– Anyone looking for that fabled tipping point in telehealth reimbursement and adoption will have to wait a bit longer.
The latest edition of the Center for Connected Health Policy’s State Telehealth Laws and Reimbursement Policies Report finds little to celebrate among connected health enthusiasts, with states making minimal changes to their telemedicine guidelines and Medicaid policies over the past year.
The report, the 16th update since its first release in 2013, finds “very little movement” in the number of states reimbursing through Medicaid for live video, asynchronous (store-and-forward) telehealth or remote patient monitoring, with video-based virtual care still the most popular. What the report did find, though, is that states are tweaking their guidelines to either remove specific barriers or define specific places or uses for which telehealth and telemedicine is allowed and funded.
“For example, Nevada clarified that services covered include physician office services, podiatry, community paramedicine services and medical nutrition therapy and specified that Nevada Medicaid providers are eligible to deliver services via telehealth as long as it is within their scope of practice,” the report, prepared by CCHP Executive Director Mei Wa Kwong, JD, notes. “Some states, such as Maine, have taken steps to clarify within their Medicaid policy that federally qualified health centers and rural health centers can serve as either an originating or distant site provider for purposes of telehealth reimbursement.”
The upshot of this analysis is that states are moving slowly and gradually to embrace connected health. They’re working through the growing pains of a method of care delivery that hasn’t yet garnered widespread support among consumers, providers or the payer market – or a clear understand of value.
The point was made clear at last week’s Connected Health Conference in Boston, which featured a debate between Andrew Watson, MD, MLitt, FACS, Vice President of Clinical Information Technology Transformation at UPMC and President of the American Telemedicine Association, and Ateev Mehrotra, MD, MPH, an Associate Professor of Healthcare Policy and Medicine at Harvard Medical School, over whether telehealth’s costs outweigh the benefits.
Mehrotra, who has issued opinions in the past stating that telehealth hasn’t proven its value, continued that argument in Boston. He noted that some telehealth and telemedicine programs may be showing positive results, but the industry as a whole hasn’t reduced healthcare expenses or improved outcomes for a majority of Americans.
“Because a payer reimburses something doesn’t mean that it is cost-effective,” he added.
Watson countered that the industry “is on the learning curve right now,” and that providers are working to prove that these services are reducing healthcare waste and costs, improving workflows, boosting patient engagement and satisfaction and improving clinical outcomes.
“We’re starting to see the early (signs) of value,” he said.
That argument carries over to the CCHP report, which finds that states are placing value on specific telehealth and telemedicine services, and letting the market grow gradually.
According to the report:
The CCHP report did note some movement in telehealth policy. The most common change implemented since the spring report was a requirement that providers get informed consent from the patient before using telehealth, with seven states adding that condition.
Along with the report, CCHP unveiled two interactive maps allowing users to track current state laws and policies and pending legislation.