Medicare Bill Could Lead to More Tech-Driven Home Health

With several CMS initiatives underway, including value-based purchasing and bundled payments, telemedicine has been on the minds of lawmakers as a way to help keep patients healthy and happy in their homes longer.

Last week, Senators Cory Gardner (R-CO) and Gary Peters (D-MI) introduced the Telehealth Innovation and Improvement Act, which would expand access to telemedicine coverage for patients in rural communities with limited access to health care services. The bill is a step forward to determine if Medicare will cover expanded telehealth services in the future.

“Telemedicine has the power to increase access to specialized services in underserved communities, and potentially lower costs and improve patient outcomes,” Senator Gardner said in a statement. “The Telehealth Innovation and Improvement Act would pave the way for Medicare to expand coverage to additional telehealth services, and potentially provide those living with life-threatening conditions in rural America with more opportunities and more options to receive the care they need.”

Currently, few telehealth costs are covered and reimbursed by Medicare. According to the Centers for Medicare & Medicaid Services (CMS), Medicare covers office visits and consultations by a doctor or other health care provider through a two-way telecommunications system with audio and video for patients who live in rural areas or are located in other health care settings. Within the home setting, consultations, visits and other health monitoring capabilities are largely excluded from Medicare coverage.

Medicare also currently does not cover remote patient monitoring, electronic storage and forward transmissions of health records and medical information, cross-state services and consultations or visits without video or outside rural settings.

As outlined in the bill, the Department of Health and Human Services (HHS) would be required to allow hospitals to test telehealth services through the Center for Medicare and Medicaid Innovation (CMMI). Eligible hospitals would be reviewed and independently evaluated by CMMI for cost, effectiveness and improvement in quality of care without increasing the cost of delivery. Should these models prove effective, coverage for telehealth will be expanded throughout the Medicare program.

“This legislation would incentivize the industry to develop more cutting edge technology that could revolutionize health care delivery,” Gardner said. “As we work toward a health care system that lowers costs and increases choices for consumers, it is important that we advance commonsense legislation like the Telehealth Innovation and Improvement Act to achieve those goals.”

The influence that remote monitoring can have on patient outcomes has also recently been further evaluated.

Researchers from the University of Missouri-Columbia studied the impact of Medicare-funded telehealth interventions on an aging in place population over 10 years and found that those with greater access to services at home through coordinated care efforts were able to remain in an independent living setting longer as they aged.

Beyond federal efforts, state lawmakers have also set their sights on expanding coverage for telemedicine through private payers. The National Law Review reported that 29 states and Washington D.C. have enacted legislation that ensures private insurers offer reimbursement for medically necessary telemedicine. Some of these laws will take effect next month. Over the past year, more than 200 pieces of legislation have been introduced in 42 states that seek to expand telemedicine delivery methods.

Written by Amy Baxter