It's About Time: Why Telemedicine is on the Verge of Changing Addiction Treatment Forever
January 12, 2016 Jacob Levenson
As featured in the January issue of Sober World Magazine. Click here to download the issue.
When it comes to blazing the healthcare trail with state-of-the art, cutting edge treatment and innovative modalities, the field of addiction treatment has lagged behind. Other healthcare specialties such as oncology have made tremendous advances in their respective fields. According to the latest research from the National Institutes of Health, cancer survival rates have more than doubled in the past thirty years. Meanwhile 125,000 Americans die of addiction every year, a number that progressively increases. The annual cost of addiction to our society is in the billions. The addiction treatment field's slow embrace of technology has done nothing to advance treatment outcomes for individuals suffering from addiction.
But today all that is changing. Long overdue advances in behavioral healthcare technology are revolutionizing the addiction treatment space. It's about time.
Of the 22 million Americans who meet the criteria for Substance Use Disorder (otherwise known as addiction), only 5 million receive any type of treatment in a given year. In the past ten years, the field has witnessed an explosion in the number of addiction treatment facilities. In one 2,000 square mile county in Florida, there are more than 500 addiction treatment facilities. This equates to an addiction treatment facility located every four miles, yet the need for treatment continues to go unmet for the majority of Americans.
The demand for addiction treatment is the strongest it has ever been yet the reality is providing treatment to those in need would cost an estimated half a trillion dollars! Despite the growth in addiction treatment facilities, there aren't enough beds and there isn't enough money to treat everyone in the traditional inpatient way. The fact that addiction is a chronic disease complicates the situation even further. As with other chronic diseases, treatment for addiction can be lengthy and may need to be repeated. We cannot expect an acute treatment model to effectively treat a chronic disease.
Without taking a technological leap, the economics and infrastructure of addiction treatment cannot come close to meeting the demand. Telemedicine is the technological leap that the field of behavioral health is embarking upon. With its characteristics of scalability, data-driven precision medicine and resource efficiencies, telemedicine holds the promise for addiction treatment that chemotherapy held for cancer treatment thirty years ago.
Prevention and maintenance are essential to successfully treating and keeping any chronic disease in remission. Twelve-step (and similar programs) have understood this premise for 80 years and health insurance payers have begun to catch on. Unconvinced of its efficacy (because addiction treatment providers have struggled to demonstrate its outcomes), health insurance payers have tired of paying for inpatient addiction treatment. When treating cancer everyone agrees that success equates to death of cancer cells and the field has been able to demonstrate this with empirical data. However, identifying successful outcomes in behavioral healthcare can be difficult. Payers, providers and patients have different concepts of success and there is little empirical data.
Payers believe that successful treatment results in a reduction of costly repetitive inpatient episodes. Subsequently, treatment models are evolving and long, extensive stays in residential treatment facilities will diminish. Insurance companies and treatment providers will pivot toward a greater emphasis on disease maintenance and management in order to improve clinical and financial outcomes. Providers can expect to be required by payers to either offer aftercare support services to their discharged patients or coordinate with someone who will. It is common practice for most patients to travel outside of their geographical area for treatment. In essence, upon completion of treatment, payers will be asking providers to embrace telehealth and value-based reimbursements.
Last year there was a significant flow of capital and resources moving into the healthcare IT space. Companies such as Google Ventures and Salesforce have set their sights on healthcare technology as the next great territorial expanse of opportunity. Behavioral health will not go untouched by this influx of financial and technological attention. Google Ventures aims to take life science entrepreneurs and introduce them to technology that can be used to improve healthcare and access to health. Dr. Krishna Yeshnet, General Partner of Google Ventures, was quoted in an April 2015 MobiHealthNews article by saying, a firm believer that we are moving into a value based, capitated world' we can take a life sciences entrepreneur and expose them to the latest machine-learning technology and help them tie that in to their business. It is with this type of vision that telemedicine will make inroads in the field of addiction treatment.
The first generation of telemedicine for behavioral health has arrived. Payers are beginning to define pay-for-performance success measures and providers will soon be required to demonstrate treatment outcomes“ a leap that Medicare and Medicaid took decades ago. Knowing the rates of treatment success of patients after they complete treatment will be more important than ever to the provider. In order to stay in the business of treating addiction and continue their revenue streams, treatment providers will use telemedicine to maintain contact, connection and provide on-going recovery support. Post-treatment support has been shown to dramatically increase a patient's ability to maintain long-term recovery from addiction. Payers are motivated to work with providers who can successfully treat chronic disease states while minimizing the potential for relapse and recidivism.
As we turn our focus to the immediate future, 2016 will be the year that telehealth transforms the addiction treatment space forever. The outcome data derived from post-treatment patient encounters will illuminate treatment modalities that are clinically successful and those that are not. The vast majority of patients will receive long-term supportive care in order to successfully maintain their chronic disease. Within a few years, the majority of addiction treatment providers will have telemedicine divisions associated with their facilities to serve as new revenue centers which will quickly become an important part of their brand identity. The addiction treatment space has historically lagged behind in the utilization of empirical data and innovative technologies. The field will no longer lag behind. It's about time.
Jacob Levenson founded Austin-based MAP Health Management, LLC in 2011 and has served as Chief Executive Officer since its inception. Levenson passionately architects and deploys data-based solutions and healthcare services that empower patients by mitigating potential relapse, increasing predictability for insurance payers and overall outcomes for treatment providers.
