Posts

"Paid in Full" rubber stamp, representing zero cost sharing for telemedicine

Pandemic Freebies Are Ending—It’s Time for Cost Sharing for Telemedicine

During the anxiety-fraught early days of the COVID-19 pandemic, most major insurers joined the Centers for Medicare & Medicaid Services (CMS) in waiving co-pays and deductibles for telemedicine visits — cost sharing for telemedicine — in order to encourage people to remain at home, thus reducing possible exposure and transmission of COVID. The public, many of whom were new to telemedicine, readily adopted the technology in favor of convenience and safety, reduced costs, and less travel. Now, however, those halcyon days may be gone. Some major private health insurers have stated that as of Oct. 1, they are no longer paying the full costs for virtual visits that are unrelated to COVID; instead, patients are expected to pay a portion of the costs for the virtual visit, as is the norm for in-person visits. Read more

Gavel for Healthcare

Are Lightened Telemedicine Regulations Here to Stay?

As we’ve noted previously, the COVID-19 pandemic has thrust telemedicine into the spotlight with pro tem lifted telemedicine regulation, allowing both patients and providers to embrace low-contact methods for accessing healthcare. Now, several months into the COVID-19 pandemic, industry stakeholders are examining the currently active telemedicine regulations to determine which changes would encourage medical facilities and providers, ranging from small-practice primary care providers to tertiary care hospitals, to permanently add telemedicine to their routine options for health care delivery. Read more

Possible Telemedicine CPT Codes Shutdown Looms

Telemedicine CPT Codes in Danger

We may still be in the throes of the COVID-19 pandemic, but that isn’t stopping policy makers from planning ahead to determine whether temporary telemedicine CPT codes should be a permanent part of the “new normal” that is expected to reign after the emergency situation dissipates. As mentioned previously, quick changes to legislation, especially those that reimburse telemedicine visits at the same value as in-office visits, made telemedicine a much more convenient and financially viable alternative to the traditional model of in-office visits—for both patients and providers. As we look ahead to 2021, however, debate surrounds the Centers for Medicare and Medicaid Services (CMS)’ decision to drop a large majority of the recently-enacted billing codes, which may return the state of telemedicine almost to where it was before the pandemic began. Read more

Doctor warning during telemedicine visit on laptop

Is Telemedicine Losing Its Novelty?

Considering the eagerness with which the health care industry embraced telemedicine as COVID-19 started circling the world, it may seem surprising that lately, physicians have been less enthused than they were earlier in the pandemic. Initially, physicians and industry watchers predicted the widespread adoption of telemedicine as a permanent aspect of primary care. However, a recent report reveals an unexpected trend: In one large health care company, telemedicine usage has been falling steadily since late April. What happened to the early enthusiasm? Read more

Cheered businessman standing with graph showing growth trend of telemedicine for coronavirus

Emergency Measures Spur Growth of Telemedicine for Coronavirus, but What Comes Afterward?

Amidst the apprehension wrought by the current COVID-19 pandemic, a silver lining has emerged: Primary care providers (PCP) are finding that telemedicine usage within their practices, previously hindered by issues such as inadequate reimbursement, privacy concerns, and costs, has begun soaring as cautious consumers seek alternatives to visiting the doctor’s office in person and, thus, potentially exposing themselves or others to COVID-19. Industry analysts are predicting that as both providers and patients embrace telemedicine for coronavirus as a solution for reducing the risk of transmission of infectious disease, as well as for other ailments, they will become accustomed to telemedicine as a tool and will expect its continuation within medical practices. Read more

Telemedicine for Coronavirus: Drive-Through Testing

Telemedicine for Coronavirus: Next Window, Please

Telemedicine offers an ideal strategy to enable more health care providers to address more patients’ needs while minimizing exposure to infectious diseases such as the currently notorious coronavirus (COVID-19). As shown by the recent expansions for Medicare reimbursement for telemedicine, our Congress and President clearly recognize the potential benefits of utilizing telemedicine for coronavirus screening and other health care concerns. Even the New England Journal of Medicine came out a week ago with a strong statement of support for telemedicine’s benefits. Now, the question is how to deploy the technology quickly and in a way that will drive better outcomes for patients, providers and society as a whole. Read more

RPM reimbursement codes clear the way for expanding RPM programs, such as glucose monitoring for diabetes patients

RPM Reimbursement Paves the Way for Expansion in 2020

With the ongoing shift in healthcare towards a value-based care model, the concept of remote patient monitoring (RPM) for chronically ill patients certainly grabbed attention throughout 2019. By introducing new reimbursement codes for RPM in late 2019, the Centers for Medicare & Medicaid Services (CMS) is clearly inviting the increased use of RPM, presumably made possible with telemedicine, in 2020. Some experts view 2019 as the trial run for RPM reimbursement; now that the CMS has officially endorsed RPM, albeit in limited capacities, 2020 is expected to see a significant rise in the adoption of RPM programs. However, current limitations in technology and software could curb growth, warn industry watchdogs. Read more

Telemedicine coverage illustrated by private payer administrator paying telemedicine doctor

Telemedicine Coverage Growing Rapidly, Says ATA Survey

The results are in: 80 percent of US states have taken action to improve telemedicine coverage or reimbursement over the last two years, according to the American Telemedicine Association’s latest survey of state laws and policies. However, each state is working alone in implementing these changes, forcing physicians who practice in more than one state to juggle confusing guidelines. Read more

Doctor at desk talking to patient with telemedicine solutions

Will Telemedicine Solutions Ease Physician Shortage?

For the next 20 years, three million baby boomers will reach retirement—each year, according to Advisory Board. Today, one in five people already lives in an area with a shortage of primary care physicians, and some hospitals are already experiencing a shortage of specialists; what will happen when we keep adding more patients than doctors to the healthcare system? Many experts, such as the Association of American Medical Colleges, predict that the shortage will only worsen. In a proactive effort to alleviate the problem and increase patients’ access to physicians, some hospitals and health systems have begun encouraging their patients to use telemedicine solutions instead of traveling to the doctor’s office, thus enabling physicians to see more patients more efficiently. Read more

ambulance with telemedicine reimbursement

Ambulances in Line for Telemedicine Reimbursement

Starting early next year, the U.S. Department of Health & Human Services (HHS) will begin a trial program with new financial incentives, including telemedicine reimbursement, to encourage emergency medical services (EMS) to use telemedicine and transport Medicare and Medicaid patients to clinics other than the emergency room. Currently, only visits to hospitals, skilled nursing facilities, and dialysis centers are reimbursed, even when a lower-acuity destination may be more appropriate. The goal is two-fold: to promote a value-based payment system and to reduce unnecessary ER visits and hospitalizations. Read more