- New payment models are the top priority in telemedicine these days – and they’ll be the linchpin in the healthcare industry’s move to value-based care.
That’s the viewpoint of the American Telemedicine Association, which convened its Fall Forum this week in New Orleans with a call to embrace new reimbursement models and use telemedicine to set the standard for healthcare in the future.
“I simply don’t see healthcare working without telemedicine,” Andrew Watson, the ATA’s vice president and UPMC’s medical director of telemedicine, told an audience of roughly 300 attendees.
Jonathan Linkous, the ATA’s CEO, helped to launch the two-day conference by noting that some 20 million Americans are benefiting from telemedicine this year, and he expects that number to double in just a few short years. To reach that number, he said the industry must deal with a number of trends, the top five of which are:
- New payment models;
- EMR integration;
- Direct-to-consumer and retail telehealth;
- Artificial intelligence and analytics; and
- The evolution from hardware to software and outsourced services.
The driver for payment reform, Linkous said, is Medicare, with the upcoming shift from the Sustainable Growth Rate to the Medicare Access and CHIP Reauthorization Act (MACRA). That, combined with concepts like Accountable Care Organizations and Patient-Centered Medical Homes, will fundamentally change how health systems provide and are paid for healthcare.
“It’s an incredible thing that is happening and it has a major impact on telemedicine,” said Linkous.
Watson, who also serves as UPMC’s vice president of international business, said telemedicine will be the key to transitioning from fee-for-service to value-based care because it represents all that value-based care strives for: patient-centered care, delivered with convenience and at a lower cost, and driving better clinical outcomes.
Kofi Jones, vice president of governmental affairs for American Well – who admirably condensed hundreds of pages of MACRA legalese into a 30-minute primer for the ATA audience – said the new rules offer ample opportunities for healthcare providers to improve their reimbursements through telemedicine. A $100 healthcare visit based on 2014 CMS reimbursement guidelines, she said, could net a physician as much as $189.50 under MACRA.
Or as low as $62.50, she noted, if providers aren’t paying attention.
“It’s critically important to know what track you’re in,” she warned. “Just having telehealth will not increase your scores (which determine reimbursements) by definition.”
Linkous said telemedicine has that power to affect the transition because it’s “the hot topic in healthcare these days.” So far this year, in preliminary data compiled for an upcoming ATA report, it has been used in some 8 million radiology cases, 1.9 million cardiac monitoring cases, 750,000 online primary care or urgent care sessions, 650,000 neurophysiological monitoring cases and 500,000 mental health sessions.
In addition, he said, roughly 30 percent of all ICU beds are covered by tele-ICU services at some point.
Those numbers give the ATA some ammunition in pushing telemedicine out to a healthcare industry bracing for radical change. LTG (Ret.) James Peake, MD, former U.S. Secretary of Veterans Affairs and the ATA’s current president, said it’s a “critical time” for healthcare providers preparing for payment reform.
“The ATA needs to be the leader in shepherding that use,” he said.