Caitlin Clement|7/27/2023|8 min read

How to Scale Your Telehealth Business (Successfully)

A guide to growing your digital health company

Asian, female physician smiling while on virtual care call with patient

First, we’d like to say congratulations! If you’re here, then that means you're ready to grow and expand your telehealth services, which is a huge accomplishment. Establishing yourself in the digital health market can be daunting, and while you conquered the first hurdle (launching), we’re here to give you the tools you need to make it scalable. Let’s get started. 

Intuitive, full-stack technology platform

Having a secure, core telehealth solution is crucial to not only your scalability, but the scalability of telehealth as a practice. Right now, most healthcare organizations are managing multiple health platforms at a time, each for different functionalities, that weren’t built to integrate with one another.

Meaning, patients are booking their appointments on one platform, the providers perform the telehealth visits on a separate video conferencing platform and then providers are charting on their internal EHR platform. 

This back and forth between systems is not only cumbersome, but it can actually become a health data security risk. Transferring patient data across systems leaves room for errors and potential omission of valuable health data.

Becoming more interoperable by investing in a full-stack health platform and EHR will save your providers and patients so much time. Not to mention, that added efficiency means more time back to your providers, less patient data errors and overall better patient outcomes. 

Expand your payer network

If you’re currently operating on a cash-only model, it might be time to start working on building your payer contracts network. By making your services reimbursable through insurance, you’ll open up the door to a much wider patient population. 

However, gaining these payer contracts can become a headache if you don’t have a well laid out plan and dedicated, experienced resources to execute it. Here’s what you need to know to start offering covered services.

Do your research first

If you’re reading this, you’re already off to a good start. It’s important to get an idea of which payers are going to make the most sense for you. Here are a couple of tips to help narrow it down:

  • Contact hospitals in the states or regions you’re looking at and see who they’re in-network with. Chances are, if they think it’s necessary, a large part of the population is covered by it.

  • Similar to hospitals, contact large employers in the states or regions you’re looking at to see who they’re in-network with.

Establish physical offices with Professional Corporations (PCs)

When you’re looking to acquire a contract with a payer, some may not even entertain the idea if you don’t already have established physical offices in local jurisdictions. Especially for government payers like Medicare and Medicaid, that are state-by-state coverage. 

This is to ensure those specific communities are provided with healthcare access. As you can imagine, this takes years to develop and can be tricky for telehealth companies to orchestrate properly. Check out our other blog dedicated to building PC groups and “friendly PC” models. 

Insurers require HIPAA compliant software

This requirement is the reason we put the technology platform first, otherwise building a payer network would be top of the list.

Before you even start the enrollment process, double check the patient visit software you plan to use meets HIPAA privacy requirements. That means having secure messaging solutions, hosting services and secure cloud storage services to keep their personal health information (PHI) safe.

Luckily, telehealth compliance is only a click away with OpenLoop’s regulatory and legal services. Within our package of benefits we offer HIPAA, FWA and CCT coaching to help you stay up-to-date on virtual care compliance. 

Or, tap into our pre-vetted and Android/iOS compatible telehealth technology platform that’s customized for your business and patients. The best part? It has HIPAA functionality built right in!

If you want a deeper dive into the enrollment process, its bottlenecks, timelines and how each telehealth visit is billed, check our other payer coverage resource here.

An efficient, end-to-end RCM solution

Revenue cycle management systems can be wrought with errors and inefficiencies, so it’s crucial to your scalability that you optimize it as much as you can. Nowadays, this means investing in RCM technology and dedicating a team of RCM experts to your reimbursement and enrollment process. 

Another great option if you’re looking to scale your telehealth business but don’t have the resources to build the internal RCM team you need is outsourcing. It gives you access to experts in RCM, but it can also be a very cost effective way to ensure a proven, end-to-end RCM solution. 

You don’t have to put in the resources to build workflows and integrate systems, it’s already done for you. Often, they can even customize their proven workflows to align with your unique patient pathways. 

The more you can work towards interoperability (there’s that word again), the better. Here are five other benefits you might experience when outsourcing your RCM to a third-party vendor.

  • Intuitive RCM technology infrastructure and integration

  • Up-to-date regulatory compliance 

  • Cost efficiency and decreased claims denials

  • Maintained focus on patient care

  • Faster billing, payments and revenue generation

Grow your clinician network

In order to give your patients the best health experience possible and expand your patient pool to meet demand, you have to grow your clinician network. Here are five areas to keep in mind.

1. Recruiting and onboarding

Finding clinicians that align with your salary expectations, scheduling, location (in-person or virtual), patient needs and corporate values can be a tricky endeavor. It gets even more challenging when you narrow in on required specialties.

To find and hire 20 clinicians yourself, it’s typical to employ a team of four full-time recruiters tasked with placing and promoting the role, verifying employment information, interviewing candidates then actually securing them for the shift(s).

If hiring that many internal recruiters sounds like a lot to bite off, outsourcing a full-vetted clinician network is another route. 

2. Licensing and credentialing 

This area is extremely high stakes and could cost you tons in penalties, lawsuits and reputation damage if not fully vetted and maintained diligently. It’s also quite costly and time consuming on the frontend to manage for your clinicians.

Medical licenses are required for each clinician for every state they support patients in. It will cost about $1,000 per license per state and take three to six months to obtain each. If your clinician is serving patients all over the U.S., the resource requirements add up quickly. 

That’s why telehealth companies typically hire multiple full-time specialists to stay on top of these 24x7. From there, each clinician needs to be credentialed with an in-network insurance payer at $200 per payer. Finally, there’s malpractice insurance that will run you about $24,000 a pop on average, although the amount does vary by specialty and state. The employer typically foots these bills for the clinicians.

