Researchers are concerned about the limits to telemedicine, particularly in rural areas, according to a JAMA news release from May. A study showed that Medicare telemedicine visits increased more than 25% each year over the past decade, yet Medicare limits reimbursement.
The JAMA news release stated, “Medicare limits telemedicine reimbursement to select live video encounters with the patient at a clinic or facility in a rural area. Federal legislation has been proposed to expand Medicare telemedicine coverage. Ateev Mehrotra, MD, Harvard Medical School, Boston, and colleagues examined trends in telemedicine utilization in Medicare from 2004-2013 using claims from a 20% random sample of traditional Medicare beneficiaries.”
Specifically, the study revealed that visits among rural patients increased from 7,015 in 2004 to 107,955 in 2013, which demonstrates an annual growth rate of 28%. Most of the visits were in an outpatient clinic while 12.5% were in hospitals or skilled nursing facilities.
“Proposed federal legislation would encourage greater use of telemedicine through expanded reimbursement,” according to the news release. “In contrast to others, we found that state laws that mandate commercial insurance reimbursement of telemedicine were not associated with faster growth in Medicare telemedicine use.”
“Our results emphasize that non-reimbursement factors may be limiting growth of telemedicine including state licensure laws and restrictions that a patient must be hosted at a clinic or facility,” the authors of the JAMA study wrote.
A March 2016 American Academy of Family Physicians news article, “MedPac Explores Expansion of Payment for Telemedicine” stated the Department of Veteran Affairs, which encourages remote consults by either lowering or waiving copayments, recorded one of the highest rates of telehealth usage.
“In the past decade, 736,000 veterans have used such services, mainly for primary care consults, chronic care management and transmission of imaging or other patient data,” the AAFP article stated. “Medicare covers a limited set of telemedicine services with a facility fee to rural sites and full fee schedule payment for patients who reside in designated health professional shortage areas.”
In February, Congress introduced the CONNECT for Health Act bill, which would expand the use of telehealth and remote patient monitoring services in Medicare.
The bill is endorsed by over 40 medical associations including the American Medical Association, which stated in a Feb. news release, “This legislation has the potential to remove barriers to new health care delivery models that promote coordinated and patient-centered care.”
“Importantly, the bill aims to maintain high standards whether a patient is seeing a physician in an office or via telemedicine,” AMA President Steven J. Stack, MD, said in the release. “Telemedicine can strengthen the patient-physician relationship and improve access for patients with chronic conditions and limited access to quality care. The AMA’s guiding principles on telemedicine seek to foster innovation while promoting quality care.”
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