- Telemedicine could be one route to move doctors into accountable care organizations, MedPage Today reports.
- Speaking last week at a meeting of the Medicare Payment Advisory Commission (MedPAC), member Sue Thompson of UnityPoint Health in Des Moines, Iowa, said incentivizing providers to use telehealth could be a way to get them out of fee-for-service models and into an environment with more risk-sharing and accountability.
- “I think we’d have an easier time recruiting providers into behavioral health modalities and family practice modalities if we could talk about how this creates a lifestyle that’s pretty attractive,” she said. “Telehealth is a piece of the puzzle that offers all kinds of opportunity.”
Thompson’s comments were part of a discussion on how Medicare pays for telehealth services. Currently, Medicare reimburses facilities originating a telehealth encounter a flat fee of $25, while the telehealth provider gets 100% of the fee-for-service facility rate. Patients’ copay amounts to 20% of the visit’s cost.
MedPAC staff reported that in 2016, Medicare paid $27 million for 319,000 telehealth encounters, up from $16 million in 2014. Still, use was low: 10% of providers and beneficiaries accounted for 72% and 46% of visits, respectively. The most common encounters were for evaluation and management, mental health and inpatient or nursing care follow-up.
Telehealth and alternative payment models are a natural fit for Medicare. CMS wants to tie 50% of the program's payments to ACOs and other advanced payment models by 2018, and providers are always looking for ways to increase access and quality of care while reducing costs. Next-generation ACOs, for example, waive certain restrictions to promote opportunities for virtual care.
Studies have shown that substituting telehealth for in-person healthcare visits can save money. According to a recent analysis by the NTCA – The Rural Broadband Association, telehealth services are associated with annual per-facility savings of $5,718 in travel costs and $3,431 in lost wages for patients, plus $20,841 for the hospitals.
Other benefits of telehealth include access to specialists, ease and timeliness of encounters and improved outcomes. There can, however, be unintended consequences like an increase in office visits prompted by telemedicine encounters.
Earlier this year, Senate lawmakers introduced a bipartisan bill that aimed at increasing telehealth services for Medicare patients, particularly in rural and underserved areas. Under the Telehealth Innovation and Improvement Act, eligible hospitals would test telehealth services through the Center for Medicare and Medicaid Innovation. Medicare would cover telehealth services for those hospitals that performed well on cost, effectiveness and quality of care. The bill has been referred to committee.