Revenue Cycle Management Blog | GroupOne Health Source

Telemedicine is Taking Off! Here's Why

Written by Kaitlyn Houseman | February 25, 2016

Healthcare is ever-changing. One advancement, telehealth, is one of the hottest trends in healthcare and technology right now. With the shortage of physicians, increase of chronic conditions, and the rising costs of healthcare, telehealth is becoming more necessary and useful than ever.

The use of telemedicine is slowly growing with over half of all U.S. hospitals now using some form of telemedicine. The Affordable Care Act has helped drive healthIT adoption across the U.S. making telehealth delivery a more practical option for physicians today. In fact, by the end of 2014, about 8 in 10 (83%) of office-based physicians had adopted an electronic health records (EHR). 

Consumer interest and acceptance is also growing, according to a recent Cisco global survey where 74% of patients said they prefer easy access to healthcare services over in-person interactions with providers. While some providers worry that telehealth could diminish the doctor/patient relationship, most patients are ready for a more convenient way to meet with their doctor.

While telemedicine can't replace actual interventional or hands-on care, it solves some of healthcare's biggest problems today while reducing costs and making access to care easier for patients.

What is telehealth?

Telehealth, called telemedicine worldwide, is the practice of exchanging medical information using electronic communication to best tend to a patient's needs. There are different formats for telehealth, including two-way video conferences, email, smartphone interaction, and utilizing other wireless tools. According to a study by the Affiliated Workers Association, more than 36 million Americans have already used telemedicine in some way, and as many as 70 percent of doctor visits can be handled over the phone — which typically cost much less than an in-person visit. So why is telehealth such a hot topic and is it the future of most healthcare delivery?

Convenience of  Care

For the elderly, home-bound, and physically incapable patients, telehealth helps them avoid frequent office visits by receiving remote care. More frequent check-ins with a provider means the more likely an ailment to be detected early on which prevents and reduces emergency room visits and ambulance rides.

With telehealth also comes the reduced frequency of office visits thus reducing the spread of disease. With lower chances of becoming ill, the overall community becomes healthier.

Physician Access to Rural Communities

Much of the U.S. is comprised of rural communities that are under-served. In the U.S., for every 100,000 rural patients, there are only 43 specialists available. With facilities, specialists, and health services being few and far between, telehealth allows those patients access to medical services without the cost of travel.

Telehealth is an innovative way to offer care and health management to a variety of patients that would otherwise go without. The practice of telehealth has proven to be successful around the world, and U.S.-based physicians are beginning to see the advantages of integrating telehealth practices into what they currently offer. 

Cost Savings

The cost of healthcare in the U.S. has increased and is estimated to continue to rise. Telehealth cuts costs and maximizes the time physicians spend with patients. Telehealth maximizes a physician's time. The doctor is able to diagnose, observe, and treat patients in far-off locations as well as those confined to their home or hospice. This allows for better time management, spending control, and competitiveness. 

Chronic diseases contribute to a large portion of healthcare costs. In the U.S. alone 75% of physician's and patient's costs were contributed to chronic illnesses. Specialists, treatment, and long-term care are needed for many chronic conditions, but with frequent vital sign checks, a patient's wellness can be monitored and early intervention can reduce emergency care.

What are the reimbursement limitations with telehealth?

Telehealth might boast a number of benefits for providers and patients but the lack of understanding in how providers are reimbursed for telehealth has been a big contributor to the lack of adoption.

Today, not all telehealth costs are reimbursed. Kofi Jones, Vice President of Government Affairs for American Well recently published an article on telemedicine reimbursement where she states:

"Medicare is quite forward-thinking when it comes to the technology, defining reimbursable telemedicine as 'interactions between a healthcare professional and a patient via real-time audio-video technology' (CFR Title 42, Part 410.78, “Telehealth Services.”). This definition is in line with the model policy of the Federation of State Medical Boards (FSMB), which represents the 70 state medical and osteopathic regulatory boards.

Medicare is also the most focused on geographic restrictions. Medicare only covers telemedicine when the patient is presenting from a defined rural area termed a Professional Shortage Areas or a county outside of a defined Metropolitan Statistical Area. However, CMS recently launched its Next Generation ACO model, which allows selected ACOs to offer care through telehealth technologies regardless of the patient’s location. And this week, the CONNECT for Health Act was introduced in the House and Senate with bipartisan support. The groundbreaking legislation would allow the vast majority of Medicare providers to use telehealth without the current geographic barriers."

There is no single widely-accepted standard for private payers. Some insurance companies value the benefits of telehealth and will reimburse a wide variety of services. Others have yet to develop comprehensive reimbursement policies, and so payment for telehealth may require prior approval. Likewise, different states have various standards by which their Medicaid programs will reimburse for telehealth expenses.

While reimbursement for telehealth might seem foggy, the benefits that telehealth yield are clear. Subscribe to blog updates from GroupOne and we'll keep you up-to-date on new developments as telehealth continues to be integrated into our healthcare system.