A couple of great articles discuss examples of Telehealth programs being run by large medical centers, as well as where the state of policy is today and what might be coming from Medicare.
The Sept/Oct edition of Health Data Management has a fairly in-depth story on specialty related telehealth programs already operating at UPMC, and an interesting section on the “bricks and clicks” primary care options at Stanford. You may be surprised to learn that UPMC has 62 telemedicine related services! They have taken the plunge, even in advance of fully monetizing the services, because they recognize it extends their reach, patients love it, and the evolving value-based payment landscape is building an ever-stronger business case.
Health Affairs in August published a terrific summary of the state of affairs in laws and regulations Health Policy Brief Telehealth.
Some key points:
Medicare is the laggard here. There is some hope that they will modernize – Congress is considering the Medicare Telehealth Parity Act, but we all know how the wheels of change move (or don’t) in that body.
Currently, Medicare only reimburses for synchronous communications for the 20% of patients in rural areas, and the patient has to show up and receive the telehealth visit at an “originating site” – which is basically a healthcare provider of some sort. Neither remote monitoring, such as for CHF patients, or asynchronous communication – like email or store and forward photo and video services, are covered under Medicare today.
Strangely, Medicaid in many states is leading the way. Levels of payment and types of services covered vary by state and both articles note that 49 states now cover at least some area of telehealth in their Medicaid programs.
A lot of advancement is being driven by consumer demand for convenience care, and employers are increasingly offering options, many times through free standing telehealth companies.
If you are a healthcare provider system – what are you doing to launch telehealth options in your organization? As the system continues to evolve to value-based payment, the financial incentives are going to move in favor of telehealth, and groups that have taken the plunge in advance of payment reform will be better situated to benefit, and keep their patients. Successful efforts require clinical leadership and workflow changes that must be thought through. Do you have a clinical leader who is a champion of this work?