When Telehealth and Legislation Converge

No matter which way you look at it, Telemedicine use has been growing at an astonishing rate.

According to the Healthcare Trends Institute:

– About 90% of healthcare executives have begun developing a telemedicine program 
(Foley 2014 Telemedicine Executive Summary)

– The number of telemedicine patients will increase from 350,000 in 2013 to 7 million in 2018 (Cisco Customer Experience Report)

– About 22% of employers with 1,000 or more employees offer telemedicine services and another 37% planned to by the end of 2015 (Foley 2014 Telemedicine Executive Summary)

– Telemedicine makes up nearly one-fourth of the health IT market that was valued at $15.6 billion in 2014 and is expected to increase to approximately $20 billion by 2019 (IHS Press Release)

Despite all this growth, the legislation that supports and allows telemedicine through the US have still been playing catch-up.

As recently as 2011, only 11 states had Telehealth Parity laws, which require that insurers reimburse Telehealth providers exactly as they would for an in-person visit.

In 2016, 29 states now have parity laws. In those jurisdictions, if a patient wants to confirm an infection and receive a prescription for antibiotics, it makes no difference to insurance companies whether the visit occurs over the computer or in an office.

Forty-eight state Medicaid programs offer some form of coverage for telemedicine. Congress is expected to take up legislation this year that would expand Telehealth coverage for Medicare enrollees.

Perhaps most telling, over 200 telemedicine bills were introduced in state legislatures in 2015.

According to Jonathan Linkous, CEO of the American Telemedicine Association this has “given an indication that the time has come to have conversation”.

These facts show the growth of interest and value in Telehealth is starting to get attention both in government and in business. Yet the medical authorities still have reservations about the usefulness and implementation.

The American Medical Association (AMA) is increasingly open to telemedicine but has taken a cautious approach. The group released recommended guidelines for Telehealth coverage and payment in 2014, but held off on releasing an ethics policy after concerns were raised that the draft proposed wasn’t thorough enough.

“This is something I’m passionate about, and I’ve been engaged with it for a while,” says AMA board member Jack Resnick. “But we need to make sure that we’re doing it right — Telehealth can’t just become another silo in health care. It’s important to us that a physician using Telehealth practices understands a patient’s full medical history and is able to coordinate that care with their other providers.”

Industry analyst Sarah Turk of IBISWorld says that could propel Telehealth to a $3.5 billion industry by 2020.

“Coverage will be expanded to include more physicians and more specialties and also a range of communications,” she said. “So instead of it being only interactive video consultation, it could be text messaging as well.”

All this data shows that a convergence of innovation and legislation is approaching. It may take another 5 years, but a day will arrive when Telemedicine is the norm, and in-office visits are the exception.

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