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Looking Ahead to 2020 and the Future of Telehealth Reimbursement Rates

Laws Ensuring Commercial Insurance Coverage for Telehealth are Increasing Among States

2019 was an impressive year for telehealth reimbursement. More states signed legislation into law that requires commercial insurance providers to cover certain telehealth services, such as live video consultations, remote patient monitoring, and “store and forward” asynchronous telehealth services. 

However, reimbursement rates tend to vary from state to state, limiting telehealth adoption rates around the country. Multi-state health networks and providers may refrain from adopting this technology if commercial insurance providers refuse to reimburse services delivered via telehealth. 

Learn how telehealth reimbursement rates continue to evolve across the country and how these trends will continue as we head into 2020.

The Latest in Commercial Insurance Coverage for Telehealth

Telehealth reimbursement rates reached new heights in 2019. According to a new report from the law firm Foley & Lardner, 42 states and the District of Columbia have statutes in place regarding commercial insurance coverage for telehealth as of October 2019. However, the study also found that these laws tend to vary widely from state to state. 

Commercial insurance providers may cover some telehealth services in one state but not in another. This discord tends to create confusion in the marketplace as providers and health networks consider investing in this technology. The language of these laws can also vary widely across state lines, further limiting telehealth adoption rates.

Many states have laws on the books requiring commercial insurance providers to cover telehealth services, but several states do not actually enforce these rules. For example, four states have telehealth coverage laws on the books that do not require health plans to cover services delivered via telehealth, including Florida, Illinois, Massachusetts, and Michigan.

While these laws are moving telehealth adoption forward, more work needs to be done in order to achieve what’s known as payment parity for telehealth. This means that services delivered via telehealth are reimbursed at the same rate as those delivered in-person. However, payment parity laws remain scarce throughout the country. Of the 16 states with laws directly dealing with telehealth reimbursement, just 10 states have laws on the books that provide full payment parity.

What’s Driving This Trend?

Despite these limitations, these laws have come a long way in recent years.  According to Epstein Becker Green’s Telemental Health Laws Survey, laws concerning commercial insurance coverage for telehealth have been largely bipartisan in recent years. 

Democrats and Republicans have been working together at the state level to improve telehealth adoption rates. This trend seems to have been largely fueled by the ongoing opioid crisis. Those struggling with chronic pain, addiction, and thoughts of suicide can use telehealth services to remotely connect with providers. Patients can find other ways to manage their chronic pain or speak to a mental health provider about their depression or addiction. Providers can also use these tools to prevent overdoses and improve medication adherence. 

Achieving Telehealth Payment Parity

State lawmakers play an outsized role when it comes to payment parity and telehealth adoption rates. Without laws requiring commercial insurance providers to cover telehealth services, fewer healthcare providers and facilities will adopt this technology. If more states pass laws requiring commercial insurance providers to cover telehealth services in 2020, it will encourage more providers and facilities to adopt this technology. 

State lawmakers continue researching these trends and the benefits of telehealth, which shows us that 2020 may lead to new breakthroughs in terms of telehealth adoption.

In the near future, virtual care may be virtually indistinguishable from in-person care. As these laws change for the better, commercial insurance providers may soon help the healthcare community achieve payment parity for telehealth services, so facilities and providers are reimbursed for services delivered via telehealth at the same rate as they are for services delivered in-person.

While the healthcare industry still has a long way to go in achieving payment parity for telehealth, 2020 looks to be the best year yet. State lawmakers should continue exploring the benefits of telehealth and ensure these services are reimbursed at the same rate as in-person care. To learn more about telehealth and how it can benefit your patients, visit InTouch Health today.