CBO finds as budget neutral telehealth in Senate CHRONIC Care Act

May 26, 2017 | by | 1 Comment

Sneaking under the holiday week wire, when Congress high-tails it for home, the Congressional Budget Office (CBO) reviewed the telemedicine and telehealth provisions in the US Senate’s pending CHRONIC Care Act and found last week that they do not increase or decrease Medicare spending overall. Formally S.870 – Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017–and sponsored by Sen. Orrin Hatch of Utah, this means that this bill developed by the Senate Finance Committee’s bipartisan Chronic Care Working Group has passed a key spending acceptability test, and is another step further towards passage. CHRONIC removes many of the qualifiers that Medicare hedged around telehealth and telemedicine, with most restricting reimbursement to rural areas. There are four areas where the Act removes barriers:

  1. Nationwide coverage for Telestroke
  2. Home remote patient monitoring for Dialysis Therapy
  3. Enhanced telehealth coverage for ACOs–this expands the provisions in the Next Generation ACO program to ACOs participating in the Medicare Shared Savings Program (MSSP) Stages II, III and the few left in Pioneer, so that telehealth will be reimbursed regardless of geographic location and in the home.
  4. Increased flexibility for telehealth coverage under Medicare Advantage plans

There’s a long way to go, but this is an important step forward to an equal playing field for telehealth services. National Law Review’s summary

The widening gyre of insurers covering telehealth (telemedicine?) (US)

February 20, 2016 | by

Is a tipping point nearing? Soon? An article in Modern Healthcare that contains a heavy dollop of promotion headlines ‘telehealth’s’ adoption by insurers such as Blue Cross Blue Shield of Alabama, Anthem and Highmark. When read through, it’s mainly about telemedicine (video consults) but does touch on the vital signs monitoring that’s the basis of telehealth. Video consults through Teladoc and other services such as Doctor on Demand and American Well are gradually being reimbursed by private insurers, despite the concern that it would actually drive up cost by being an ‘add-on’ to an in-person visits. Medicaid increasingly covers it, and states are enacting ‘parity’ regulations equalizing in-office and virtual visits including, in many cases, telehealth. Yet the move for coverage is hampered by lack of reimbursement to doctors, or the perception of limited or no payment. Even Medicare, a big advocate for alternative models of care, currently pays little out for telehealth–$17.6 million on a $630 million+ program. The Congressional Budget Office is skeptical, despite the savings claimed by CONNECT for Health Act in both the Senate and House [TTA 12 Feb]. Virtual reality: More insurers are embracing telehealth