Wednesday, November 1, 2017

The Promise of Telemedicine for American Health Care

NetworkNewsWire Editorial CoverageAlthough amazing advances unceasingly occur in drug development and medical procedures, delivery of health care services to patients has been woefully slow to embrace technology. It took a federal government mandate in 2014 to force health care providers to adopt and demonstrate “meaningful use” of electronic medical records (EMR) in order to maintain Medicare and Medicaid reimbursement levels. Since the mandate, the use of EMR’s has expanded worldwide, improving quality, safety and efficiencies throughout global health organizations. However, health care still, disturbingly, stands apart from all other industries in the efficient conveyance of patient services, which is most acutely felt among the 80+ million Americans that live in underserved rural areas. These regions suffer from a chronic shortage of primary care physicians and, even more critically, specialty care physicians. Urban-based health companies have little incentive to expand footprints into sparsely populated communities, and the promises that telemedicine would fill this critical void have fallen far short of expectations. This dilemma presents an enormous societal challenge, but, conversely, it presents an even greater opportunity for health care companies that provide operative solutions. In this space, Medical Innovation Holdings, Inc. (MIHI) (MIHI Profileis rolling out a disruptive telemedicine business model that positions it among the ranks of larger peers. At the same time, MIHI’s approach greatly differentiates it from its peers, including Teladoc, Inc(TDOC), eWellness Healthcare Corp. (EWLL), Evolent Health Inc. (EVH) and health care behemoth UnitedHealth Group Inc. (UNH).
The telemedicine market in the United States is forecast to exceed $13 billion by 2021, according to research and consulting firm Pharmaion (http://nnw.fm/Y7wSr). An aging population, the rising incidence of chronic diseases and spiraling health care costs are making telemedicine one of the fastest growing sectors in health care. Telemedicine includes multiple medical subspecialties, such as telepediatrics, teleradiology, telepsychiatry and telecardiology, though, often, these services are not being effectively delivered to the people that need them most.
By partnering with rural doctors and Affordable Care Organizations (ACOs), Medical Innovation Holdings (MIHI)  has turned the moribund telemedicine business model on its head to provide access to previously inaccessible specialty medical services.
Traditional telemedicine companies charge a monthly online subscription fee to join a network to access doctors on demand. Patients using this business-to-consumer (B2C) service are forced into a symptom-based medical approach with limited treatment options, since the doctor has no immediate access to diagnostic tests or patient records. The patient is responsible for the monthly subscription fee, as well as doctor charges, because insurance isn’t accepted.  Patients pay more, receive less and have no continuity of care. In essence, these companies are contract service providers that deliver virtual physician interfaces and not genuine medical practices.
This is where MIHI stands apart from its peers. Employing its unique business-to-business (B2B) and B2C models, MIHI connects virtual health specialty doctors with primary care physicians and their patients, reducing cost while enhancing quality of care. Upon partnership with primary care doctors, MIHI provides the necessary tools for expanded patient care and the opportunity for physicians to expand their businesses. MIHI gives the primary doctor a full tele-cart workstation with comprehensive peripherals. When a patient electronically interfaces with a specialist in the local doctor’s office, the specialist has immediate access to multiple diagnostic tests and patient records in order to determine an appropriate course of action based on evidentiary findings.
To provide rural clinics unmatched efficacy and set a new standard in the marketplace, Medical Innovation has entered into an exclusive manufacturing supply agreement for customized NextGen telemedicine equipment that will fit the footprint of any doctor’s office partnered with MIHI and support a blend of in-office and virtual visits (http://nnw.fm/2FeuN). The agreement with MDI Source, a 30-year veteran of the technology industry, will seamlessly couple MDI’s hardware with MIHI’s EMR/PMS software solution.
MIHI doesn’t charge a subscription fee like other telemedicine companies but rather readily accepts insurance, including Medicare, Medicaid and the Veterans Choice Program. The company’s mission is being embraced by the medical community. As indication, MIHI recently engaged a new ACO in Florida, and another, in Georgia, is ready to come aboard, opening the door to over 1,000 new doctors.
Substantially expanding its market reach, MIHI also recently announced the launch of Telemedicos USA (http://www.TelemedicosUSA.com), a Spanish-language health care platform positioned to address the needs of the 58 million Hispanics living in the United States. Telemedicos USA provides the opportunity for MIHI to deliver its specialty services to a significant market demographic and provide needed services for those who are more comfortable in the Spanish language.
