CMS Approval Another National Nod to the Power of Telehealth

Screen Shot 2016-03-11 at 3.43.26 PMApproximately 12 million Americans utilize some type of home health care every year.  From home health aides visiting the infirmed in their homes, to physical therapy services to aide in recovery, to medical equipment being used to treat the chronically ill, home health has been a critical component of care management for decades.

One of the Medicare payment requirements for these services is for the prescribing practitioner to have a “face to face” encounter with the patient within a reasonable timeframe. This has widely been viewed as a burden on patients, many of whom face mobility issues and other barriers to meeting this obligation. It has also been a barrier for our overburdened physician supply.

Just recently, CMS published a new rule extending this requirement to states – stating that home healthcare matching Medicaid funds will be linked to this same requirement.  But, there’s another component of the rule which mirrors Medicare and will have a tremendously positive impact on the home health care community – the face-to-face requirement can be met through telehealth.

Telehealth is increasingly being acknowledged as a vital component of our healthcare ecosystem. Thirty states mandate commercial payment for care provided through these technologies and nearly every state offers some level of telehealth payment within Medicaid. Early this month, a bipartisan bill was introduced which would greatly increase the amount of payment which exists for telehealth within Medicare. And, all across our healthcare ecosystem, from health plans to health systems, telehealth is being integrated to increase access and lower costs.

Now, as states and providers prepare to operationalize this new Medicaid rule and deal with the budgetary and organizational requirements that will naturally result from it, they can breathe a sigh of relief. The caveat that telehealth can meet this requirement is significant.

Now, providers can examine and appropriately prescribe home health while their patient is remote – streamlining treatment time frames and maximizing the utilization of their clinical resources.

And in 2016 these technologies offer so much more. Telehealth brings the ability to manage these patients on an on-going basis, much of which is now payable in a fee-for-service Medicaid environment. Modern telehealth technologies also provide HIPAA compliance, integration with back-end systems, claims submission, continuity of care, and support multi-disciplinary collaboration, including Accountable Care Organizations and Patient Centered Medical Homes.

The end result – compliance with the new rule and a vastly broader ability to treat and manage patients. This rule may, at first blush, seem like a burden too far, but with telehealth, the good news outweighs the bad.

Kofi Jones is VP of Government Affairs for American Well, a national provider of telehealth technology and services and creator of Amwell for online doctor visits.

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  1. Great points Kofi. I am sure that the future is on telehealth/telemedicine side. It is perfect for rural areas as well as for some populated areas. I don’t know anybody who would enjoy going to a doctor and spending time waiting in room full of sick people.