{"id":8856,"date":"2016-01-14T11:16:41","date_gmt":"2016-01-14T11:16:41","guid":{"rendered":"https:\/\/www.edrugstore.com\/blog\/blog\/?p=8856"},"modified":"2016-03-14T13:26:30","modified_gmt":"2016-03-14T13:26:30","slug":"will-the-congressional-budget-office-impede-telemedicines-expansion","status":"publish","type":"post","link":"https:\/\/www.edrugstore.com\/blog\/current-health-news\/will-the-congressional-budget-office-impede-telemedicines-expansion\/","title":{"rendered":"Will the Congressional Budget Office Impede Telemedicine&#8217;s Expansion?"},"content":{"rendered":"<figure style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/mediashower.com\/img\/9C6FA556-97EC-11E5-8EE2-A8E9B579FF79\/bigstock-Doctor-hand-touching-E-HEALTH--109849076.jpg\" alt=\"Telemedicine\" width=\"300\" height=\"200\" border=\"0\" \/><figcaption class=\"wp-caption-text\">Telemedicine and other e-health solutions offer health care providers with an innovative way to extend their services to those in rural areas.<\/figcaption><\/figure>\n<p>A few pieces of legislation pending before Congress or soon to be introduced would significantly expand the use of telemedicine in this country. However, proponents of telemedicine growth worry that the Congressional Budget Office&#8217;s less than enthusiastic view of the new technology could create roadblocks to its growth.<\/p>\n<p>These roadblocks might well come in the form of overestimates of the cost of expanding Medicare coverage for telemedicine-enabled services. As an example of what might happen, telemedicine proponents point to an overblown CBO estimate of what it would cost Medicare to cover a limited number of telemedicine services under legislation passed back in 2001.<\/p>\n<p><b>Federal Spending Watchdog<\/b><\/p>\n<p>Created more than four decades ago to keep a watchful eye on federal spending, CBO in 2001 estimated that the coverage of limited telemedicine services would cost Medicare $150 million over the first five years the law was in force. In fact, actual telemedicine outlays over a period of 14 years totaled only $57 million, according to the Center for Telehealth and eHealth Law.<\/p>\n<p>And it&#8217;s hardly the first time the CBO has come in with a significant overestimate of what a change to Medicare policy would actually cost. In a recent article posted at <a href=\"http:\/\/www.politico.com\/story\/2015\/12\/telemedicine-fans-point-to-cbos-history-of-cost-overestimates-216915\">Politico.com<\/a>, eHealth reporter David Pittman cites several examples of CBO estimates that were well off the mark.<\/p>\n<ul>\n<ul>\n<li>CBO projected that the insurance-related provisions of the Affordable Care Act would cost $710 billion from 2015 to 2019. However, the watchdog office revised that figure downward to $506 billion in its March 2015 updated projection. Pittman points out that the CBO failed to take into account &#8220;either the 2013 Supreme Court decision that made Medicaid expansion optional for states, or the slowdown in health spending soon after the law&#8217;s passage. It also assumed an overly high number for private health plans sold under the ACA.&#8221;<\/li>\n<\/ul>\n<\/ul>\n<ul>\n<ul>\n<li>CBO estimated that Medicare Part D, which provided a prescription drug benefit starting in 2003, would cost $552 billion in its first decade. Part D&#8217;s actual cost during that period came in at $358, nearly one-third less than the budget office&#8217;s estimate.<\/li>\n<\/ul>\n<\/ul>\n<ul>\n<ul>\n<li>The actual savings from the establishment of a prospective payment system at the Centers for Medicare and Medicaid Services were twice as high as was originally predicted by CBO. This change in how hospitals are reimbursed realized actual savings of $21 billion in its first four years, according to a 2010 study published by the Commonwealth Fund.