3. Salary

Once you find and verify the right candidate, it’s time to talk pay. On average, physicians pull in around $225k per year and expect guaranteed hours to support that salary. 

When you’re a startup looking to scale, it’s oftentimes easier to hire fractionally instead of full-time, so that’s something to seriously consider. Keep in mind, this does come with the juggling of more clinicians, more licenses and more shifts to coordinate. 

4. Schedule

As we mentioned above, if you decide to go the fractional hiring route, be prepared to manage multiple part-time clinicians across different specialty areas, states and shifts. Planning and communication are key to ensuring a seamless experience for the clinicians and your patients receiving their care.

Remember, if you’re conducting visits virtually, there’s an added technology element to keep top-of-mind. Be sure your clinicians are familiar with the devices, applications and “webside manner” etiquette. This should take center stage during onboarding, and is also something an experienced telehealth partner could guide you through.

5. Payroll

If you are working with part-time clinicians, you also need to be ready to track and manage payroll. This includes creating a time tracking system for per-visit or hourly encounters. Most clinicians like to be paid every two weeks or even sometimes weekly. Your team will be tasked with creating the proper accounts payable processes in order to make sure everyone is paid correctly and on time.

HIPAA and CPOM compliance laws and regulations

I’m sure this is top of mind for your virtual care company, but we have to mention compliance. While there are many regulations to adhere to, HIPAA and CPOM are two of the major ones that should be in every conversation when trying to scale. 

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is one of, if not the, most prominent set of regulations within the healthcare industry in regard to patient health information (PHI) security. Especially when choosing a HIPAA compliant EHR platform, which is essential for winning payer contracts. The following are the key HIPAA implementation telehealth companies must maintain as they scale:

Security Risk Assessment: As you continue to scale, it’s important to do additional assessments for any new security risks. 

Data Encryption: Implement strong encryption mechanisms for data transmission and storage to protect PHI from unauthorized access or disclosure. 

Access Controls: Use robust access controls to restrict PHI access to authorized individuals only. This involves unique user IDs, strong passwords, multi-factor authentication and role-based access control (RBAC).

Business Associate Agreements (BAAs): Establish legally binding agreements with any third-party vendors or business associates who have access to PHI. BAAs ensure that these entities also comply with HIPAA regulations and take appropriate measures to protect PHI.

Employee Training: Train employees on HIPAA regulations, security protocols and best practices to handle PHI. 

Secure Communication Channels: Utilize secure and encrypted communication channels, such as secure messaging platforms, virtual private networks (VPNs) or other secure telehealth platforms to transmit PHI between healthcare providers and patients.

Incident Response Plan: Develop an incident response plan that outlines steps to be taken in case of a security breach or unauthorized disclosure of PHI. Be sure to update as you scale.

Privacy Policies and Notices: Maintain clear and comprehensive privacy policies and notices that inform patients about their rights regarding their PHI, how their information will be used and how their privacy will be protected during telehealth interactions.

Outsource Legal and Regulatory Services: If you lack the internal resources to keep up with ever-evolving regulatory compliance or you're ready to allocate internal resources elsewhere as you scale your services, outsourcing to proven experts in the space can be a great strategy. 

For a complete list of HIPAA safeguards to look out for when choosing an EHR platform, check out our most recent whitepaper that dives deeper into how to navigate HIPAA and CPOM compliance when scaling. 

Corporate Practice of Medicine (CPOM)

The corporate practice of medicine doctrine prohibits corporations from practicing medicine or employing a physician to provide professional medical services. This doctrine arises from state medical practice acts and can be boiled down to two public policy concerns. 

1. Prevent corporations from prioritizing profit over patient-care.

2. Prevent non-licensed control of medical practices.

Professional Corporations (PCs) and CPOM Compliance 

Here are those PC groups again! In order to adhere to CPOM regulations and its state-by-state variations, it’s important for telehealth companies and practices to establish PC groups if looking to expand in more than one state.

Key features of professional corporations include:

  • Limited Liability: Shareholders of a professional corporation generally have limited personal liability for the debts and obligations of the corporation. This means that personal assets of shareholders are typically shielded from business-related liabilities.

  • Licensing Requirements: PCs are subject to specific regulations and licensing requirements imposed by professional regulatory bodies or state authorities. Shareholders of the corporation must usually hold the required professional licenses and meet any other professional qualifications.

  • Governance: PCs typically have a board of directors and officers responsible for managing the corporation's affairs. The board of directors is usually composed of licensed professionals who are shareholders in the corporation. Some states require all officers, directors and shareholders be licensed within that state, others allow a minority percentage to be unlicensed professionals.

  • Taxation: PCs may have different tax treatment depending on the jurisdiction and corporate election. In some cases, they are taxed similarly to regular corporations (PC), while in other instances (PLLC), they may be treated as pass-through entities, where profits and losses flow through to the individual shareholders' personal tax returns.

Scale your telehealth business faster

As you can see, a lot goes into scaling a successful telehealth practice. Thankfully, there are experts in the industry dedicated to delivering services that will enhance your operations to save you time, money and headaches each step of the way— becoming a valuable extension of your team.

At OpenLoop, we’re a telehealth company dedicated to empowering other telehealth companies through many years of virtual care delivery experience. We set ourselves apart with a 24x7 real live team that takes the time to understand your business and patients to match you with pre-vetted, certified clinicians aligned to your values and brand. 

We take on many of the daunting tasks listed earlier, including credentialing, licensing, staffing and scheduling to keep you focused on driving business growth. Best of luck as you scale your own virtual healthcare delivery services!

Interested in what we can do for your organization? Get in touch here!

Our full suite of white-labeled Telehealth Support Services include: