A new bipartisan bill has been introduced in the House of Representatives to permit the use of telemedicine in treating patients in long-term care centers such as skilled nursing facilities (SNFs). The Reducing Unnecessary Senior Hospitalizations Act of 2018 (RUSH Act) is intended to reduce hospital admissions by allowing Medicare to enter into value-based care arrangements with medical groups to provide health care through telemedicine consultations; this would increase access to care in SNFs, particularly emergency care, thus reducing the need for hospital visits. Instead, SNF telemedicine would address the urgent situation on the spot.
Medicare is expected to support the bill; the agency believes that nearly half of the admissions from SNFs are unnecessary. Health IT Now, a coalition of patients, care providers, vendors, employers and insurance stakeholders, has announced its support of the legislation, promoting the treatment of patients in their place of residence rather than the hospital.
In order to qualify under the program, SNFs must be certified by the Secretary of Health and Human Services as having met requirements such as having on-site diagnostic equipment and ensuring that residents are permitted to prepare an advanced care directive. Physician group practices can also apply for certification and must have at least one clinician present at the SNF at all times. The clinician can be a physician, nurse practitioner, physician assistant, or advanced trauma support specialist.
To entice group practices and SNFs to enroll, the RUSH Act includes a shared saving program; participants whose expenditures are reduced as a result of the program would be paid a percentage of the estimated annual reduction in cost.
In 2024, Medicare will evaluate the outcome of the program and determine the project’s future accordingly.
The bill is currently being considered by the House Ways and Means Committee, whose leadership is believed to support the act.