AcuteCare Telemedicine Blog


Paying for the Promises of Telemedicine

Telemedicine is living up to its hype on revolutionizing the healthcare delivery model. With many of the most formidable barriers to increased expansion being overcome, virtual technology is quickly becoming a preferred method for patients when connecting with their care provider. New advances in hardware and software coupled with faster digital info structure, is driving more and more healthcare professionals to electronic communications. Patients are warming-up to using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions in the comfort of their home.

Healthcare providers, payers and governmen supported healthcare programs are recognizing the potential cost savings of telemedicine technologies. However, payment policies for telehealth services, while expanding quickly, continue to be inconsistent and are discouraging the progress towards realizing the full potential of virtual healthcare. Providers are eager to embrace telehealth. A survey of more than 1,500 family physicians conducted for Anthem and the American Academy of Family Physicians (AAFP) found that “almost 90% of respondents would use telehealth to help treat their patients—if they were compensated for that care.” Richard Bakalar, MD, managing director at KPMG and a member of the firm’s Global Healthcare Center of Excellence says, “Healthcare providers need to figure out how to become more efficient and the technology behind telemedicine allows caregivers to connect with patients remotely, efficiently and effectively.”

Currently payments for telehealth services are as far flung as the 50 states landscape. New rules for Medicaid managed care and MACRA are becoming telehealth-friendly, but Medicare and Medicaid reimbursements are spotty, with Medicaid payment varying greatly from state to state. Today, 48 states and the District of Columbia provide some form of Medicaid payment for telehealth services, according to the National Conference of State Legislatures. Commercial insurers seem to be embracing telehealth but consistency of payment policy remains elusive. In just over half of the states and the District of Columbia, private insurers are answering the call of parity laws that require them to pay for telehealth services. Payment parity is important for providers because it protects them against arbitrary cuts in reimbursement for telehealth services as compared to services provided in-person.

While expansion of virtual technology continues to progress at a steady pace, solutions to resolving remaining barriers like payment for services, multistate licensing, credentialing, and regulation are evolving at a deliberate pace.