The State of Telemedicine: Recent Surveys and Analysis

Posted by Mike Fontana on 01 Dec 2015

telemedicine compensation models

The American Telemedicine Association (ATA) recently released some interesting information within a September 2014 report entitled State Telemedicine Gaps Analysis.

The report grades and compares state telemedicine services along 13 indicators, including Medicaid Service Coverage and Conditions of Payment and Parity. According to the ATA, parity is the measure of how well state coverage and reimbursement for telemedicine compares to that of in-person patient services. It is examined from a private insurance, Medicaid, and state employee health plan perspective.

Results included the following:

  • Only 21 states have telemedicine parity laws for private insurance. Over half the states received failing scores because they do not have parity laws in place.

  • Of those 21, only 15 states and Washington D.C. scored the highest grades indicating the policies authorize state-wide coverage without provider or technology restrictions.

  • Forty-seven state Medicaid programs offer some level of coverage for telemedicine. States are slowly moving away from the hub-and-spoke model and allowing for a variety of technology applications.

  • Twenty-three states and Washington D.C. do not specify a patient setting or patient location as a condition for telemedicine compensation. In addition, 21 states recognize the home as an originating site, while 13 states recognize schools and/or school-based health centers as an originating site.

  • The report illustrated an unfortunate lack of coverage and reimbursement for telemedicine under state employee health plans.

The ATA report highlights the increased attention on telemedicine in recent times as policymakers look to reduce healthcare delivery issues, control costs, improve the coordination of care, and deal with a shortage of healthcare providers. It also addresses the concern of state telemedicine policies that limit the scope or prevent involved parties from accessing the system and receiving maximum benefits.

A telemedicine survey was also performed at an October 2014 Academy of Integrative Health and Medicine conference. More than 750 healthcare practitioners were polled, with 78% of them being physicians. Results indicated:

  • Just 19% of the polled healthcare practitioners have a mechanism to get paid for telemedicine-based services or are in a network that allows for this. In comparison, 33% of the survey respondents are providing telemedicine-based services, and 29% of them are planning to do so in the next few years.

  • While 68% of survey respondents do not think telemedicine-based services are appropriate for initial visits, 62% indicated that more than 20% of patient follow-ups are suited for telemedicine.

Another telemedicine survey performed by Foley and Lardner LLP in fall 2014 questioned 57 healthcare executives, 56% of them being from hospitals. While 84% of these survey respondents indicated telemedicine-based services are either important or very important to their organizations, 87% believe less than 50% of their patients will use these services three years from now. Although an indication of a possible downward trend, several factors may have influenced the responses. A more accurate assessment of the future use of telemedicine-based services would require specific questions around business models, patient economic levels, geographic location, and the organization’s specific purpose for telemedicine.

Survey results are arguably mixed, and an accurate forecast on the future of telemedicine would require deeper analysis. However, reports from various organizations all indicate that telemedicine-based services are playing an important role in the current healthcare system and will likely continue to grow in importance. As a result, it will be imperative for healthcare organizations to keep technology, organizational infrastructure, and other business aspects updated and able to handle the demands of an evolving healthcare landscape.

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Mike Fontana Healthcare Industry Executive Mike has served in various roles for Consumer Directed Health Care Technology companies. His background also includes Management, Market Development, Consultant, and other roles for healthcare providers, financial institutions, and payers. Mike holds an MBA in Finance from Pace University in New York.

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