This year, the ATA Fall Forum focused on the management of chronic conditions through telemedicine. Sessions, programs, and discussions concerned ways telemedicine can be used to
- Reduce healthcare costs
- Reduce hospital readmissions
- Improve healthcare outcomes
- Improve access to healthcare services
in a healthcare economy where cost containment is a priority. Technology has advanced to where telemedicine experts can now shift their attention toward calculating the value provided by telemedicine. Access is expanding so more consumers can anticipate better access, convenience, and affordability of healthcare services through the use of telemedicine.
Fall Forum: Chronic Disease and Telemedicine
Yulun Wang, PhD, president of the ATA Board of Directors, says that addressing chronic disease through telemedicine could be an important way to contain costs. As healthcare increasingly focuses on a “pay for value” model, keeping patients with chronic diseases healthier is seen as an important way to address rising healthcare costs. When chronic conditions are managed better, patients are less likely to require hospital readmission – an outcome that is expensive and stressful to patients.
Chronic diseases like cancer, heart disease, and diabetes are leading causes of death and disability in the United States, and 75% of US healthcare dollars are spent treating these diseases. The ATA Fall Forum gathered America’s leading telemedicine experts to focus on how telecommunications technology can be used to deliver healthcare services to people with chronic illnesses in new, more convenient, lest costly ways.
The Fall Forum marked the first time experts in telemedicine have gathered with the purpose of identifying through validated evidence what works and what doesn’t work when using telemedicine to prevent, treat, and manage chronic health conditions. Some of the topics addressed at the Fall Forum included
- Return on investment models for remote patient monitoring
- Innovative payment strategies for chronic disease management
- Methods for reducing readmissions
- Regulatory and legal issues
- Outcomes of telemedicine utilization with specific chronic diseases
- Selection of patients for telemedicine services
Reimbursement, Physician Practice Standards, Licensure: Looking Forward
While the Fall Forum was going on, the ATA released two policy reports identifying gaps in coverage and reimbursement for telemedicine services, and state-to-state differences in physician practice standards and licensure. These policy reports compare state policies in a “report card” fashion, based on telemedicine reimbursement and physician practice standards. This was a major undertaking, considering that all 50 states have different telemedicine policies, but the reports put this data into an easy-to-understand format.
These reports show that evidence-based research highlighting the positive clinical outcomes of telemedicine has received mixed reception from different states’ policymakers. Seven states (Maryland, Maine, Mississippi, New Hampshire, New Mexico, Tennessee, and Virginia) were called out as having the most supportive policy landscape in terms of accommodating the adoption of telemedicine. Connecticut, Iowa, and Rhode Island were listed as the states least supportive in terms of policy to telemedicine adoption.
Congress Considering Several Telemedicine Bills
While the ATA Fall Forum was going on in California, lawmakers returned to Congress after their August recess, and several telemedicine bills awaited them. Though many telemedicine bills have been filed on Capitol Hill, it remains to be seen which of them will gain enough traction to progress through the lawmaking process. These bills are primarily aimed at helping Medicare loosen restrictions on payments for telemedicine services. Last year, Medicare only spent $12 million on telemedicine reimbursements.
Enthusiasm for telemedicine in Washington DC is noticeable, but with mid-term elections coming up in November, the pace of the legislative agenda is expected to be slow. A lobbying group called the Alliance for Connected Care, formed by former Senate Majority Leaders Tom Daschle and Trent Lott, and former Louisiana Senator John Breaux, is lobbying heavily to change Medicare’s stance on telemedicine reimbursement.
Until the past year or so, telemedicine was considered a “niche” issue in healthcare, but that is changing, if the number of telemedicine bills introduced is any indication. In a Congress that is deeply divided politically, telemedicine is one area where there is bipartisan support. Bills have been sponsored in the House of Representatives by Reps Mike Thompson (D-California) and Gregg Harper (R-Mississippi), and Rep Peter Welch (D-Vermont) hopes to file legislation dealing with use of telemedicine by accountable care organizations.
In the senate, Mississippi Senators Thad Cochran and Roger Wicker, both Republicans, filed a companion bill in the Senate to Rep. Harper’s House bill. Rep. Welch told Politico, “I am working to build bipartisan support for our bill by sharing with my colleagues the success stories of telemedicine that I’m hearing back home. The returns on investment in telemedicine are clear — lower costs and improved health.”
Towers Watson Study: $6 Billion Per Year in Savings
Legislators at the federal and state levels won’t have to search hard for data on the cost savings associated with telemedicine. New York City-based consulting firm Towers Watson released a report in August stating that telemedicine could result in savings of $6 billion or more per year in healthcare costs for US employers. The report, titled “2014 Health Care Changes Ahead Survey,” found that 22% of US employers with at least 1,000 employees offer telemedicine options, but that number is expected to increase to 37% next year, with even more jumping onboard in 2016 and 2017.
One of the biggest hurdles to telemedicine adoption is how telemedicine consultations are billed to insurers. But where companies have introduced telemedicine options, savings have resulted. Boston’s Houghton Mifflin Harcourt publishers have reported a reduction in lost productivity of approximately one-half day of work per employee due to the use of telemedicine rather than in-person physician visits.
Conclusion
The ATA’s Fall Forum indicated that the time for telemedicine adoption has arrived. The technology has matured, and data has been gathered showing that telemedicine increases convenience, cuts costs, and saves time. At the same time, Congress is considering bills allowing Medicare to reimburse more telemedicine services, indicating that telemedicine has a bright future in American healthcare.
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