MedPAC staffer Amy Phillips, for instance, pointed out that “a 2011 study found improvements in mortality for patients with congestive heart failure using telemedicine, but research published the following year found the opposite,” according to the Politico coverage of the MedPAC meeting on Nov 6.
Although MedPAC is not ready to offer a glowing endorsement of telemedicine at this point in time, there are indications that Washington is taking a closer look at the field. In July, 4 members of the House of Representatives introduced the Medicare Telehealth Parity Act (HR 2948). The bill aims to improve coverage for telemedicine services for Medicare patients and eventually put it on par with in-person patient visits. If HR 2938 is enacted, it would provide Medicare coverage for telehealth services in rural, underserved, and metropolitan areas and expand telestroke services.
MedPAC’s concerns about telemedicine being an effective solution are well founded. To date, there are still mixed literature results on this. But it underscores the concerns everyone has about Telemedicine as a whole, and an odd Catch 22. Until reimbursement for telemedicine meets in person visits, we won’t see innovation in this area and real change.
Right now, innovation has stalled because major players are waiting on the sidelines to see if legitimate reimbursement solutions will actually happen. Several telemedicine type services have been available already. Google had a HIPPA compliant video platform — Google Helpouts — until it was pulled recently. The biggest player right now is Teledoc — but these are platforms that don’t rely on an insurance reimbursement model.
With Medicare / Medicaid reimbursements overall declining, many physicians have stopped taking these patients. Telemedicine offers physicians the ability to see more patients with lower overhead. You could see a boom in access to care if there was some sort of reimbursement parity.
But for us to see legitimate public health change, from telemedicine visits and innovation in this arena, physicians need the reimbursement dollars to be there.
What criteria to consider when selecting doctors for TeleMedicine network? How to verify their competence and certification?