“This was a natural evolution for us. We purposefully positioned MIHI for this market because we understand the nuances of providing services to such an ethnically diverse group that make up the Hispanic community,” MIHI CEO Jake Sanchez stated in the press release.
To effectively manage rapid national deployment and maximize operational opportunities, MIHI appointed Kevin Swint to the position of chief operating officer (http://nnw.fm/mGE9V). A 25-year veteran in operations and senior leadership experience in the health and wellness industry, Swint will contribute his wealth of knowledge in IT, retail, health care and executive management to support the company’s corporate vision. With tenures at Arthur Andersen, IDS Scheer, Canon Technology Solutions and IBM, Swint is also a certified professional in Healthcare Information and Management Systems (CPHIMS) and an active member of HIMSS.
“MIHI is well-positioned to drive new value for patients, providers and payers by increasing access to critical health and wellness services and products while seeking to bend the cost curve in pursuit of lower cost and improved outcomes for patients and their families,” Swint stated in the news release announcing his appointment.
MIHI is also developing ancillary products and services that synergistically blend with its mission. The company is negotiating the purchase of a recognized nutraceutical company, pursuing CBD hemp oil therapies for distribution and developing insurance programs to cover alternative medical therapeutics. All of these products and services will dovetail into MIHI’s nationwide network, providing discounts to consumers and added revenue streams to both MIHI and its local physician partners.
Using a subscription-based business-to-consumer model, Teladoc (TDOC) offers 24/7 access to U.S. primary care doctors and pediatricians. Patients receive symptom-based diagnoses when they use the service for non-emergency medical issues such as flu symptoms, ear infections or rashes. Insurance is not accepted, and, in addition to the subscription fee, patients are responsible for the doctor’s “encounter fee.” The fee the patient pays is typically less than the physician charges Teladoc. This means that Teladoc makes up the difference from its subscription revenue.  Early in the telemedicine industry, the company has 11.5 million members and will likely be challenged to achieve its goal of profitability by 2018. With an all-time high of $37.55, Teladoc is trading around $32 per share. The stock surged 100% over the last year, carries a market capitalization of $1.8 billion and has a -20.77 P/E.
Physical therapy focused, eWellness Healthcare (EWLL) offers insurance reimbursable real-time distance-monitored treatments. The company’s business model centers on licensing its PHZIO platform to physical therapy clinics across the U.S. and also as a monitored corporate wellness program. The company is developing marketing channel partnerships with industry association members, existing software-based telemedicine providers and physical therapy billing and practice management providers. Due to its real-time patient monitoring feature, the PHZIO platform is insurance reimbursable. The company has a market cap of $17.3 million, losing $0.24 per share, and a price earnings ratio of -55.
Evolent Health (EVH) supports health systems and physician organizations in their migration toward value-based care, rewarding health care providers with incentive payments for the quality of care they give. Evolent provides an end-to-end, technology-enabled services platform for providers that processes and integrates services and enables providers to migrate their economic orientation from fee-for-service reimbursement to models that reward value-based payment models. The stock trades around $17 a share, down from its 52-week high of $27.50. The company has a $1.3 billion market cap and a -13.94 P/E.
The obvious elephant in the industry, UnitedHealth Group (UNH) operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight and OptumRx. It conducts operations through two business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum. NowClinic, an Internet-based service of OptumHealth, allows consumers to select and interact with independent health care providers. Enrollment is free, and patients pay for 10-minute visits via credit card. Providing what may be deemed only peripheral primary care, NowClinic collects payment, keeps a portion and pays the doctor. There’s no continuity of care, as doctors set available hours and choose to accept or decline patient visits.  Trading at all-time highs around $210, UNH has a market cap of just over $200 billion.
Telemedicine has been around in varying incarnations for nearly 20 years, yet millions of citizens still suffer with little to no critical care. History has shown preceding business models to be self-serving top-down systems that never really practiced community-based medicine. Only through the intelligent integration of telecommunications, information technology and local community-based care will telemedicine genuinely deliver on its long-standing promise. Far flung communities will then be healthier, and the companies that deliver on that promise will be amply rewarded.
For more information on Medical Innovation Holdings visit Medical Innovation Holdings, Inc. (MIHI)
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