Healthcare News & Insights

Is now prime time to consider providing telehealth?

Telehealth is poised to be one of the industry’s fastest growing areas. And new regulations and federal legislation means it may be time for your facility to consider providing more telehealth services. 

78484619Telehealth — remotely providing services to patients via videoconferecing — has garnered a lot of attention recently from federal agencies and payors. Many believe that it may be an effective way to lower costs, while still meeting quality of care requirements.

Typically, healthcare providers are reimbursed for telehealth services only when the patient lives in a remote area and can’t easily come in for appointments due to a medical condition. Since not many patients qualify under that criteria, many physicians have shirked telehealth as a viable way to bring in added revenue.

Recently, the government has been pushed to allow greater coverage for services physicians provide remotely, so now may be a good time to reconsider providing telehealth.

Support from CMS

The Centers for Medicare & Medicaid Services (CMS) showed its support for telehealth by proposing changes to the Medicare Physician Fee Schedule, as Modern Healthcare reports. The proposed rules would allow more services, like annual wellness visits, to be reimbursable when provided via telehealth.

Most interestingly, the rule proposes a wider definition of rural — one that would include areas closer to metropolitan areas than previously allowed.

It should be noted that Medicare’s standards for telehealth require, “at a minimum, audio and video … permitting two-way, real-time interactive communication.” That means, when deciding if your facility will expand its telehealth services, you’ll need to consider what resources you’ll have to invest in first. Telephone and email interactions alone won’t meet the standards for payment.

Many private payors have looked to Medicare and federal standards to influence their own policies on telehealth coverage. The changes and support from CMS means that other insurers may soon follow suit.

New telehealth bill

In addition to CMS’ expansion, a new bill may further facilitate telehealth reimbursement, according to Fierce HealthIT.

The “Telehealth Enhancement Act” was recently proposed in Congress. If passed, the Act would remove more Medicare restrictions and adjust Medicare telehealth payments for home health services. It also would extend telehealth coverage to critical access and sole-community hospitals regardless of their location.

The act would even allow states to offer Medicaid coverage for treating some symptoms of women with high-risk pregnancies.

Plus, another new bill making its way through Congress, the Medicare Telehealth Parity Act of 2014, would allow managing chronic condition through telehealth.

Whether or not these particular bills become law, they signify the support telehealth has from the feds. It’s probable to assume then that the government will continue to explore and promote telehealth as an alternate form of care.

Many private payors also have looked to Medicare and federal standards to influence their own policies on telehealth coverage. The recent CMS rule and proposed laws may lead other insurers to expand telehealth coverage, as well.

Facilities that want to take advantage of the new telehealth coverage should examine their patient mix to see who might be eligible or interested in receiving telehealth services.

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