In Brief: CMS, state governments, and investors are looking to increase telehealth adoption among consumers and clinicians. Here’s the latest on how telehealth is being implemented across the nation and three indicators to consider in assessing telehealth’s future.
Technology simplifies what was complex and facilitates what was impossible. It crosses boundaries in fields as varied as politics to healthcare, by enabling lifesaving consults for patients in rural communities.
With the range of telehealth spanning from personal health monitoring to clinician engagement, numerous entities, including CMS, state governments, and private companies, are continuing their efforts to bring the functionality to the mainstream.
The adoption of telemedicine will be critical to an organization’s transition to patient-centric, value-based care, and should be considered in every organization’s strategy. Here are three reasons why.
1. CMS Is Testing the Waters
The CMS Innovation Center has been keen to include telehealth in many of the payment reform demonstration projects aimed at testing and assessing the viability of innovative care delivery models. The successful implementation of telehealth within these payment reform projects will provide additional momentum for organizations as they push toward the Triple Aim and will further support CMS’s transition toward a value-based model.
2. Some States Have Already Embraced Telemedicine
Because states have different policies on telehealth, commercial payers’ and Medicaid’s coverage for telehealth services varies dramatically. However, care delivered via live video is one area where reimbursement has increased across the board. As of August 2016, 48 states provide reimbursement for some form of live video within the Medicaid fee-for-service structure. In addition, according to the American Telemedicine Association, 31 states and the District of Columbia have legislated parity for private coverage. This requires payers to cover telehealth services at the same rate as an in-person visit.
3. Investments in Innovative Telehealth Solutions Are Growing
According to Mercom Capital Group, healthcare technology companies benefited from more than $1.4 billion in venture capital funding in the first quarter of 2016 alone, of which $171 million was made in telemedicine solutions. Innovative companies will give hospitals and providers a slew of new tools aimed at providing effective care in an efficient way. Even if payers and regulatory bodies are slow to embrace telehealth, forward-thinking physicians and organizations will be eager to explore new care delivery solutions.
Looking Ahead
Telemedicine, at its core, is a tool that builds a virtual physician-patient relationship while expanding access to care and expertise. With CMS’s goal of progressively tying Medicare reimbursement to quality and value in the coming years, telemedicine can offer flexibility for both clinicians and patients.
And yet, there remain barriers to the widespread adoption of telehealth, including variation in state policy, the need for additional data to demonstrate the direct impact on quality, and the need for greater standardization of telehealth tools.
But while policy lags, the telehealth market continues to expand. With the rise of patient consumerism, the increased need for provider flexibility in delivering care, and the ongoing shift toward value, healthcare organizations that are willing to experiment with innovative solutions to today’s challenges will become the market leaders of tomorrow.
Published January 24, 2017