How Telemedicine Could Greatly Help Florida’s Over-65 PopulationIn the United States, California has the highest total number of elderly residents, but the state of Florida has the highest percentage of elderly in its population, according to the US Census Bureau.
Florida has more senior citizens per capita than any other state.
In 2014, just over 19% of Floridians were over age 65, compared with 14.5% in the US population overall.
Telemedicine, the delivery of healthcare services remotely via phone, email, text, chat, or video conference seems to be the perfect solution for healthcare provision for seniors for many reasons:
• Aging in place is safer and is preferable to most elderly people and their families. Telemedicine allows a number of FDA-approved devices to send automatic alerts to healthcare workers’ phones after a fall, a drop in blood pressure, or some other noteworthy health event.
• Telemedicine eliminates many transportation worries. Since many elderly people use mobility aids or have difficulty driving, simply getting to and from healthcare appointments can be challenging. Telemedicine, however, lets them access healthcare from home, with no transport needed.
• Monitoring of chronic conditions is possible with telemedicine. Conditions like chronic obstructive pulmonary disease (COPD), heart failure, and diabetes can be monitored with telemedicine applications and devices. Vital signs can be transmitted to doctors in real time.
• Telemedicine has the potential to significantly reduce the costs of healthcare for older people by reducing hospital readmissions and emergency department visits.
Infrastructure and Overutilization Fears Are Hurdles
One obstacle that prevents telemedicine from being used more widely with senior citizens is broadband infrastructure in rural areas – the exact areas where transportation can be a problem too. Only 4% of Americans don’t have access to broadband, but FCC Chairman Tom Wheeler thinks that percentage is too high and has formed a task force to “move the needle” on expanding broadband infrastructure.
Another hurdle to expanded use of telemedicine for seniors is fear. But it isn’t seniors’ “fear” of technology that’s at issue. It’s Congress’s fear that telemedicine for seniors will be too convenient, leading to overutilization and higher costs. Currently, fewer than 1% of Medicare recipients use video conferencing for telemedicine, however, and Medicare has been very slow to loosen the reins concerning what it will and will not reimburse for services to Medicare recipients.
Medicare Advantage Providers May Be More Supportive of Telemedicine
Seniors who use a Medicare Advantage rather than original Medicare have, in some instances, greater access to telemedicine. Two Medicare Advantage insurers (University of Pittsburgh Medical Center health plan and Anthem) offer virtual doctor visits for their patients. Two others, Aetna, and UnitedHealthcare, only cover telemedicine services for Medicare Advantage patients who are younger than 65. While this is certainly less restrictive than Medicare itself, which only offers telemedicine services in rural areas, and only from clinics (not from homes), it doesn’t exactly open up telemedicine services to seniors very much.
This handful of Medicare Advantage plans have discovered that telemedicine can be a cost-effective and appropriate use of healthcare. But don’t count on all the other Medicare Advantage plans to follow along and start offering telemedicine coverage. Typically, private insurers follow what Medicare does, and since Medicare is still quite stringent in its requirements for reimbursement with telemedicine, Medicare Advantage insurers have by and large not seen fit to emphasize telemedicine in their coverage.
Providers Say Overutilization Is a Myth
Providers like Anthem, which have moved out in front of the telemedicine trend with their Medicare Advantage plans, say that telemedicine pays off for them in terms of care quality, patient satisfaction, and costs. Though they only cover around 350,000 seniors in only 12 states, their experiences with telemedicine have been positive. After six months of offering telemedicine services, the company says it has not experienced overutilization. In fact, they say their biggest challenge is making senior Medicare Advantage patients aware that telemedicine is an option for them.
Meanwhile, patients and insurers alike hope that the Center for Medicare and Medicaid Studies (CMS) will lift more restraints on traditional Medicare beneficiaries. If this happens, insurers believe that more physicians will incorporate telemedicine into their practices. This could benefit seniors greatly – particularly ones who currently must rely on family, friends, or paid caregivers to drive them to healthcare appointments.Mobile Telemedicine: A New Type of Service for Seniors
Some telecommunications service providers aren’t waiting around to see what Medicare does before offering expanded telemedicine options to seniors. Virtual network provider Emveno subsidiary Seniors Wireless, recently launched a telemedicine mobile virtual network operator (MVNO) service in the US. It costs $1 per day and offers Seniors Wireless users unlimited access to board-certified physicians 24/7/365 from their phones.
Some mobile providers are incorporating telemedicine into their plans.
With this service, subscribers can speak or videoconference with qualified physicians, who are allowed to evaluate, refer, and prescribe remotely. A “teleMED Assist” button on the Seniors Wireless app allows access, and connection with a doctor usually takes place within two minutes. Currently there are no limits on how many times subscribers can call and how long they can talk.
Moreover, teleMED Assist is paired with smartphones specifically designed for older users, including the iPhone 4, and the Samsung Galaxy S3, S4, and S5. A number of different talk / text / and data plans are available to go along with teleMED Assist. One goal of the service is to prevent expensive alternatives, like visits to emergency departments.
Telemedicine makes sense for senior citizens for a number of reasons, and despite Medicare’s slow warm-up to telemedicine reimbursement and Congress’s fears about overutilization, most people believe that telemedicine for seniors will gain prominence in the coming years. Not only can it prevent hospital readmissions and reduce visits to emergency departments, telemedicine can also help seniors who do not have access to reliable transportation – patients who might otherwise do without medical care, or leave problems until they’re severe enough to require an ambulance.
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