MedPAC concerned increased telehealth reimbursement could lead to unnecessary consults

The Medicare Payment Advisory Commission, an independent federal panel, recently addressed the question of whether expanded payments to doctors would spur adoption of telemedicine.

Just 15 percent of American Academy of Family Physician (AAFP) members had used telehealth in 2014, according to a recently published survey by the group. And less than 1 percent of physicians accounted for 22 percent of telemedicine visits that year. Just 69,000 patients used telemedicine in 2014, according to that study, and only 6 percent of consults took place across state lines.

One of the prime concerns about increasing telemedicine reimbursement is the possibility that it could encourage unnecessary consults, according to an article at AAFP.org.

One way to address those concerns would be to use telemedicine for specific populations, such as stroke victims or hemodialysis patients, suggested Mark Miller, MedPAC executive director.

Commissioners also discussed the possibility of paying primary care physicians a monthly fee of about $8 per member to encourage wider adoption of telemedicine.

Some commissioners were concerned that expanding Medicare payment for such services would increase costs substantially without noticeably improving quality of care. They also worried that Congressional Budget Office estimates of the cost would lead Congress to reject it.

They pointed to a report from the Agency for Healthcare Research and Quality (AHRQ) that called for more research on the effectiveness of telemedicine in primary care.

Despite previous research in the UK that failed to link telemedicine to cost-effectiveness or better quality of life for patients, the National Health Service (NHS) has laid out an ambitious plan to use telemedicine for chronic care. And London-based healthcare think tank 2020health suggested it take a page from the U.S. Department of Veterans Affairs' rollout of telehealth services.

To learn more:
- read the AAFP.org article
- check out the MedPAC presentation (.pdf)

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