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“In 2015, CTeL asked the CBO what they needed to reassess telehealth expansion,” she added. “The answer? Large-scale, comprehensive cost analysis from a neutral source. So we started on that path.”
They’re not alone in questioning the CBO’s cost estimates. In 2015, complaints about the process prompted the agency to defend its actions.
“If all or most telemedicine services substituted for or prevented the use of more expensive services, coverage of telemedicine could reduce federal spending,” the agency said in a July 2015 blog. “If instead telemedicine services were mostly used in addition to currently covered services, coverage of telemedicine would tend to increase Medicare spending. Many proposals to expand coverage of telemedicine strive to facilitate enrollees’ access to healthcare. Therefore, such proposals could increase spending by adding payments for new services instead of substituting for existing services.”
Roughly a year later, however, nearly a dozen health plans sent a letter to CBO Director Keith Hall asking him to give telehealth more credit.
“While many of us are embracing telemedicine in our offerings outside of Medicare Advantage (MA), we want to clearly note that the barriers in Medicare hamper our ability to offer these services to our MA customers,” the letter stated. “We have worked closely with (the Centers for Medicare & Medicaid Services) to find ways to provide telemedicine through MA plans, but can only do so as a supplemental benefit.”
“Our options are also limited without Congressional action to reduce barriers in the Medicare fee-for-service benefit,” the letter - signed by Aetna, Anthem, Blue Cross Blue Shield of Tennessee, Cambia Health Solutions, CareSource, EmblemHealth, HMSA-Blue Cross Blue Shield of Hawaii, Horizon Blue Cross Blue Shield of New Jersey, Humana, Molina Healthcare and MVP Health Care - added. “Congressional action depends, in part, on a budget impact analysis from your office.”
CTeL launched its project in 2017, partnering with Mercer University to survey more than 16,000 telehealth studies. Shortly thereafter, the organization created a “data dictionary” to help researchers standardize large amounts of data gathered from those studies.
“Most telehealth programs and their institution-based platforms utilize their own data fields and terminologies,” Jason Goldwater, a senior research scientist from Index Analytics who was hired to create the data dictionary, said in the press release. “We worked with health systems to gather initial data, identify common elements, and create a framework that will allow us to plug-and-play in the future. This framework, the data dictionary, enables us to do research that lawmakers have been asking for for years.”
CTeL is now seeking $10,000 donations from healthcare organizations to study how virtual care compares to in-person care, including how expensive treatment might be if providers and patients don’t have access to connected health. That includes the cost of healthcare services down the road when patients aren’t treated in a timely fashion.
The organization has set an October 30 deadline for the donations.
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