New Study Looks at National Progress on Expanding Telehealth Coverage and Reimbursement > Hospital Association of Pennsylvania


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New Study Looks at National Progress on Expanding Telehealth Coverage and Reimbursement

July 29, 2019

A new study suggests Pennsylvania has some catching up to do when it comes to policies related to telehealth coverage and reimbursement. Telehealth—or telemedicine—is the exchange of medical information from one site to another via electronic communications in order to improve a patient’s clinical health status.

The American Telemedicine Association (ATA) recently issued a report stating that more states than ever are taking steps to expand telehealth coverage and reimbursement. Key findings from the ATA report reveal that:

  • 40 states and the District of Columbia have adopted policies or received awards to expand telehealth coverage and reimbursement since 2017
  • 36 states and D.C. have parity policies for private payer coverage; only 21 states and D.C. have coverage parity policies in Medicaid
  • 28 states have Medicaid payment parity policies; only 16 mandate payment parity for private payers
  • The majority of states have no restrictions around eligible provider types; ten states have authorized six or more types of providers to treat patients through telehealth
  • Only 16 states limit telehealth to synchronous technologies while most of the country recognizes the benefits of remote patient monitoring (RPM) and store and forward (S&F)

The report suggests that Pennsylvania has room to grow, by improving polices to:

  • Remove restrictions that condition coverage on synchronous technologies
  • Increase eligible providers that can treat patients through telehealth
  • Adopt parity policies to cover telehealth services
  • Adopt private payer parity policies

Last legislative session, HAP and its members backed a bill that would have required health insurers to provide reimbursement for telemedicine services if they pay for the same service in person. The bill advanced, but did not make it to the Governor before the end of the session.

There is no question about the value of telehealth, which can be used to connect a specialist to a patient at a distance, to deliver life-saving care, and to deliver routine care in a timely, cost-effective manner. Services delivered through telehealth can save time and money, as well as improve health outcomes and population health. Telehealth can increase consumer access to specialists in urban, suburban, and importantly, rural areas.

HAP urges state leaders to once again consider the importance of improving the state’s coverage and reimbursement policies for this important health care platform. For additional information, contact Stephanie Watkins, HAP’s vice president, state legislative advocacy.

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