Telemedicine stakeholders urge Burwell to change policies that stifle innovation

Outdated government policies are holding Accountable Care Organizations (ACOs) back from making better use of technology to lower cost while simultaneously improving care say no less than 70 individual companies, institutions and groups in three separate letters sent to incoming U.S. Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell.

The organizations include major insurers like WellPoint, national pharmacy chains Walgreens and CVS, and leading providers such as Banner, Geisinger and Essentia, as well as the key healthcare information technology associations like HiMSS and ATA that have long advocated for better use of telemedicine and remote monitoring technologies in care delivery.

Specifically, the groups asked Burwell to use her authority as the new HHS Secretary to waive current restrictions on use of telemedicine and remote patient monitoring in the Medicare Shared Savings Program (MSSP). In addition, they asked that she use the upcoming Notice of Proposed Rulemaking (NPRM) to request public comment on telemedicine and remote monitoring use by ACOs — an important first step in achieving regulatory change.

“Those of us working with providers who do not receive reimbursement for connected care services are faced with the difficult decision of assuming financial risk by providing the care for free. For many physician-led and smaller ACOs without access to a lot of capital, it is not even an option,” wrote the healthcare executive members of the Alliance for Connected Health in their letter.

Removing government limitations on when telemedicine and remote monitoring care can be reimbursed by Medicare, as well as creating standard nationwide definitions for what counts as legitimate care delivery by means of such technologies is important, the letters say, because what the government does often sets the pace for technological change in the healthcare sector.

At least one new survey backs up that idea. The June issue of the journal Telemedicine and e-Health includes the results of an online questionnaire on telemedicine reimbursement by private payors. It indicated that while progress on reimbursement has been made, it “remains slow and a barrier to the practice of telehealth.”

The very first item the authors list as a policy implication of their survey is that because government payers “set precedent for payment policies for some private payers. Elimination of the disparities in federal and state public policy for reimbursement for services delivered via telemedicine would probably encourage more private payers to change their internal policies regarding telemedicine reimbursement.”