Telehealth Works in Obesity Care, but What’s Next?

A new study in Obesity tells us that telehealth can work just fine in obesity care. But what will the future hold? Payers and patients will likely have their their say. Already, telehealth businesses have had quite a bumpy ride. A prime example would be Teledoc, which saw its stock soar from $83 per share at the beginning of 2020 to $294 – only to tumble back down to $76 most recently.

Without a doubt, telehealth leapt forward in ways that never would have happened without the pandemic. But anyone who says they know exactly what comes next is a deceiver.

Good Outcomes in a Behavioral Program

Kathryn Ross and colleagues studied the effects of moving to telehealth from a face-to-face behavioral program for weight management. They wanted to know if outcomes would be significantly more modest. They had two cohorts. One group of 78 persons had their first ten weeks of sessions in person. They started before the pandemic, and then transitioned to telehealth sessions via video conferencing. The second cohort of 82 persons enrolled after the pandemic began and completed the program entirely via telehealth.

The bottom line was quite simple. People in both groups lost similar amounts of weight – about seven percent of their starting weight. This is both clinically meaningful and comparable to historic controls. Clearly, people can get good results in a telehealth setting.

People Are Using It

Recent survey research tells us that behavioral health is among the top three uses of telehealth by U.S. adults. Some 54 percent of all adults have used it for primary care. Another 26 percent have used it for getting a prescription refill. Nearly as many (24 percent) have used it for behavioral health. Reporting for Insider Intelligence, Sara Lebow writes:

“Patients are most likely to regard telehealth as one piece of a hybrid care plan, coupling virtual visits with in-person ones, as needed.”

But Payers Will Have a Big Say

It works, it’s efficient, and many patients like the convenience of telehealth for obesity care. But the real question is what payers will do next. During the pandemic, health insurers made record profits. So pressure to loosen up reimbursement for telehealth was not a huge problem for them. CMS was helpful with easing Medicare rules, too. But many medical practices will not be able to continue providing telehealth services if payers revert to old ways of doing business.

Already, telehealth visits have dropped as people started back to some pre-pandemic patterns for life. The numbers hit a new pandemic low in October. Nonetheless, people are still using it ten times more often than they did before the pandemic.

The big positive of telehealth is better access to care – especially access to specialized care and behavioral health. So we are eager to see health systems and payers find a way forward to benefit the people they should serve first – patients.

Click here and here for more on the future of telehealth. For the study by Ross et al, click here. Finally, you’ll find perspective on successes and failures of telehealth for obesity here.

Computer, photograph by Taichiro Ueki, licensed under CC BY-NC-ND 2.0

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January 19, 2022