Perseverance, Even Without Pay

Talk about a catch-22. Providers need evidence to convince payers that telemedicine improves outcomes at perhaps lower costs, but inadequate or zero reimbursement poses a barrier to implementing these programs.

In a survey conducted in 2014 by Foley & Lardner, 41 percent of healthcare executives indicated their greatest concern with reimbursement for telemedicine was lack of pay for a telemedicine visit. Another 20 percent tagged lower rates compared with in-person visits under managed care companies and 21 percent said Medicare covered too few telemedicine services.  

Only 18 percent cited no requirements under state laws for commercial carriers to cover telemedicine visits, although the architect of the survey sees commercial payers as the linchpin to making telemedicine a key component in healthcare delivery.

“Providers see quality as the No. 1 benefit of telemedicine,” says Nathaniel M. Lacktman, JD, a partner at Foley & Lardner who leads its telemedicine practice. “If we can get commercial reimbursement aligned in more than half the states, then that will be a huge win toward widespread adoption.”

Our cover story looks at cardiology-specific telemedicine programs, some in the early stages and others established. For instance, a telecardiology program at Minneapolis Heart Institute launched about half a year ago is getting high marks for patient and physician satisfaction but it is not expected to improve the bottom line, at least not yet. Geisinger Health’s telemonitoring heart failure program, six years strong, shows a return on investment that can be used to build out its population health program.

The survey and Lacktman’s analysis put perspective on the obstacles and opportunities of telemedicine. More than half of the executives considered the development of telemedicine services to be very important for their organizations and another 32 percent ranked it as important. Two-thirds had remote monitoring programs, despite reimbursement roadblocks.

They are investing in futures: not the financial kind, but the visionary kind. Let’s hope payers catch up with them soon.