Tuesday, December 20, 2011

Improving Neonatal Care

The American Telemedicine Association (ATA) developed a legislative proposal to expand the use of telemedicine for Medicaid enrollees with high-risk pregnancies and neonatal care needs. If adopted, the plan would improve care delivery for an at-risk population and create significant long term savings for the government and tax-payers.

Commissioned by ATA to appraise the proposal, Avalere Health determined that using telemedicine would generate a savings of up to $186 million over the next 10 years and estimates modest participation by states, managed care organizations, and individual providers over the ten year period. The estimated savings take into account changes in Medicaid enrollment expansion as a result of the Recovery Act as well as higher proposed Federal Medical Assistance Percentage rates.

The proposal uses a shared savings approach to encourage provider adoption, as well as a 90 percent contribution from the Federal government in the first two years to encourage state adoption. Participating providers in the birthing network would be eligible for shared savings if Medicaid spending associated with eligible individuals in the program was below a baseline expectation.

The proposal would provide Medicaid coverage of telemedicine for maternal-fetal and neonatal care via a comprehensive care “birthing network”. These networks could leverage telemedicine technologies to more effectively treat major conditions associated with high-risk pregnancies, including pre-term labor, gestational hypertension, mild preeclampsia, and gestational diabetes mellitus. HHS would ensure the quality of care through performance reporting.

This innovation builds on the successful experience of the University of Arkansas ANGELS Program, which has cost-effectively managed a birthing network in that state for nearly ten years. The program is also grounded in findings from the Institute of Medicine.

“This is a win-win for both patients and Federal taxpayers,” said Jonathan Linkous, ATA CEO. “We urge Congressional leaders to quickly adopt this proposal and realize the savings.”

For more information, email Benjamin Forstag at bforstag@americantelemed.org or call (201) 223-3333. Go to www.americantelemed.org/MedicaidProposal for the complete Avalere memorandum on ATA’s proposal.