Various telehealth definitions, policies 'confusing' for providers

While 48 states and the District of Columbia all have definitions of telehealth or telemedicine written into law or their Medicaid program, differences in those definitions are creating "confusing environments" for end users, according to a new report by the Center for Connected Health Policy.

The report, CCHP's latest annual look into state telehealth laws and Medicaid program policies, also found that 47 states have some form of reimbursement for telehealth in their public program, and determined the most reimbursed form of telehealth to be live video.

"However, what and how it is reimbursed varies widely," the report notes. "The spectrum ranges from a Medicaid program in a state like Idaho, which will only reimburse for a limited number of mental health and developmental disability services, to states like California, which reimburses for live video across a wide variety of medical specialties."

Store-and-forward services, meanwhile, are scarcely reimbursed by state Medicaid programs, with only nine currently paying providers for such services, and a tenth, New York, set to reimburse doctors next year. What's more, only 16 states reimburse for remote patient monitoring in their Medicaid programs. Restrictions on remote monitoring include only offering payments to home health agencies using the technology and limiting which conditions are reimbursed.

"For example, Colorado requires the patient to be receiving services for at least one of the following: congestive heart failure, chronic obstructive pulmonary disease, asthma or diabetes," the report says. "Further, the patient must still meet other conditions."

Raymond Hino, president and CEO of Sonoma West Medical Center in California, believes that telemedicine partnerships ultimately can reduce hospital readmissions. In a recent commentary for Hospital Impact, Hino talks about his organization's experience benefiting from telemedicine.

"I have seen ICUs that have reopened after the introduction of telemedicine and remote presence physician coverage of the units," Hino says. "In short, telemedicine has proven itself as a revenue producing service for our hospital."

And a majority of medical residents say they would be willing to conduct visits with patients through telehealth services, according to a recent Medscape study. More than 1,700 residents across 24 specialties participated in the survey.

Still, not all patients are on board. A recent study conducted by TechnologyAdvice Research of 504 adults in the U.S. found that roughly 65 percent of respondents would be "somewhat or very unlikely" to use telemedicine in place of a face-to-face meeting with their provider. Nearly 37 percent of respondents said they would feel uncomfortable with a virtual visit.

An April 2014 study published in the journal Telemedicine and e-Health determined there to be seven different federal definitions of telehealth.

To learn more:
- here's the CCHP report (.pdf)

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