The Emergence of Telemedicine: More Proponents and More Reimbursement

Telemedicine is becoming more popular, and the American Medical Association (AMA) asked for its doctors to be reimbursed for telemedicine encounters between patient and doctor. Telemedicine is considered to be any care that is provided via the phone, via e-mail, web sites, or any electronic means.

The AMA’s House of Delegates want insurance companies and Medicare to recognize telemedicine as a viable form of healthcare. Currently, only a limited amount of telemedicine is reimbursable through insurance companies. The AMA’s aggressive policy, however, asks that  “pilot projects of innovative payment models be structured to include incentive payments for the use of electronic communications such as Web portals, remote patient monitoring, real-time virtual office visits, and e-mail and telephone communications.”

Since Congress probably won’t provide substantial additional funding for telemedicine in the near future, the AMA has begun to ask states and private insurers to pay for more telemedicine. In fact, there are already 12 states with laws that mandate that telemedicine be covered.

The laws vary by state. For example, Virginia law covers care that uses interactive audio, video or any other form of electronic media used to consult with, diagnosis or treat a patient. The Virginia law does not cover care given over regular telephones, email, or fax.

Telemedicine is not new to Virginia. The Department of Corrections and the Veterans hospitals there already use telemedicine services. They have installed networks for telemedicine that are funded by government grants. The reason for the support behind telemedicine laws in Virginia is simple – legislators and providers realize the benefits of telemedicine, and that it provides better care for people in rural areas.

About half of the states in the U.S. cover telemedicine through Medicaid in some limited shape or form, and the American Telemedicine Association (ATA) believes this practice will soon expand nationwide. The CEO of ATA, Jon Linkous, states that telemedicine has three main impacts on patients: increased access to care, improved quality of care, and reduced costs.

Insurance companies are looking for more guidance before they cover telemedicine on a broad basis, but they are already realizing that telemedicine save both patients and providers money. This means the writing is on the wall for telemedicine, which has been proven through many studies to be an effective way to treat various health conditions.

Yet the insurance carriers want more specifics on how and when doctors and patients should turn to telemedicine, and under what circumstances the insurance should cover it. The proponents of telemedicine argue that it is a valuable tool for doctors to be able to consult with specialists, no matter where they are located. This provides a better standard of care – especially in remote areas – proponents say, because it provides for a diagnosis or assessment in a more timely fashion.

It also allows patients to keep in touch with their doctors without having to travel long distances for office visits, which in turn cuts down on health expenditures. Telemedicine supporters also agree that telemedicine is not appropriate for all situations, and certain circumstances still call for a face-to-face visit with your physician.