6 steps the government needs to take to advance telehealth

The Washington, D.C.-based think tank the Information Technology and Innovation Foundation issued a report this week that highlighted important regulatory and policy changes that need to be made to fully realize the potential cost savings of telehealth services.

Pointing to case studies such as the Veterans’ Administration’s success in lowering chronic care costs with telehealth services, the non-profit non-partisan Information Technology and Innovation Foundation concluded that in the U.S. healthcare system, where both the incidence of chronic illness and the cost of care is high, telehealth services have the potential to save money and increase access to care. However, the U.S. healthcare system as it currently operates presents considerable barriers to telemedicine and telehealth adoption, especially on a national level, due to differences in state-level regulations and the sheer number of different groups involved in healthcare delivery.

If policy makers and regulators are serious about wanting to realize the possible savings in telehealth, the Information Technology and Innovation Foundation recommended they advance the following six changes.

1. Adopt a standard national definition for telehealth with consequences for non-adopting states. Currently, each of the 50 states defines telehealth individually, and conflicting definitions create a complex legal environment for providers, payors and patients. There is a voluntary standard from the Federation of State Medical Boards (FSMB) that individual state medical boards can chose to adopt. (Learn more here.) In addition, a bill in Congress — H.R. 3750, the Telehealth Modernization Act of 2013 — would create a voluntary federal standard that states could adopt. However, the Information Technology and Innovation Foundation recommends that legislators should go beyond just creating a voluntary federal standard and actually create some mandatory penalties for states that do not adopt the national standard within a certain number of years.
2. Establish a single national license for telehealth providers if states don’t create an interstate licensing agreement within the next 18 months. Conflicting state license requirements are a considerable barrier to national telehealth services, so the Information Technology and Innovation Foundation recommends Congress should both create a national licensing requirement and require states to recognize it if the states cannot arrive at their own solution to this problem.
3. Create technology- and location-neutral insurance payment policies. Currently, telehealth services are either not covered or covered at different rates from the exact same healthcare service delivered in the traditional in-person office-based way. In addition, many insurers only cover telehealth services for patients in rural locations where the equivalent in-person healthcare service would be either unavailable or very limited. To encourage insurers to drop policies that restrict telehealth services, the Information Technology and Innovation Foundation wants
4. Congress to require Medicare to change its reimbursement policies to make reimbursement technology- and location-neutral, and it wants state legislatures to adjust their policies for Medicaid and private insurers in the same way.
5. Make state-level prescription drug monitoring programs interoperable, by having the U.S. Department of Health and Human Services (HHS) work with the states to develop interoperable standards for these databases and require that the data be available for aggregate analysis. Interoperable state-level prescription drug monitoring programs would address the risk that telehealth could create a new opportunity for criminals to trade in controlled substances.
6. Create more federal research funding for identifying best practices in telehealth and new ways to use it to lower costs and improve care quality.