NEW YORK (TheStreet) -- Technology is capable of improving health care for elderly and rural patients, but so far the lack of a standardized reimbursements has been a major obstacle.
States needs to step in with legislation that standardizes Medicare and Medicaid reimbursements for what has come to be known as telemedicine, or the use of communications technology to exchange information between patients and medical professionals in different geographic locations. (Sometimes people also use the technically broader term "telehealth" to describe this technology.)
Although many industries have already transitioned smoothly to incorporate innovative technologies into their business models, the health care industry has moved too slowly.
Telemedicine has actually been practiced in some form for a long time. As early as the 1960s, NASA was regularly monitoring U.S. astronauts' vital signs including blood pressure and pulse oximetry during space missions. Fifty years, later, devices for remotely monitoring a wide range of needy patients, particularly elderly Americans living with chronic diseases or conditions, are available, but their use has been stymied.A key factor has been the lack of standardized reimbursement for telemedicine technology and services.
In a recent report, the American Telemedicine Association said:
"Payment and coverage for services delivered via telemedicine are one of the biggest challenges for telemedicine adoption. Patients and health care providers may encounter a patchwork of arbitrary insurance requirements and disparate payment streams that do not allow them to fully take advantage of telemedicine."
Standardized telehealth reimbursement policies that reflect the multiplicity of payment sources within the U.S. health care system are needed.
It's true that over the past several years, state policies on telehealth have been evolving, mandating reimbursements by private insurers, Medicare or Medicaid in more states, and expanding the scope of existing reimbursement regulations.
For instance, the number of states with telemedicine parity laws that require private insurers to cover telehealth expenses as they would in-person consultations has doubled in the past few year, and Medicaid has also been incorporating telehealth reimbursement in its policy reforms.
Even with these developments, however, there remain significant limitations in reimbursement programs, limitations that are largely dictated by myriad factors: no standardized payment methodology, and unevenly circumscribed requirements related to the distance of the eligible patient population from eligible telehealth services and technologies to be used for them at remote locations.
We also seem to be overdoing the telemedicine pilot study phase, rather than focusing on getting the tools to remote patients who need them and paying providers for their services.
Take a look at an article about the passage in January 2012 of the Centers for Medicare & Medicaid Services' telehealth code to be used for submitting claims, and known as Code S9110. Use of the code appears wrought with confusion, and the pilot demonstration project testing telemedicine's value stayed an object of study for more than six years.