Like many hospitals and health systems, UMass Memorial Health Care is looking to improve the quality and overall health of its patients as the federal government moves to reimburse providers based on value and results, as opposed to volume. To that end, the four-hospital system plans to double down on its virtual care efforts, the Boston Business Journal reports.
Spending on virtual care will balloon from $8 million a year to $15 million in an effort to "fill a bunch of gaps" in service, according to UMass Memorial CEO Eric Dickson. "By filling those gaps, we'll be much better positioned to manage the full cost of a population and think like an insurance company," Dickson tells the Journal.
UMass first plans to launch the virtual medicine program for employees within 120 days; it then will make it available to patients with a physician in the system.
In its final rule on Medicare Shared Savings Program accountable care organizations, unveiled June 4, the Centers for Medicare & Medicaid Services, however, says it will not provide waivers enabling increased reimbursement for use of telemedicine by ACOs in one-sided risk models, or Track 1 of the program. Instead, it will consider such requests from ACOs in two-sided risk models, but anticipates initially limiting waivers to ACOs in Track 3 of the program. CMS says it intends to offer such a waiver starting in 2017, with specific requirements to be based on the agency's efforts implementing telemedicine-based waivers in the Next Generation ACO Model.
The American Telemedicine Association calls the ruling a disappointment, saying that it "severely restricts" how providers can use telemedicine to care for millions of patients.
"Medicaid, private payers, the VA and the Department of Defense long ago realized the importance of telehealth to reduce costs, expand access and improve quality," ATA CEO Jonathan Linkous says in a statement. "For over four years, ATA has urged CMS to waive restrictions on ACOs use of telemedicine. This is a longstanding issue that the agency has made very little movement on."