- The growth of the telehealth market space has been truly revolutionary due to the ongoing remote monitoring developments, new innovations, and increase in state policies expanding reimbursement and telemedicine services. Currently, there are 29 states and the District of Columbia that have enacted new laws favoring coverage for the telehealth market space.
“There will always be differences among state laws on telehealth coverage, but what is remarkable is the rapidly increasing pace at which states have been adopting coverage statutes in the last few years,” wrote Nathaniel Lacktman, attorney and expert in telemedicine law from Foley & Lardner.
Benefits of Current Telehealth Coverage Laws
According to Lacktman, all segments of the telehealth market space should benefit from the ongoing legislation and telemedicine coverage changes. This may also depend on the language of the legislation.
Telemedicine vendors and manufacturers as well as healthcare providers working in the telehealth market space will likely experience a rise in their business dealings when these state coverage laws are passed. However, such growth is truly dependent on the type of legislation that is passed, as some may be more focused on specific telemedicine services and may push forward solely video-based physician consultations.
When legislation is broader and includes language toward virtual care and remote patient monitoring, this would expand telehealth coverage more inclusively. In fact, broader legislation could push forward technology development and equipment manufacturing across the board.
Additionally, mobile health apps could become more prevalent among the patient community if patient-centered care and engagement is pushed forward with inclusive telehealth regulations.
Key Aspects Telehealth Coverage Regulation Requires
It is beneficial for the telehealth market space if state regulations focus on ensuring video-based physician consults are reimbursed in the same level as in-person doctor visits, which are called payment parity laws. Additionally, healthcare providers and the patient community would find it advantageous if additional services such as remote patient monitoring and mobile health apps are covered by health insurers as well.
Along with the 29 states that have passed telehealth coverage laws, there are at least half a dozen more bills being introduced in various state legislatures to support reimbursement for telemedicine services, Lacktman explains.
There should be more laws passed in the coming years in favor of telehealth coverage. Additionally, many state legislatures may be looking to change the language of their current policies to more broadly implement telemedicine across the healthcare spectrum.
Addressing Challenges of Telehealth Implementation
Additionally, healthcare providers may experience some significant challenges when attempting to implement telehealth technology in a state without any payment parity laws. While reimbursement from state Medicaid and Medicare programs could be beneficial for various providers, there are other methods for ensuring payment from telemedicine services, according to Lacktman.
“Viewing the health care industry in terms of ‘reimbursement’ often means fee-for-service payments from government programs. That renders ‘reimbursement’ narrow and limited when compared to the ‘revenue’ and ‘payment’ opportunities available to hospitals, health systems, providers, and innovative companies in the telehealth and virtual care space. Shift the concept from ‘reimbursement’ to ‘payment’ and telehealth providers can embrace more financial sources,” the telemedicine expert stated.
“In 2014, Medicare paid only $14 million for telehealth services. Medicare is not ‘reimbursing’ for many telehealth services,” Lacktman continued. “Compare that to the payments being made for telehealth services across the country by employer-sponsored plans, employers out of pocket, commercial health plans, patient self-pay, retail market, hospital-to-hospital arrangements, institution-to-provider arrangements, ICU arrangements, platform licensing, etc. Providers can learn to understand and explore these opportunities, and build robust models that look beyond ‘reimbursement’ for their revenue needs.”