Reimbursement persists as obstacle to telehealth adoption

Photo credit: Getty/AndreyPopov

Telehealth plays an important role in providing high-quality "anytime, anywhere" healthcare services at lower cost, but a lack of uniform regulations hinders its adoption, according to a brief at Health Affairs.

Reimbursement remains a primary hurdle when it comes to use of the services by providers as well as consumers.

Though a majority of states have parity laws requiring reimbursement for telehealth services, the coverage and requirements for payment vary wildly. There are few incentives for providers to promote telehealth over in-person care, which can be key to lowering costs and improving access, according to the brief, sponsored by the Robert Wood Johnson Foundation.

Though the Centers for Medicare & Medicaid has proposed expanding telehealth coverage for Medicare, its existing requirements limit its effectiveness.

Twenty-three states and the District of Columbia require telehealth reimbursement comparable to that for in-person services. Other states place limits on the types of technology, patient locations, covered provider types and may require an in-person visit to establish a patient-provider relationship, according to the brief. Nevada is the only state to extend parity to workers' compensation programs.

In most states, reimbursement is limited to live videoconferencing. Under Medicaid, only nine states reimburse for store-and-forward services, while 16 states pay for remote patient monitoring. Pennsylvania and South Dakota cover remote patient monitoring through their departments of aging.

Three Medicaid reimbursement policy changes for telehealth and remote patient monitoring could save the federal government $1.8 billion over the next 10 years, according to a report by consultancy Avalere Health. 

Without a uniform approach to telehealth reimbursement, the nation cannot fully realize the cost savings of telehealth, according to the brief.

To learn more:
- here's the brief