The Government Accountability Office (GAO) released a market status report on telehealth and remote health monitoring last month. Though nothing new from my knowledge gain per se, it is a good read and reminds me of how slow the reimbursement policy has evolved since I started covering digital health in 2006. CMS is the gatekeeper of Medicare’s reimbursement policy and has historically been slow to embrace telehealth or remote health monitoring for fear of over-utilization and cost over-run. The current “originating site” restriction is a typical measure that CMS uses to limit usage, whereas infrastructure challenges happen to be more prevalent in locations where the originating sites are on—the rural areas.
Having said that, the telehealth industry has several of its own barriers to blame, including the lack of a cross-states licensure framework, higher cost of telehealth equipment in the past, and physician’s own concerns about new work flows and lack of direct reimbursement tracks for telehealth and remote health monitoring.
CMS has gradually opened the gate—through creative waiver programs, new value-based care payment schemes, and incentive payment to care providers—to build digital infrastructure for practicing telehealth (e.g., the meaningful use). We feel strongly that the slow adoption of telehealth should not be blamed on one agency, and by the same token, the hope of accelerated adoption cannot be pinned on one agency. It should be a collaborative effort to make practicing telehealth as if it is equitable to face-to-face visit in consumer experience, clinical outcome, and payment. Only then will doctors be willing to invest in telehealth solutions and drive the overall acceptance of telehealth as a normal practice. As we said repeatedly in our industry reports, CMS is unlikely to fund the purchase of telehealth equipment and software directly. Only through embedding telehealth in doctor’s practice will they be able to cover such cost through delivering service more efficiently and providing better care.
For this argument, we are very hopeful that value-based care will be the ultimate catalyst through which telehealth can prove its value, convince suspicious care providers, and spur its adoption in doctor’s practices. CMS has been leading the effort in value-based care, and we are only wishing its pace could be faster and goals be higher.
At our upcoming Connected Health Summit in San Diego, CA on August 29-31, We will have more to share about value-based care and CMS' reimbursement policy trends. We welcome you to join us and contribute.
Further Reading:
