December 7, 2015
From BNA's Health Care Policy Report

Changing reimbursement methods and the rise in popularity of accountable care organizations are poised to drive growth and innovations in telehealth in 2016 into areas that until now have been blocked by regulators, according to a panel at the American Bar Association's Washington Health Law Summit Dec. 7.

The panel, consisting of Cybil G. Roehrenbeck of Polsinelli in Washington, Nathaniel Lacktman of Foley & Lardner in Tampa, Fla., Natasa Sokolovich of UPMC in Pittsburgh and Robert Jarrin of Qualcomm Inc. in Washington, told attendees that much of the development in telehealth technologies should see a dramatic increase once the reimbursement provisions of the Medicare Access and CHIP Reauthorization Act begin to take effect in 2016.

The panelists cited the need for this development, with Lacktman pointing to the fact that, while newly created ACOs are providing real cost savings to their participants, only 20 percent of those organizations are using telehealth services that could represent even greater savings.

Changes in Regulation

According to Jarrin, the implementation of the MACRA requirements will have the largest impact on the broader development of telehealth. The statute requires that providers begin to move away from a fee-for-service model to a more qualitative analysis reimbursement model that ties reimbursement rates in part to patient satisfaction rates.
"If they are really looking at tying reimbursement to quality, the only way that they are going to achieve that is through innovative technologies,”Jarrin said.

Roehrenbeck agreed. “Reimbursement is very important,” she said. “Getting those states that don't have parity acts on the books to act”will be a large step in the direction of advancing telehealth in the next few years.

According to Lacktman, advancement of the proposed federal Medicare Telehealth Parity Act “is the biggest potential change and could blow the doors open for the development of telehealth.”

Expected Growth Areas

Lacktman said 2016 was “going to be the year of telehealth and ACOs,”arguing that the organizations would jump at the chance to provide their participants with cost savings through the latest technological advancements.

Sokolovich focused on the direct-to-consumer aspects of telehealth that she believed could be the largest growth area for the technology.

She pointed to an example of geriatric patients who must be transferred out of their assisted care facility to a medical facility for medical consultation, when it would be much less disruptive and would eliminate transit costs to allow those patients to consult with telehealth portals.

Sokolovich also said many innovations in telehealth that were being researched could provide payers with ways to reduce costs and could allow providers to bring their patients access to subspecialties that they don't currently provide.

Reproduced with permission from BNA's Health Care Daily Report, 235 HCDR (Dec. 8, 2015). Copyright 2015 by The Bureau of National Affairs, Inc. (800-372-1033)