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Telehealth Programs Likely to Expand, But Payment a Barrier

November 29, 2017

Most health care organizations and providers plan to expand their use of telehealth. But some also expressed concerns about reimbursement and other potential limitations, according to a recent study by KLAS Research and the College of Healthcare Information Management Executives. 

Telehealth (also called telemedicine) is the exchange of medical information from one location to another via electronic communications in order to improve a patient’s clinical health status. Of the 104 health care organizations with telehealth programs that participated in the study:

  • The majority of organizations planned to expand the number of specialties served or expand patient access to providers using telehealth, citing patient convenience among the top benefits.
  • About half listed reimbursement as a limitation, noting that some payers have been slow to reimburse telehealth visits, or reimburse at rates that are lower than in-person care.
  • Most said integration between their electronic medical record and virtual care platform was nonexistent or unidirectional.

The study found that health care organizations used virtual care in one or more of these ways: 

  • To increase patient access, by allowing patients to schedule and conduct clinical visits virtually 
  • To decrease the costs for patients and providers, by addressing patients' urgent and nonemergency medical needs on-demand 
  • To improve the clinical outcomes of patients, by increasing their access to needed specialists

HAP supports the use of telemedicine in hospitals to improve health care access and help hospitals continue to improve the delivery of care at the right time and place for patients. 

Pennsylvania Representative Marguerite Quinn (R-Bucks) and Senator Vogel (R-Beaver) have introduced legislation to address the lag in telemedicine reimbursement. House Bill 1648 and Senate Bill 780:

  • Define the key components of telemedicine
  • Set licensing requirements
  • Require health insurers to provide reimbursement for a telemedicine service if they pay for the same service in person

Pennsylvania hospitals urge the state legislature to continue to move forward with this important legislation.

For more information, contact HAP’s Scott Bishop, senior vice president, legislative advocacy, or Stephanie Watkins, vice president, state legislative advocacy.

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