While there may be considerable variation in telemedicine policies and reimbursement models from state to state, standards in some specialized types of telemedicine should be consistent, according to new practice guidelines from the American Telemedicine Association.
Telehealth will only succeed if providers are reimbursed at the same rate as in-person care.
That’s the conclusion drawn from a health policy brief developed by Health Affairs and the Robert Wood Johnson Foundation. It argues that the nation’s move from volume-based to value-based healthcare will be accomplished only if providers can be assured of delivering high-value care at a lower cost – and that’s what telehealth promises.
The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, proposed February 3 by Sen. Brian Schatz (D-Hawaii), has strong bipartisan support and would expand Medicare telehealth services, improve care outcomes and help cut costs for patients and providers. Other bill sponsors include Senators Ben Cardin (D-Md.), Thad Cochran (R-Miss.), John Thune (R-SD), Mark Warner (D-Va.), and Roger Wicker (R-Miss.),
The subject of telehealth reimbursement continues to vex the community. For example, Medicare lags far behind. According to the Center for Telehealth and eHealth Law, Medicare reimbursed approximately $14 million total under its telehealth benefit for 2014.
The American Telemedicine Association (ATA) has released the latest edition of its telemedicine state-by-state score card reports. There’s good news and bad news. In the area of coverage and reimbursement, 11 states and the District of Columbia saw their grades improve since September 2014, when ATA released the first editions of these reports, and only two saw their grades decline. But in the area of physician practice standards and licensure, 11 states saw their grades lowered while just six improved. Nevada was the only state to improve in both categories.
The only way that telemedicine services can truly expand and improve healthcare quality across the nation is by developing new state and federal policies that move toward digital and video-based physician-patient relationships. In efforts to support the expansion of telemedicine services, the state of Delaware passed a telemedicine commercial reimbursement statute, according to The National Law Review.
Currently, 21 states do have some form of what’s called a “parity” law requiring private insurance companies to reimburse for televisits, according to the September 2014 review of the laws by the American Telemedicine Association. Pennsylvania is not one of them.