Telehealth not only has the ability to increase convenience and improve care for remote patients, it also improves emergency department throughput, and ultimately can reduce potentially avoidable admissions.
While telemedicine capabilities are some of the most exciting existing in healthcare today, inconsistent reimbursement standards continue to hinder successful program adoption. Challenges continue in navigating the state-level variability in regulations and capturing procedures to receive the appropriate compensation and reimbursement. Because of its potential, it is crucial for organizations implementing telehealth to work closely with legislators and insurance companies to ensure reimbursement occurs in a timely and effective manner. Fortunately, the growing interest in implementing telehealth solutions has prioritized reimbursement evolution.
The purpose of this paper is to review the current landscape of telehealth reimbursement and provide insight into strategies for dealing with the complex regulatory environment. For example, when we asked a renown Academic Medical Center in Dallas about its telemedicine capabilities, they give a semi-standard response: “We would like to offer more, but billing is a significant challenge.” We’ll also take a deeper dive and show how one particular organization’s telehealth services are functioning like a well-oiled machine.
Download our Tactical Report on Telehealth Reimbursement >
While the major shift from inpatient to ambulatory care is allowing healthcare systems to remain at the forefront of medicine, it also creates significant challenges with respect to reimbursement, revenue, and patient volume. Exacerbating those challenges, there isn’t a “one size fits all” ambulatory strategy. Just as there is no single type of consumer, there is no single right or highest use of an ambulatory facility. Every patient is unique in how they want to interact with a health institution. And technology, digital solutions, experience, and patient expectations all play a role in their interactions.
In order to build a successful ambulatory strategy, health systems need to approach ambulatory care similar to how a chef approaches a recipe. While you may start with the same ingredients, the different amounts and ways in which they are mixed together will create very different results. It is essential for health systems to identify those ingredients, and then combine them strategically to create the successful recipe that matches their patients’ expectations.
Our ambulatory care team understands the many questions this “recipe” may pose for an organization, which is why our approach recognizes the uniqueness of each health system – targeting our efforts to identify ambulatory marketing opportunities and tailor solutions that correlate with each client’s definition of value.
We recently created a report that outlines the four major categories of ambulatory influencers and defines the building blocks for an ambulatory care site, to guide healthcare systems in tailoring an ambulatory strategy to their own unique brand of healthcare delivery.
READ OUR REPORT – PERSPECTIVES AND FUTURES IN AMBULATORY CARE >
In 2006, CannonDesign saw a rare opportunity for its St. Louis office in one of the city’s signature buildings: a vacant steam-heat power plant built in 1928 as part of the city’s post-World’s Fair economic re-development efforts.
Ten years later, after a major redesign and adaptive re-use process that gutted its interior and created a new-meets-old design concept, the Power House is still generating positive energy for its occupants — our St. Louis headquarters — its neighborhood, and its city. We celebrate its first decade with a look back at its history and impact.
When built, the Power House powered a dozen downtown city buildings, including City Hall, the Kiel Opera House, and multiple municipal buildings and courthouses. Its coal-burning mechanics were visible to the public through the glorious 26-foot-tall arched windows. A significant building for residents, the Power House was a flagship of great civic initiative and a pillar of municipal pride.
But in 1980, after more than a half-century in operation, the plant was decommissioned. Falling sharply into disrepair, its beautiful brick facade became an eyesore; its roof infamously sprouted trees — an ironic last hope for life on this blighted neighborhood cornerstone. A landmark on the National Register of Historic Places, the Power House needed new fuel.
It sat vacant for some 25 years, until CannonDesign purchased it as a new home for our St. Louis regional office. The team quickly realized its potential as a truly unique office environment, and as an emblem of the neighborhood’s rebirth.
Under the project leadership of principal Thomas Bergmann and design leadership of David Polzin, the new design that emerged reflected CannonDesign’s ideals of creativity, collaboration and sustainable design.
