Medicare: Good And Bad News For Telehealth

September 13, 2017 By InTouch Health

In some ways, telehealth is a bit like Virtual Reality technology: praised for its potential, but not yet a revolution.

That’s mainly because CMS has erected many barriers to telehealth’s wider adoption. Physicians still can’t get reimbursed for providing telehealth services to Medicare patients at home. There are now eight locations that qualify as “originating sites” – including hospitals, physicians’ offices, and skilled nursing facilities – but home isn’t one of them. That’s as silly as making banking customers go to a brick-and-mortar location to check their balance instead of doing it from home.

Not surprisingly, Medicare’s 2016 statistics on telehealth usage are a bittersweet blend of good news and bad news. Last year, Medicare paid out $28.7 million for telehealth services, about 28% more than it did in 2015. But that’s still a drop in the bucket compared to Medicare’s total 2016 payout of over $600 billion.

While Medicare telehealth claims rose 33% last year, patient usage is still flatlining: only about 1% of Medicare beneficiaries are currently using telehealth services.

Needless to say, Congress is getting increasingly frustrated with Medicare’s inability to harness the life-saving potential of telehealth. The gigantic CONNECT for Health Act is slowly winding its way through the U.S. Congress, but it will be difficult to pass this year due to its complexity. So legislators have introduced a half-dozen simpler, more targeted bills – including the revived Telehealth Enhancement Act and the CHRONIC Care Act. The latter would at long last authorize payment for remote care of home-bound Medicare patients.

HHS Secretary Tom Price isn’t afraid to upset the apple cart, witness his edict to postpone several bundled-payment initiatives. Perhaps he’ll take steps to demolish some of Medicare’s roadblocks to more robust telehealth adoption. In business vernacular, it’s time for the slow, lumbering Medicare machine to start acting “nimble” when it comes to telehealth.