Momentum Builds To Expand Medicare’s Teleheath Coverage – Forbes

Rare bipartisan healthcare legislation has emerged to broaden access to telehealth services for seniors covered by Medicare.

The Telehealth Innovation and Improvement Act, introduced by Sens. Cory Gardner (R-Colorado) and Gary Peters (D-Michigan), would “expand access to healthcare in both rural and urban areas to cover additional telehealth services” than the more limited Medicare benefit under the program today.

American Well and other telehealth providers like Teladoc and MDLive would benefit from expanded Medicare coverage

(American Well photo)

Companies like American Well are growing rapidly, providing telemedicine services to health plans, employers and physicians (American Well photo)

It’s the latest potential expansion of insurance coverage via telehealth, which offers access to physicians and patients via smart phone, tablet or computer. Employers and private insurers are already embracing the trend as a way to make healthcare more convenient and avoid costly and unnecessary trips to the emergency room or a more expensive physician’s office.

The U.S. Senate legislation would require the U.S. Department of Health and Human Services to allow “eligible hospitals to test telehealth services” through the Center for Medicare and Medicaid Innovation (CMMI).  “It would. . . incentivize the healthcare industry to develop new technologies that could potentially reduce costs and improve patient health,” Gardner said.

Though the legislation would still have to pass the full Senate and the House, the introduction of rare bipartisan legislation in an intensely divided Washington is seen as a victory for telehealth providers like Teladoc, MDLive and American Well. These companies have already benefited from expanding commercial coverage of telehealth consultations from large insurers like Aetna, Anthem, UnitedHealth Group and most Blue Cross and Blue Shield plans.

Existing regulations have been a hurdle to the industry, says Dr. Roy Schoenberg, chief executive officer at telehealth provider, American Well, who described the legislation as a “strategic bull’s eye.”

“The approach is to force CMMI to clear its constituents to use telehealth as a way to measure its outcomes,” Schoenberg said. “Remarkably, while Americans under 65 have almost ubiquitous access to the world of online healthcare, those of us who are frail, the home bound, those that need it frequently and are challenged the most to access it – our 65+ elderly – are denied access to it. A mind boggling social injustice that is excused by red-tape and antiquated pre-iPhone regulations.”

But some are leery that expanding telehealth coverage merely adds to cost by increasing usage of services by Americans who already have traditional access to doctors. A March study in the journal Health Affairs estimated that “12% of direct-to-consumer telehealth visits replaced visits to other providers and 88% represented new utilization.”


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