For the Sake of Patients and Providers, We Need a Uniform Approach to Telemedicine Reimbursement

Is it possible for hospitals to obtain telemedicine reimbursement? Most of us are aware of the shortage of physicians, exacerbated in many geographic areas, and typically worst at night and on weekends. Physicians utilizing telemedicine technology have demonstrated time and time again the ability to provide quality care via telemedicine on a 24/7 basis virtually anywhere. It is not technology or physician capability that is impeding this substantial ability to bring care to patients when they need it, regardless of location; sadly, it is reimbursement obstacles that have been thrown up by payors that minimize this potential being realized.

A thorough wrap-up of the status of telemedicine reimbursement parity laws, published Aug. 15, 2016, in HealthAffairs online, provides excellent detail on the woeful lack of reimbursement uniformity from state to state for telemedicine service providers and remote care. The Affordable Care Act made a move toward encouraging telemedicine services, but didn’t establish consistent guidelines for telemedicine reimbursement that benefits all patients. That’s a problem.

Disparity from state to state

The bottom line is that current federal and state law varies widely on how Medicare, Medicaid, and private insurers can provider telemedicine reimbursement for services. Some services are not reimbursed, or are reimbursed at lower levels than in-person physician services. This continues to be a major challenge in the effective provisioning of telemedicine to the people who could benefit from it.

In particular, Florida’s legislature has had difficulty deciding how to regulate the use of telemedicine. At last report, a task force had been appointed to recommend solutions for reimbursing telemedicine providers. And we support organizations, such as the American Telemedicine Association, that work toward equal access to telemedicine care for all Americans.

The benefits are clear

While some lawmakers and physicians express concerns that telemedicine should be approached with caution and might lead to improper diagnosis and treatment, the evidence on the other side of the argument is mounting a hundred-fold. The key points:

• Patients want it. Consumer demand for telehealth services is on the rise. We see it every day as more consumers understand its benefits: access to care, efficient service, shorter wait times in doctor’s offices and hospital EDs.
• It saves money. A 2007 study by the Center for Information Technology Leadership found that the combination of store-and-forward, real-time communication, and remote patient monitoring in EDs, prisons, nursing home facilities, and physician offices could save the United States $4.28 billion on healthcare spending each year.
• It increases access to and provision of quality healthcare. In medically underserved communities, we continue to see the substantial benefits it brings to patients who might otherwise have limited or nonexistent access to physician care.
• Patients and families get care in their own communities. Telemedicine provides the opportunity to “bring the doctor to the patient,” rather than transporting patients hundreds of miles for the exact same care.The individual success stories we see with our telemedicine programs are inspiring; the collective results impressive. As we’ve said many times, there are tangible and intangible values that hospitals, doctors, nurses, patients, and families receive from properly designed inpatient telemedicine programs that typically dwarf the value of reimbursement of professional fees. If appropriate professional reimbursement for the services were consistently available, these programs would be more widely accessible to patients. We’ll be sharing some of those success stories in future blog posts. In the meantime, we welcome your comments on this topic.