The American Telemedicine Association (ATA) provided specific comments and recommendations on May 15th to Chairman Max Baucus, Ranking Member Chuck Grassley, and other members of the Senate Finance Committee concerning the Committee’s Policy Options paper of April 29th. The paper is titled “Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce health Care Costs.”
ATA is very interested in addressing Medicare coverage for telemedicine. According to the data, Medicare payments for interactive telehealth services were only $6 million in 2007. One of Medicare’s worst restrictions is that it essentially excludes beneficiaries in metropolitan areas and as a result, 83 percent of the U.S. population is left out.
Surprisingly, this affects even some of the most rural states in the country. For example, 47 percent of North Dakota’s population resides in a metropolitan area and the figure for Montana residents is 35 percent. New Jersey and Rhode Island beneficiaries essentially do not have telehealth coverage because all of their counties are within a metropolitan area. Also Medicare’s restrictions block telehealth services in HHS identified health professional shortage areas, medically underserved areas, or medically underserved populations within metropolitan areas.
ATA estimates that extending covered telehealth services for all Medicare beneficiaries would result in less than $40 million in total expenditures per year, even without factoring in any resulting cost savings for remote services.
According to ATA, home telehealth and patient monitoring services have proven to yield substantial cost savings and improve care in homebound and chronic disease patient groups. Telehealth has been singled out as a valued service by patients but Medicare pays for almost no remote health monitoring.
Telemedicine is set to have a widespread and significant impact on the delivery of healthcare. Physicians and other providers have been learning and adapting. For example, the application of advanced life-saving therapies for people suffering a stroke requires access to specialized stroke and brain imaging expertise. The American Heart Association and the American Stroke Association recommends the use of telemedicine to overcome significant disparities in access to care in the U.S.
Telemedicine encompasses a wide variety of applications from remote reads of medical images, to live video consultations, to distant monitoring of vital signs. Key technologies such as wireless, video resolution, sensors, and mobile devices have been rapidly advancing and allowing telemedicine to be better, faster, and cheaper.
ATA strongly urges the Senate Committee to include Medicare reimbursement for telehealth services throughout the country. It makes no sense to invest billions of taxpayer dollars to purchase health information technology, deploy broadband telecommunications, but not allow providers to use the technology and for patients not to receive the benefits.
Some of ATA’s recommendations and clarifications sent to the Senate Committee want telemedicine and telehealth technologies included in coverage to Medicare beneficiaries regardless of their location, Medicare facilities to be originating sites for interactive video, store-and-forward applications use needs to be expanded, advanced software systems need to be used in hospital intensive care units, and remote monitoring should be used when treating chronic conditions in the home.
For more information, contact Gary Capistrant at gcapistrant@americantelemed.org.
