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reimbursement for telemedicine

Medicare Falls Behind in Reimbursement for Telemedicine

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You might think that the passage of the Affordable Care Act in 2010 and the resulting opportunities for telemedicine would have led to widespread telemedicine usage to increase access to healthcare while reducing costs, but the reality is that reimbursement from government agencies—such as Medicare—has fallen far behind the rhetoric. And when good intentions aren’t backed up with adequate funding, progress can become slower than molasses.

Telemedicine has certainly grown steadily, but the impact has been felt more significantly among those with private insurance that provides reimbursement for telemedicine visits. Among Medicare beneficiaries, less than 1% have coverage for telemedicine (1). And of those who are fortunate enough to enjoy such coverage, particularly those in rural areas, Medicare often requires the beneficiary to already be at a clinic. So much for making healthcare more convenient. Read more

An Open Letter and Call To Action to the Telemedicine Industry

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reimbursement boulder in road crop

“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

Hackers and Telemedicine Security – Thoughts?

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hacked

Today’s reporting (and here, here, and many other places) that Community Health Systems hospital network was hacked for personal information is alarming.  Although no credit card–and NO CARE INFORMATION–was taken, social security, birthdays, and addresses all were.  That is, everything necessary to open bank accounts, sign up for credit cards, and nearly anything else that counts as identity theft.

As potentially bad for the patients as this is, it’s equally bad for Community Health Systems.  Apparently their stock took only a brief hit (CYH), although it wouldn’t be shocking if it moves lower again assuming the news becomes more widespread and if they are sued.  This scenario is possible because although–and I would like to emphasize this yet again–NO CARE INFORMATION WAS TAKEN (medical histories, treatments, etc.) the information was still covered under HIPAA.  (They do have insurance to cover cyber liability, but even so…)

I do not know how the data was kept or encrypted.  It’s interesting…and somewhat heartening…to know that the care information was not accessed by the hackers.  However, I believe it helps us remember that no system is completely safe, and that the highest available level of security should always be used.  Currently, regarding encryption, that would be AES 256-bit encryption.  It also means use of secure one-time-use keys for communication software endpoints and conscientious use of regularly changed passwords by users.  It means keeping devices used within networks either on VPNs (vitual private networks) or, again, using 256-bit encrypted, password-secured communication over non-VPN networks (and why not do it on the VPNs anyway?).

So, now the question is: Does this security breach have any implications for telemedicine and mHealth?  My guess is that mHealth is probably at the greater risk.  I think there’s less of a general use for cybercriminals for care data than simply personal data, and that certain types of personal data, such as location data combined with the pedometer on (could indicate you’re out jogging 10 miles from your house…might be a good time to break in), make mHealth a little more nerve-wracking.  Just a guess.  There may be very creative ways to make use of mass medical histories and treatment information that just hasn’t been discovered yet.  Thoughts?

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