Reimbursement

Medicare Changes Needed for Telehealth

February 4, 2016

 

Changes are needed in Medicare to enable coordinated telehealth programs that improve cost and outcomes for patients with multiple complex chronic conditions. This is the key message of comments Philips recently submitted to the US Senate Finance Committee, which is reviewing options in managing chronic care.

 

“Coverage of telehealth under Medicare fee-for-service (FFS) is extremely limited both in terms of geographical limits and in terms of originating site requirements,” said Philips. It suggested changes in the FFS program, as well as in Medicare Advantage and Accountable Care Organizations to make such services more widely available. Among the suggested changes are adequate reimbursement levels and recognition of telehealth beyond just substitution for face-to-face encounters.

 

Philips explained that the coordinated telehealth programs offer a “high-tech/high-touch” approach that is effective with patients suffering from multiple, complex, and high-cost chronic decisions. Telehealth technologies facilitate coordinated and effective clinical action among caregivers, while personalized care tailored to the needs and preferences of individual patients improve patient compliance.

 

Data from a pilot program involving Philips’ partnership with Banner Health in Phoenix, AZ, indicate such a program has the potential for reducing:

 

  • costs in the range of 27%
  • acute and long-term care in the range of 32%, and
  • hospitalization in the range of 45%.

 

View Philips comments