“We wanted the office to be demonstrative of our values. We wanted to inject the work environment with an atmosphere that would stimulate design exploration; we created multiple soft spaces for teams to come together to collaborate, and we pursued LEED Gold certification, working with our engineers to understand building performance,” says David.
The challenge was a small building footprint, but a large volume of space. The immense interior was gutted to its brick shell, maintaining the only massive steel plate columns. A whole new interior was injected into the brick shell, calling for “ship-in-a-bottle”-precision construction methods.
All-new HVAC, plumbing and electrical infrastructure were added; concrete foundations were exposed as walls for conference rooms; and two new floor plates were added above the ground floor to make use of the building’s dramatic height. By holding the new floors away from the exterior walls, all employees benefit from access to significant daylight and beautiful beautiful panoramic views of the neighboorhood.
[Learn more about the Power House’s adaptive re-use design in High Performing Buildings.]
The new design was an immediate success for CannonDesign’s 100-employee St. Louis team, as David explains: “The most gratifying part about the building has been the joy of seeing it used as it was intended … it has been transformative for our design culture.”
It also signaled a new day for its community. Since opening, the office has renewed the area’s interest in adaptive re-use of its historical structures, and has inspired a new generation of similar projects throughout the design-build landscape.
For CannonDesign, the project has garnered us with multiple international awards, including the AIA Institute Honor Award, the SARA Distinguished Building of the Year, and the ARIDO Project of the year, among others.
But beyond awards and recognition sits the nearly century-old truth of the great Power House — that in generating and distributing power to a city, even a hallmark building is more than its beams and bricks. When it becomes a city’s hub of energy, growth and later rebirth, it becomes the very cornerstone of its identity.
That the company’s vision in 2006 paid off is an enormous feather in our cap, to be sure. But that it did so in honor of the city’s legacy of design, industry and midwestern sense of community, is an even bigger reward.
Happy new 10th birthday, Power House! A toast from your CannonDesign family, working hard to fuel your next 90 years!
TAKE A CLOSER LOOK AT THE HISTORIC POWER HOUSE >
Each year, members of the CannonDesign education team head to the Society for College and University Planning (SCUP) 2018 Annual Conference to learn about the latest trends in campus planning, and gather insights that will help inform our own designs and plans moving forward.
This year, five CannonDesign leaders – clockwise, from top left: Phil Dordai, Trevor Calarco, Mike Glaros, Jenny Miller and David Coleman – attended and report on their visits here. The conference presented a broad, relevant topic that is top of mind for planners on both the client and architect side: setting the stage for the future of higher education.
Talks explored challenges facing higher education, the impact of politics on campus, and how planners, administrators and designers can adapt to changing generational demands.
A key theme discussed surrounded how campuses are looking for creative ways to insert new or updated buildings within already dense campuses. Right-sizing and right-spacing facilities, finding ways to house multiple curriculums (even if disparate in nature) under one roof, and using data and analytics to find the most efficient use of space are just some of the methods planners are adopting to ensure student, faculty and administrative needs are met.
In a similar vein, campuses are also getting innovative in creating new subtypes of spaces or programs, such as creating new multipurpose student centers/unions that house shared environments. These ladder into the trend of incoming generations being interested now more than ever before in the quality of their experiences on campus. Students want accessible wellness centers, retail, dining, prayer spaces, etc. They want to know that they have spaces where they can proactively spend time, versus reactively finding them in times of need. As a result, planners and designers alike will need to continue to source new ideas for creating these proactive experiences, and give students spaces they want to hang out and spend time in.
A final hot topic of focus was the impact of politics on campus. As with many industries, issues like immigration policies are affecting international student enrollment numbers. And like other industries, it’s predicted that decreases in international enrollment could result in serious consequences for business plans in higher education institutions if those drops in enrollment from last year continue. It remains to be seen what these consequences will entail, but will be important to monitor, and prepare for.
Overall the conference provided interesting takeaways, but more importantly, challenged those that presented and attended to continue to expand their creative thinking within a campus planning framework. It will be interesting to see how these trends and insights are reflected within the physical campus space in the coming years.