This year’s American Telemedicine Association conference just wrapped up this week in Orlando. The theme, Telehealth 2.0, emphasized that when it’s done right, telehealth can benefit patients and providers, and they both prefer it. Throughout the numerous panels and talks, the tremendous growth of the industry showcased innovation, technology, and workable solutions. In case you missed it, here are the top six takeaways that we learned from the conference. Read more
Last week, the American Telemedicine Association (ATA) issued its yearly reports of telemedicine coverage, reimbursement, and standards across the country. In general, telemedicine has consistently become an accepted tool by patients, providers, and third-party payers in all states, with improved coverage and reimbursement in several states. Some state legislatures are removing restrictive requirements for physician practice standards, even allowing them to practice telemedicine across state lines. Read more
In a move aimed at increasing reimbursement for telehealth services, the American Telemedicine Association (ATA) and American Medical Association (AMA) are working together to suggest new CPT codes to the Centers for Medicare & Medicaid Services (CMS) later this month. If accepted, the new codes would allow CMS to recognize and reimburse more telemedicine services. Read more
I admit it’s been too long since I last posted here. Well, I have an excuse…
We’ve been busy getting ready for the HIMSS and ATA 2015 conferences. We’re very excited to be going because we believe this is the year swyMed really makes its presence known in the healthcare space.
At HIMSS we will be introducing some very special technology for home health use as well as new partnerships that will make the deployment and delivery of healthcare even easier. Read more
Recently, CMS (the Centers for Medicare and Medicaid Services) released a proposal of new rulemaking asking for comments on easing “telehealth” requirements for ACOs (Accountable Care Organizations). You can find a wonderful press release here from the ATA (American Telemedicine Association), who was instrumental in getting CMS to reconsider their earlier rules.
Having reviewed the proposal, I had to remind myself that CMS (and, ultimately, the Department of Health and Human Services) is to actually very committed to enabling greater adoption of telehealth, and that their final rules have historically been heavily modified from their proposals. Having said that–and I’m no doctor or lawyer–but I felt this proposal to use waivers rather than simply waiving antiquated requirements just adds red tape where there shouldn’t be any. Does anyone else get that sense?
First, a quick statement of why s Read more
Last week I posted a press release from the ATA about expanded Medicare coverage for Telemedicine. Well, I decided to actually read the 1200 page rulemaking from the Centers for Medicare and Medicaid Services (CMS). You can guess why it’s taken a week to write a follow up article…
Actually, no. I didn’t read the entire rulemaking, only the pages relevant to all things “tele” in medicine and healthcare. In doing so, I was reminded of something interesting:
There are a number of procedures already covered by Medicare without specific telemedicine codes. In fact, of the seven bullet points listing the 22 codes rejected or deleted from inclusion, five noted the affected codes were largely unnecessary due to either an existing telehealth code or because Medicare does not distinguish whether the procedure is tele or not.
Here are a few examples:
Regarding electrocardiograms and echocardiograms: “By definition, Read more
WASHINGTON – Saturday, Nov. 1, 2014 — Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued a rulemaking that includes significant additional coverage for telemedicine services.
“This Halloween, Medicare beneficiaries got an important treat for home care of chronic care management, remote patient monitoring of chronic conditions, and other services when provided via telehealth,” said Jonathan Linkous, CEO of the American Telemedicine Association. The association has been asking CMS for such coverage for over five years.
Buried in an almost 1200-page rulemaking about 2015 Medicare payments to physicians and practitioners were provisions paying for remote chronic care management using a new current procedural terminology (CPT) code, 99490, with a monthly unadjusted, non-facility fee of $42.60. Also, Medicare will pay for remote-patient monitoring of chronic conditions with a monthly unadjusted, non-facility fee of $56.92 using CPT code 99091. Prior to this, Medicare did not pay separately for such services, requiring that such billing be bundled with an “evaluation and management” code.
Also in the rulemaking were seven new covered procedure codes for telehealth including annual wellness visits, psychotherapy services, and prolonged services in the office.
“It has been a long time coming, but this rulemaking signals a clear and bold step in the right direction for Medicare,” added Linkous. “This allows providers to use telemedicine technology to improve the cost and quality of healthcare delivery.”
