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young man sleeping with CPAP machine

Sleep Telemedicine Promises to Ease Shortage—But Only If It’s Reimbursed

As telemedicine has evolved over the years, sleep medicine has advanced accordingly to incorporate the growing technologies into the field. As described by Barry Fields, MD, MSEd, an assistant professor of medicine at Emory University School of Medicine and a sleep physician at the Atlanta VA Medical Center in a recent interview with Pulmonology Consultant, sleep telemedicine first began as telephone calls between the patient and provider. Now, anyone with a smartphone and the appropriate app can participate in synchronous (real-time) sleep telemedicine. Read more

Two doctors reviewing brain scans on hospital computers

Telemedicine Reimbursement, Savings, and Care—Oh, My!

The Centers for Medicare & Medicaid Services has accepted five new Current Procedural Terminology (CPT) codes to allow physicians to be reimbursed for telemedicine specialist consultations and to expand remote patient monitoring conducted via telemedicine. The telemedicine reimbursement codes were originally proposed by the American Medical Association; now approved, they took effect on Jan. 1, 2019. Read more

handing over stacks of cash

Did Medicare Overpay for Telemedicine Reimbursement?

Amidst concerns that current levels of telemedicine reimbursement are insufficient to support the demand for telemedicine visits, a 2018 report by the Department of Health and Human Services Office of Inspector General (OIG) reveals that a significant portion of the Medicare telemedicine payments that have occurred were actually improper; they never should have been approved in the first place. The overpayments amounted to roughly $3.7 million—a sizable chunk of the total $13.8 million in payments that Medicare made in 2014 and 2015. The reasons for the disallowed claims were numerous and varied. Read more

paper money falling into piggy bank

Telemedicine Cost Savings Are Just Beginning

Telemedicine has long been touted as a balm for rising healthcare costs. Indeed, a 2017 report from the Rural Broadband Association found that annual telemedicine cost savings averaged $20,841 per hospital in the US. Some believe that telemedicine, including remote patient monitoring, could shave a combined $4.3 billion off the country’s yearly healthcare bill. While a first glance at the cost savings looks promising, digging deeper reveals that several obstacles are still preventing us from maximizing the benefits of telemedicine; this suggests that, with full support, cost savings could be driven higher yet. Read more

farm along country road in Southern York County, PA

Rural Telemedicine Growing More Slowly than Expected

Telemedicine has been touted as a revolutionary solution to the shortage of physicians in rural areas, but a recent study published in JAMA suggests that although this trend may have begun, it has not yet snowballed as expected. Between 2005 and 2017, 83.3% of patients with commercial insurance who used telemedicine services lived in urban areas. This suggests that they were not driven to use telemedicine by a shortage of physicians, but rather by other factors such as convenience. Such a surprising result seems contrary to the belief that rural patients are seeking greater access to physicians; if this were the case, then one might expect more rural telemedicine than urban telemedicine. Read more

bar graph growing upwards w magnifying glass

Telemedicine Usage Exploding since 2005

According to a new study published in JAMA, telemedicine use has been skyrocketing since 2005. Researchers, curious about the adoption pattern of telemedicine, examined the trends in telemedicine use and its association with factors such as parity legislation and physician supply within a large commercial health plan. They found that from 2005 to 2017, telemedicine usage grew from 206 visits in 2005 to about 202,300 visits in 2017. Telemedicine usage expanded the most in primary care and telemental health (telepsychiatry); this rise, they surmise, may be largely due to increasing payer coverage for direct-to-consumer telemedicine. Read more

"equal pay" street signs

Telemedicine Payment Parity Fails in Pennsylvania

Pennsylvania remains one of the few states that still lacks a dedicated Telemedicine Act. In an attempt to address both telemedicine payment parity and professional regulation in one Act, Pennsylvania Senate Bill 780—including its clause on coverage and reimbursement for its use—was unanimously approved last June by two Pennsylvania Senate committees, the full Senate, and the House Professional Licensure Committee. However, it failed to pass in the House of Representatives in October. Read more

hands holding pills

SUPPORT Act Eases Way for Telemedicine for Opioid Treatment

This week, on the one-year anniversary of declaring a national opioid public health emergency, President Trump signed into law the bipartisan “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act,” known as the “SUPPORT Act” for short. The goals of the legislation are to reduce “access to and the supply of opioids” and expand “access to prevention, treatment, and recovery services” through multiple angles, including via telemedicine for opioid treatment. Read more

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Aging Population Welcomes Telemedicine for Seniors

Last winter, Medicare expanded its telemedicine coverage to make telestroke, dialysis, and home healthcare more accessible for seniors starting in 2020. Now, a recent poll shows that almost 9 out of 10 adults age 40 and over feel they would be comfortable using telemedicine for seniors in their families or for themselves—as long as the quality of care and health information privacy are as good as what they would get from an in-person visit. Read more

ambulance hurrying down street

Anthem Begins EMS Reimbursements, Even without Transport

When it comes to EMS reimbursements—even without transferring the patient—Anthem BlueCross BlueShield is leading the way. In an era when community paramedicine, mobile healthcare concepts, and telemedicine programs have sometimes struggled to garner financial support, Anthem quietly began paying for on-site treatment by EMS in situations where the consult does not result in a ride to the emergency department. Read more