Some 90% of healthcare executives say their organizations are developing or have implemented telemedicine programs, and by the year 2018 an estimated 7 million telemedicine visits are expected annually. Nearly one-quarter of employers with 1,000 or more employees offer telemedicine services to employees, and many more plan to. And telemedicine already accounts for almost one-fourth of the modern health IT market.
Other statistics indicate just why telemedicine is so popular. With an average ER visit costing over $750, the average primary care physician visit costing around $105, and the average telemedicine visit costing around $45, it’s clear why patients like this option for routine and minor medical needs. And now some telemedicine users will be able to select which doctor they see in telemedicine interactions.
Addressing the Issue of Continuity of Care
As convenient as telemedicine can be, and as cost-effective, one criticism of the way early telemedicine systems have been set up is that there’s no guarantee of continuity of care. Of course, there’s no absolute guarantee of continuity of care with in-person visits, but people are able to choose who they see to some extent. Addressing the need for a primary telemedicine doctor is a new phase of telemedicine development.
Telehealth company American Well, which offers telemedicine services to more than 100 million people and which is the company people with Anthem health insurance use for telehealth services, is launching an online marketplace that allows patients to select from a menu of doctors. Dr. Roy Schoenberg, one of American Well’s founders, says that people care which physician they see, and offering that functionality is a natural extension of current telemedicine services.
Arizona: Telemedicine Not Just for Rural Areas
Arizona is committed to expanding the use of telemedicine beyond just its vast rural areas. In May, Arizona Governor Doug Ducey signed a bill into law that requiring private insurers to pay for telemedicine throughout the state rather than only in rural areas. After all, if a person doesn’t have access to transportation and is ill, the urban clinic five miles away may as well be 500 miles away.
The previous version of the law in Arizona, which went into effect in January of 2015 only required reimbursement by insurers for services offered in rural areas. While Arizona has large rural expanses, it also has a large population of retirees, who may benefit from telemedicine services even if they live relatively close to healthcare providers. There is still room for improvement, however, since the new law only covers a limited set of services rather than providing full parity of reimbursement between telemedicine and in-person delivery.
Mayo Clinic Doctor Urges Telemedicine Expansion
American Well’s new feature allowing telemedicine patients to pick their own doctor is a welcome trend as telehealth services become a more widely accepted aspect of mainstream healthcare delivery. The technology hasn’t been a barrier for a while now, but regulatory barriers have slowed adoption of telehealth services. Individual states have crafted telemedicine policies concerning things like parity.
Dr. John Noseworthy, president and CEO of Minnesota-based Mayo Clinic, says that telemedicine has a “track record for improving access to care and lowering the cost of care,” but the federal government in particular lags behind the states in telehealth policy. In 2015, Minnesota passed two laws in support of telemedicine, including a law that permits Minnesota physicians to obtain medical licenses in other states, and a parity law that requires telemedicine services to be reimbursed just like other healthcare services. Noseworthy believes most states are on track with their telehealth legislation, but at the federal level, progress is not happening quickly enough.
Medicare, Early Adopter of Telemedicine, Still Slow to Expand Access
Medicare, the federal health insurance program for Americans over 65 and disabled people, has actually been using telemedicine longer than just about anyone else in the US. However, since Medicare started out its telemedicine services in very limited applications, for Medicare recipients living in defined rural areas where telemedicine could be delivered through a rural clinic, it hasn’t expanded much.
One early concern was that telemedicine expansion among Medicare patients would make it too easy to seek medical care, prompting people to seek services for things they would normally wait out or treat themselves. Overutilization could, of course, drive costs up if it were bad enough, but experience in telemedicine services with private insurers suggests overutilization won’t be a significant problem.
Telemedicine as an Answer to Physician Shortage
Another reason Medicare is being urged to consider expanding its telemedicine policy a bit faster is that by the year 2025, the US is expected to have a shortage of 12,000 to 31,000 primary care physicians, making it harder to find doctors or schedule appointments. With baby boomers hitting retirement age, plus an estimated 30 million more Americans becoming insured since implementation of the Affordable Care Act (ACA) in 2010, a shortage of primary physicians could be alleviated to some extent by telemedicine services provided by nurse practitioners and physician assistants.
Some office-based doctors offer telemedicine services, but the more common paradigm is providers who practice telemedicine exclusively, or retail clinics offering telemedicine. Rite Aid, Walgreens, and CVS are three big providers getting into telemedicine as an adjunct to their on-site retail clinics.
The advancement of telemedicine technology coupled with a possible shortage of primary care physicians is making telemedicine an emerging career field not only for physicians, but also for nurse practitioners and physician assistants. This new type of medical career would theoretically allow healthcare providers to work from anywhere, including a home office with secure technology while earning reasonable compensation with more predictable hours than the clinician working in a hospital or private practice.
Status of the Interstate Medical Licensure Compact
One program designed to ease problems with the US’s state-based physician licensure system is a new Interstate Medical Licensure Compact, which will offer an expedited pathway to licensure in multiple states for physicians who wish to practice telemedicine across state lines. In addition to facilitating multi-state licensing, the Compact is also designed to make it easier for states to share investigative and disciplinary information about physicians. Sixteen states have signed on to the Interstate Medical Licensure Compact, and an additional ten have introduced legislation to join it.
American Well’s decision to allow telemedicine users to select from a menu of doctors could be a new trend in telehealth delivery, offering many of the advantages of continuity of care along with the convenience and cost savings of telemedicine technology. eDrugstore.com understands the tremendous value of healthcare delivered at a distance, and has served over half a million customers with prescription lifestyle medications at competitive prices with unmatched convenience. We encourage you to look through our blog to learn more about telemedicine and other health topics that affect your life.
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