Read the full document here: http://www.regulations.gov/#!documentDetail;D=CMS-2014-0094-2363. To learn more about telemedicine and public policy, visit http://www.americantelemed.org/policy/overview-news.
About the American Telemedicine Association
The American Telemedicine Association is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and its diverse membership work to fully integrate telemedicine into healthcare systems to improve quality, equity and affordability of healthcare throughout the world. Established in 1993, ATA is headquartered in Washington, DC. For more information visit www.americantelemed.org.
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“Is your cucumber bitter? Throw it away. Are there briars in your path? Turn aside. That is enough.”
Marcus Aurelius, Meditations.
For an industry full of innovators, there’s a distinct lack of innovation in overcoming the reimbursement issue. I believe this is largely because we’ve trained ourselves to continue focusing on reimbursement, rather than discovering how to make the lack of reimbursement work for us or on creating a new model of telemedicine that makes reimbursement an afterthought.
If you believe telemedicine won’t expand until reimbursement is solved, why are any of us involved in Telemedicine? (I assume it’s to improve healthcare, which means we shouldn’t let reimbursement stop us.)
This is not to say that reimbursement is not impo Read more
I attended a webinar last week where the speaker, Jeff Robbins, Director of Neurodiagnostics and Telehealth at Tift Regional Medical Center, recounted the following (paraphrased) story:
Eight years ago Tift had purchased their first batch of telemedicine equipment. For the first year or so they mostly stared at it, with no idea how to go about using it.
They wondered whether they could be reimbursed for anything they used it for and whether they could figure out how to use it and wondered what it could do. They weren’t using their equipment. They weren’t using telemedicine.
Then Jeff said they decided to “put the patients first.” They purposefully forgot about reimbursement, coverage regulations, computer abilities of the doctors, or whether the possible uses fit into the business plan of the hospital. They focused on finding out, through actually doing it, if telemedicine could help their patients. When that happened…
All those things took care of themselves.
Or, as Jeff put Read more
As with last month, this is largely geared to updates about legislation along with reminders about the upcoming Fall Forum conference in Palm Springs, CA, which I’ll have to consider as I live out Orange County.
This month’s takeaways are a little more subdued than last month which had some pretty big news (see here). The ATA had just done a survey on online consultations and had over 500 respondents.
1) 45% of respondents are using telemedicine TODAY. This is fantastic news and, in my mind, is possibly underreported because, as Mr. Linkous and Mr. Capistrant pointed out on the last call (and pointed out in our 3 Things from last month), nearly every institution is already using some form of telemedicine and the boards don’t realize it.
2) Specialty Care and Behavioral Health were the leading segments. Not terribly surprising, as specialty care often needs to use leading edge tools to leverage resources for special care, and behavioral health lends itself well to an old-school videoconferencing set up (patient and doctor meet via video), leading to less push-back on its use while providing maximum benefit to both patients and providers. The industry will have to really work, I think, to make sure providers and CDOs are aware of the more specialized applications and the benefits to be had. Telemedice will not yield a large harvest if we only pick the low-hanging fruit. As if to prove that point:
3) 77% use video, 57% use audio and 28% use medical peripherals. Just over a quarter are using peripherals, while three times that are using video. Being at a video-primary solution provider: Yay! Being a proponent of telemedicine as a whole: We can do better. Even the video-primary medical solutions offer a lot of specialized or integrated offerings that provide more than just adding a visual element to distance care. Again, the question is, how do we get this to the doctors and CDOs?
4) Of the 55% of respondents that replied they are not using telemedicine today, 75% plan to implement it very soon. I present that as Exhibit A to the tipping point naysayers…although I concede that if you responded to a survey about telemedicine from the American Telemedicine Association, you’re probably already predisposed to an interest in telemedicine. Having said that, interest in telemedicine has been on the rise, and 75% of that growing crowd being interested in giving it a shot can only be a good thing.
4) Mr. Linkous pointed out something toward the end that I assumed would be a primary driver (or at least remove an obstacle) but assumed would take several more years: Private insurance is increasingly taking the lead in pushing telemedicine. I’ve been noting that the reduced cost/better outcome/reduced readmissions scenario HAS to eventually turn private insurance into champions of telemedicine. Amongst the names he mentioned were Kaiser Permanente, Aetna, WellPoint, and others.
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