<\/li>\n<\/ul>\n<\/ul>\n<ul>\n<ul>\n<li>CBO projected that federal savings under the 1997 Balanced Budget Act would total $112 billion between 1998 and 2002. In fact, the savings by 1998 were 50 percent above CBO&#8217;s four-year projection and 113 percent higher by 1999<\/li>\n<\/ul>\n<\/ul>\n<figure style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/mediashower.com\/img\/9C6FA556-97EC-11E5-8EE2-A8E9B579FF79\/bigstock-Tele-doctor-portrait-95187092 (1).jpg\" alt=\"Telemedicine\" width=\"300\" height=\"299\" border=\"0\" \/><figcaption class=\"wp-caption-text\">Using video-conferencing technology, health care providers can pay virtual visits to patients in their homes.<\/figcaption><\/figure>\n<p>In defense of CBO&#8217;s estimates, Douglas W. Elmendorf, who was director of the budget office from January 2009 until March 2015, told Politico that he feels it is &#8220;incorrect to say that CBO always overestimates the cost of health care proposals.&#8221; However, he pointed out that &#8220;it is difficult to estimate the cost of health care proposals and CBO will often turn out to be high or low in its estimates.&#8221;<\/p>\n<p><b>CBO&#8217;s &#8216;Cautious Methods&#8217; Blamed<\/b><\/p>\n<p>The budget office&#8217;s overestimates on the cost of some health care proposals and underestimates on the savings potential of some budgetary changes were blamed primarily on CBO&#8217;s &#8220;cautious methods&#8221; by Jon Gabel of the National Opinion Research Center.<\/p>\n<p>Echoing Gabel&#8217;s sentiments, Dan Mendelson, CEO of Washington, D.C.-based health care consulting firm Avalere Health, said officials at CBO &#8220;tend to overestimate the cost of this legislation because they&#8217;re trying to be conservative, so you are not sticking the federal government with liability it didn&#8217;t anticipate.&#8221;<\/p>\n<p>Among those anxiously awaiting CBO&#8217;s estimates on telemedicine-related spending legislation are members of the Alliance for Connected Care, a D.C.-based lobbying group that was formed in 2014 by former U.S. Senators Tom Daschle and Trent Lott. In the second half of 2014, the alliance commissioned an actuarial study on the potential costs and savings of telemedicine proposals.<\/p>\n<p><b>Alliance Underwrites Report<\/b><\/p>\n<p>The alliance also underwrote <a href=\"http:\/\/online.liebertpub.com\/doi\/abs\/10.1089\/tmj.2014.9981?journalCode=tmj\">a similar report<\/a> put together by Rashid Bashshur, the executive director of eHealth at the University of Michigan Health System. That report, published in the September 2014 issue of &#8220;Telemedicine and e-Health,&#8221; was based on Bashshur&#8217;s review of hundreds of telemedicine studies. Based on his review of those research findings, Bashshur concluded that telemedicine technologies can significantly reduce hospitalizations of patients with chronic illnesses and visits to hospital emergency rooms.<\/p>\n<figure style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/mediashower.com\/img\/9C6FA556-97EC-11E5-8EE2-A8E9B579FF79\/3664385777_2a1dc84a33_z.jpg\" alt=\"Telemedicine\" width=\"300\" height=\"200\" border=\"0\" \/><figcaption class=\"wp-caption-text\">Congress created the Congressional Budget Office to keep a close tab on the potential cost of &#8212; and savings from &#8212; proposed legislation.<\/figcaption><\/figure>\n<p>Telemedicine proponents are watching closely for CBO&#8217;s reaction to new telehealth-related legislation that was either introduced in the second half of 2015 or is expected to be introduced early in 2016.<\/p>\n<p><b>Telehealth Improvement and Innovation Act<\/b><\/p>\n<p>Introduced in early December 2015 by U.S. Senators Cory Gardner (R-CO) and Gary Peters (D-MI), the Telehealth Improvement and Innovation Act would allow Medicare to expand its coverage of telemedicine services. It would accomplish this goal by allowing more telehealth projects at the Center for Medicare &amp; Medicaid Innovation. The bill would require the Department of Health and Human Services to allow eligible hospitals to test new telehealth concepts at the CMMI. It would also require CMMI to separately evaluate new telehealth models on multiple criteria, including cost, efficacy, and the ability to improve the quality of care without boosting the cost of delivery.