/li\u003e\n \u003cli\u003eTech-enabled home medication administration: the visit included administration of drugs in a clinic/outpatient setting (for example, administration of \u0026ldquo;J-code\u0026rdquo; infusible/injectable drugs). We included only a portion of the spend associated with these procedures, using our estimates of what portion of the procedure spend could be saved by shifting administration of these drugs from outpatient to home settings\u003c/li\u003e\n \u003cli\u003eOther: all other visits\u003c/li\u003e\n\u003c/ul\u003e\n\n\u003cp\u003eWe conducted clinical reviews to further categorize the various kinds of procedures into high, medium, and low probability of being virtual.\u003c/p\u003e\n\n\u003ch3\u003eHome health attendant services\u003c/h3\u003e\n\n\u003cp\u003eWe filtered for visits and services occurring in a home setting, and looked at what types of services were rendered during such visits:\u003c/p\u003e\n\n\u003cul\u003e\n \u003cli\u003eDirect nursing and attendant services (such as wound care, assistance with daily living routines, administration of IV) which are much less likely to be delivered virtually\u0026mdash;if at all\u003c/li\u003e\n \u003cli\u003eServices that can potentially be delivered virtually (such as evaluation, general assessment, patient and caregiver education, physical therapy, occupational therapy and speech therapy)\u003c/li\u003e\n\u003c/ul\u003e\n\n\u003cp\u003eFor services that did not involve direct nursing or attendant services, we conducted clinical reviews to further categorize them into high, medium, and low ability to virtualize.\u003c/p\u003e\n\n\u003cp\u003eAfter conducting these analyses for each of the commercial, Medicare, and Medicaid data sets, we scaled and projected the spend and utilization to represent national 2020 spend figures, using CMS National Health Expenditure projections.[[footnote 2]]\u003c/p\u003e"}},"aboutTheAuthors":{"jsonValue":{"value":""}},"headline":{"jsonValue":{"value":"Technical Appendix"}},"footnotes":{"value":"\u003col\u003e\n \u003cli\u003e\u0026ldquo;Faculty \u0026amp; research,\u0026rdquo; NYU Wagner, wagner.nyu.edu.\u003c/li\u003e\n \u003cli\u003e\u0026ldquo;NHE fact sheet,\u0026rdquo; Centers for Medicare \u0026amp; Medicaid Services, last modified March 24, 2020, cms.gov.\u003c/li\u003e\n\u003c/ol\u003e"},"showShareTools":{"boolValue":true},"backgroundColor":{"targetItem":{"key":{"value":"Lightest Grey"},"value":{"value":"lightest-grey"}}},"gradientDirection":{"targetItem":{"key":{"value":"Bottom Right"},"value":{"value":"bottom-right"}}},"renderMode":{"targetItem":{"key":{"value":"Collapsible"},"value":{"value":"default"}}},"isAboutAuthor":{"boolValue":false},"background":{"targetItem":null},"image":{"src":null,"alt":""}}]},"boxout":{"results":[]},"globalsidebar":{"results":[]},"video":{"results":[]},"scrollycontainer":{"results":[]},"bespokeinteractive":{"results":[]},"storycontainer":{"results":[]},"interactive":{"results":[]},"sectionheader":{"results":[]},"statementdisruptor":{"results":[]},"fullbleedphoto":{"results":[]},"tocitem":{"results":[]},"quizcontainer":{"results":[]},"generalup":{"results":[]},"twoupmedium":{"results":[]},"accordion":{"results":[]},"factoid":{"results":[]},"promobarwithquote":{"results":[]},"oneupmedium":{"results":[]},"oneupmediumquote":{"results":[]},"gridwall":{"results":[]},"twoupsmall":{"results":[]},"oneclicksubscribe":{"results":[]},"promobar":{"results":[]},"promobanner":{"results":[]},"sectionhero":{"results":[]},"threeuplinklist":{"results":[]},"table":{"results":[]},"explainertooltip":{"results":[]},"isFiveFiftyHorizontalArticle":{"boolValue":false},"fiveFifty":{"results":[]}},"contextItem":{"ancestors":[{"breadCrumbUrl":{"path":"/industries/healthcare/our-insights"},"breadCrumbTitle":{"value":"Our Insights"},"isMiniSite":{"boolValue":false},"displayName":"Insights on Healthcare Systems \u0026 Services","template":{"id":"85FF05307883480F9A4C82123F72FFD8"}},{"breadCrumbUrl":{"path":"/industries/healthcare/how-we-help-clients"},"breadCrumbTitle":null,"isMiniSite":{"boolValue":true},"displayName":"Healthcare","template":{"id":"414C6C64AD35440E9668CF39D8A18CCF"}},{"breadCrumbUrl":{"path":"/industries"},"breadCrumbTitle":{"value":"Industries"},"isMiniSite":{"boolValue":false},"displayName":"Industries","template":{"id":"85FF05307883480F9A4C82123F72FFD8"}},{"breadCrumbUrl":{"path":"/"},"breadCrumbTitle":{"value":""},"isMiniSite":{"boolValue":false},"displayName":"Home","template":{"id":"85FF05307883480F9A4C82123F72FFD8"}}]}}},"placeholders":{"main-area":[],"sidebar-area":[]}}]}},"itemId":"d8974509-3bcc-4439-a706-64f450972af2","pageEditing":false,"site":{"name":"website"},"pageState":"normal","language":"en","pageMetaData":{"alternateLanguages":[{"languageCode":"en","displayName":"English","url":"/industries/healthcare/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality"}],"currentLanguage":"en","navigationLink":"industries","activeItemId":"{3A5EE1BB-D67F-492F-B071-5A4C1EA27A2B}","miniSiteId":"{9355FD92-4458-4A6E-931E-5F4B6015ADB1}","officeCode":"","officeDisplayName":"","subscriptionPracticeData":null,"isAlaisedPage":false,"originalHostName":"www.mckinsey.com","updatedDate":"2023-03-04T09:25:03Z","createdDate":"2021-07-08T18:26:11Z","practice":{"isDefaultPractice":false,"name":"Healthcare","code":"N16","stickyTitle":"Sign up for emails on new Healthcare articles","stickySubtitle":"Never miss an insight. 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