American Well Case Study free essay sample

American Well Benefits of Online Care for patients, health providers, and health insurance companies a)Benefits for patients With Online Care wait times are drastically reduced from days to hours or minutes and patients do not need to travel to the clinic. This service can be accessed at home providing privacy as well as protection from infections that can be contracted from other patients in the waiting area. The service is much cheaper compared to clinic visits. Patients can also instantly seek second opinion. There are no time constraints and PCPs are available on-demand with greater choice. The patients can easily manage and access their medical records and information online. Online care will allow for immediate professional medical attention leading to better and earlier diagnosis of disease. It is mentioned in the case that 17% of people under age 65 paid out of pocket or avoided clinic visits due to high costs. These people can also benefit from using this service. Team Edition is designed to enhance and improve the patient experience by providing a direct and seamless connection to specialists while the patient is in the PCP office. The lower cost access to specialty care offered through Team Edition should ave growing appeal as consumers pay increasingly more out of their own pocket for healthcare (Ofek and Laufer, 201, p. 9). Ido and Roy Schoenberg consider their target market for this new product to be healthcare delivery systems, such as hospitals, clinic chains and other physician groups (Ofek and Laufer, 2011, p. 14). They should also include home health agencies, skilled nursing facilities and any other clinical services that would benefit from better connectivity with primary care. Both primary care and specialist physicians can use Team Edition to help improve efficiency. For specialists in particular, this product offers a lower cost solution for providing expertise to rural and outreach locations. A tool that connects primary care and specialists can also provide a more efficient way to deliver multi-disciplinary care and provide chronic disease care. This is important in the new landscape of accountable care organizations (ACOs) and healthcare exchanges, particularly since ACOs are required to create ways to promote evidence-based medicine and patient engagement, report on quality and cost measures, and coordinate care. The patient-centered medical neighborhood requires connected care delivery between PCP and specialist (Standards for Patient-Centered Medical Home, 2011). Furthermore, with the ever increasing shortage of primary care and specialty physicians and accelerating efforts to reduce healthcare costs, practices are being challenged to take on larger patient panels. This means practices are looking for ways to care for patients, manage populations and deliver quality care without bringing the patient into the office. Team Edition offers a new path to clinical collaboration and co-management. Some barriers to adoption of this technology include defining payment to specialists and PCPs. Reimbursement remains a problem. Medicare only reimburses for telemedicine if the originating site (where the patient is) is in a Health Professional Shortage Area (HPSA) or in a county that is outside of any Metropolitan Statistical Area (Reimbursement issues for telehealth, 2013). Many other health insurers follow The Centers for Medicare and Medicaid (CMS). This barrier can be at least partially overcome if American Well leverages its existing relationships with health insurance networks. Otherwise, without a clear mechanism for reimbursement, it will be challenging to develop a robust specialist network. The carrot for insurance companies is that telemedicine is still less expensive than paying a PCP and a specialist for traditional visits. Another barrier is technology. According to an article in Executive Healthcare, rural and elderly populations have less access to broadband structures (Pryke, 2013). The Federal Communications Commission (FCC) states that up to 70 percent of clinicians outside the metropolitan districts do not currently have access to broadband structures and have to pay three to four times more than their urban counterparts (Pryke, 2013). Promising new market opportunities American Well has also been considering the following new market opportunities: (1) developing online kiosks for Retail Clinics1; (2) Expanding American Well platform to pharmacy chains; (3) expanding internationally; or (4) explore the software’s applications beyond the healthcare industry – legal or accounting services as examples. Developing kiosks for Retail Clinics would require more development capital and represent a new business segment that would require new resources. Furthermore, I believe that international expansion and expansion into other business sectors such as legal consults and accounting are premature for American Well. The company’s products have not completely taken root in its home market – the U. S (Ofek and Laufer, 2011). Expanding internationally without having a sound base to work from represents a risk for the company. International expansion would require American Well to completely re-organize its company structure and would require significant financing. Without a sound base to work from and complete product adoption expansion into other markets seems to add unnecessary complexity to the business. Team Edition is a natural extension of the services already offered by American Well. Offering this service might actually foster adoption of the core American Well online system because it offers clinics a fuller menu of telemedicine services. The addition of Team Edition would not add significant development costs to American Well as the company intends to use its existing technology platform for this product. In addition, Team Edition could help differentiate American Well from its competition. This product helps American Well offer a complete range of services for insurance companies and physician offices and will support practices moving into new care delivery models such as medical homes. Finally, one of American Well’s customers is sure to develop a similar offering since this is such a natural extension of telemedicine and would fill a significant need in the marketplace – timely, convenient access to specialists. The company should not miss the opportunity to be first-to-market. 1 Retail clinics are health care clinics located in retail stores, supermarkets, and pharmacies that treat uncomplicated minor illnesses and provide preventative health care services. What is the potential of online care to revolutionize the healthcare industry? Better mobile technologies, more mature electronic health records and clinical decision support systems as well as shortages in medical experts are helping to fuel interest in telemedicine (McGee, 2012). Telemedicine is a  rapidly growing area of healthcare in the United States. There are currently about 200 telemedicine networks, with  3,500 service sites in the US (McGee, 2012). Over half of all U. S. hospitals now use some form of telemedicine (McGee, 2012). Around the world, millions of patients use telemedicine to monitor their vital signs, remain healthy and out of hospitals and emergency rooms (McGee, 2012) The implementation of the Obama administrations Patient Protection and Affordable Care Act (PPACA), has further intensified the focus on telemedicine as a way to treat an increasing number of people who will be seeking health insurance and medical services. Telemedicine technology enables healthcare personnel to meet this increasing demand without delays in treatment or rationing care (McGee, 2012). The FCC recently released data that confirmed that remote patient monitoring and e-care devices could save the healthcare industry upwards of $700 billion over the next 15 to 25 years (Lewis, 2012). Healthcare already accounts for 17 percent of Americas GDP and is predicted to climb to 20% by 2020 (Lewis, 2012). Strategies that help deliver quality care at a reduced cost are expected to gain ever increasing traction. Recommendation to American Well to pursue next-generation options My recommendation is for American Well to launch Team Edition and forgo the opportunities listed on page 3 with the following caveats: (1) American Well should consider health insurance companies as customers for this service in addition to its target audience healthcare delivery systems and clinics. Specialty care is higher cost than primary care and represents even more significant saving s for insurance companies. Furthermore, insurance companies can help address some of the reimbursement issues for specialists. 2) American Well should conduct some survey research to further gauge market readiness. Attracting specialists to participate will be the key to success. The drivers for specialist practices are different than those of primary care. For instances, their salaries, and therefore opportunity costs, tend to be higher, and they are often balancing their practice with hospital responsibilities. A robust program w ould require availability of a variety of specialists. Reaching critical mass and making it worthwhile for specialist participants could be complicated. Of 100 patients maybe only twenty need a referral to a specialist and of those twenty maybe only five need to consult with a cardiologist. I would recommend that Team Edition be launched as a pilot, perhaps with a particular health system in partnership with an aligned health plan first so the company can work through some of the complexities identified above before launching the product to a broader market. Finally, I believe it is possible for American Well to position Team Edition as an expansion and enhancement to its original Online Care System.