<\/p>\n<p>In remarks made during the introduction of the legislation, Senator Gardner said, &#8220;People living in rural Colorado should have access to the same health care services as those living in urban areas. Telemedicine has the power to increase access to specialized services in underserved communities, and potentially lower costs and improve patient outcomes.&#8221;<\/p>\n<p><b>Sen. Schatz to Introduce Bill<\/b><\/p>\n<p>Another eagerly awaited piece of legislation is expected to be introduced early in 2016 by Senator Brian Schatz (D-HI). Senator Schatz&#8217;s bill, according to an article posted at mHealthIntelligence.com, would allow health care providers to use telemedicine technology in new alternative payment programs that would be overseen by the Centers for Medicare and Medicaid Services.<\/p>\n<p>Introduced in the House on July 7, 2015, the <a href=\"https:\/\/www.congress.gov\/bill\/114th-congress\/house-bill\/2948\">Medicare Telehealth Parity Act of 2015<\/a> (H.R. 2948) would gradually increase the range of telehealth services covered by Medicare. The bill also addresses existing constraints on Medicare coverage of health care services provided remotely. According to HealthLawPolicyMatters.com, the bill would also &#8220;permit reimbursement under Medicare for certain services provided in a beneficiary&#8217;s home, regardless of rural or urban designation.&#8221;<\/p>\n<p><b>TELE-MED Act of 2015<\/b><\/p>\n<p>Introduced in the Senate in mid-2015, the <a href=\"https:\/\/www.congress.gov\/bill\/114th-congress\/senate-bill\/1778\/text\">TELE-MED Act of 2015<\/a> (S. 1778) seeks to streamline professional medical standards by permitting doctors in one state to provide care remotely to Medicare beneficiaries in other states without the need to obtain a medical license in the patient&#8217;s state.<\/p>\n<p>If you&#8217;d like to read additional articles about the outlook for telemedicine and related matters of interest to health care consumers, check out out <a href=\"https:\/\/www.edrugstore.com\/blog\/\">our blog<\/a>.<\/p>\n<p><i>Photo credit: <a href=\"https:\/\/www.flickr.com\/photos\/wallyg\/\">Wally Gobetz<\/a><\/i><\/p>\n<p><i><a href=\"&lt;br&gt; https:\/\/plus.google.com\/u\/0\/106560092528696206076\/posts\/p\/pub\">Don Amerman<\/a> is a freelance author who writes extensively about a wide array of nutrition and health-related topics.<\/i><\/p>\n<p><!-- Begin Media Shower Content Reporting code --><img decoding=\"async\" style=\"height: 1px; width: 1px; border: 0px;\" src=\"http:\/\/mediashower.com\/content?Action=tp&amp;cid=34745\" alt=\"\" \/><!-- End Media Shower Content Reporting code --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A few pieces of legislation pending before Congress or soon to be introduced would significantly expand the use of telemedicine in this country. However, proponents of telemedicine growth worry that the Congressional Budget Office&#8217;s less than enthusiastic view of the new technology could create roadblocks to its growth. These roadblocks might well come in the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_autoblog_aioseo_focus_keyphrase":"","_autoblog_aioseo_title":"","_autoblog_aioseo_description":"","footnotes":""},"categories":[18],"tags":[189],"class_list":["post-8856","post","type-post","status-publish","format-standard","hentry","category-current-health-news","tag-telemedicine"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO Pro 4.9.10 - aioseo.com -->\n\t<meta name=\"description\" content=\"A few pieces of legislation pending before Congress or soon to be introduced would significantly expand the use of telemedicine in this country. 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