Dive Brief:
- After legislative efforts to waive CMS's Medicare coverage restrictions for telehealth stalled, health systems, ACOs and other stakeholders wrote recent letters to urge new HHS Secretary Sylvia Burwell to do so. One letter came from the top executives of 29 health systems and ACOs; other letters were from telehealth vendors and telecommunications firms.
- Specifically, stakeholders requested changes to a 2001 federal law that bars CMS reimbursement for “originating sites” outside of rural areas; rules barring “store-and-forward” policies that prevent data from being forwarded to outside services; and a lack of coverage for services in the home.
- ACOs, which use bundled payments, said if they work with providers that don't get reimbursed for telehealth, they face the difficult decision of whether to assume financial risk and provide free care. “For many physician-led and smaller ACOs without access to a lot of capital, it is not even an option," the ACOs' letter to HHS states.
Dive Insight:
Telehealth is a significant, rapidly growing component of U.S. health-care delivery, and many hospitals are embracing it in order to extend services and improve efficiency. It began as a way for people in rural areas to gain access to care, but now more than half of all U.S. hospitals use some form of telemedicine, says the American Telemedicine Association. The technology, which allows remote patient monitoring and doctor-to-doctor communication, among other services, is seen as another way to shift health-care to lower-cost settings and to prevent emergency room visits.
Yet stakeholders assert that a patchwork of regulations and reimbursement policies, put in place before the technology evolved, continues to hinder broader adoption of useful telehealth services under Medicare. They struck out in urging former HHS Secretary Kathleen Sebelius to waive restrictions. If regulators again don't react to their pleas, then telehealth groups vow to refocus their lobbying efforts on federal lawmakers.