Several telehealth companies are negotiating potentially high-risk, high-reward contracts that give them a larger stake in patient care.

These payment systems reward them for keeping patients' costs low and penalize them for overspending. For example, they could cover the full cost of care upfront and pocket the savings or attempt to drive down costs and share the savings later. These types of contracts, which are a departure from traditional fee-for-service, reflect the need to find novel ways to get paid for a range of telehealth offerings that don't fit traditional billing models, such as in-app messaging and automated reminders to check vital signs.

"Many of these companies have a model where they're having lots of touchpoints [with patients]," said Ateev Mehrotra, a Harvard University health policy professor, according to Stat. "Payments for a visit doesn't really make sense in that view."

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