Guest post by Dr. Talbot “Mac” McCormick, president and CEO, Eagle Hospital Physicians.
Looking back at 2015, we see significant trends impacting inpatient telemedicine that will gain strength through 2016. Here are the Top Five: How they impacted healthcare, and how they will change hospital medicine moving forward.
More Legislation and Regulation Activity
A recent report from the National Conference of State Legislatures showed there were 200 telemedicine bills introduced in all but eight states in 2015. The federal government also introduced the TELEMedicine for MEDicare Act of 2015 and the Veteran’s E-Health and Telemedicine Support Act of 2015, which are aimed at creating an interstate license for those practicing telemedicine for these patient populations. Last year, 32 states and the District of Columbia enacted telemedicine parity laws, requiring health plans to reimburse telemedicine the same way—and at the same cost—as in-person service. We expect to see more of this activity as telemedicine becomes an increasingly integral part of healthcare in America.
Easier Licensure Across States
Currently, if you have a group of physicians caring for patients in hospitals in four or five states, they must become licensed in each of those states. As noted above, recent legislation (along with new telehealth licensing compacts between states) will make it easier for physicians to get a license across state lines. This will clearly help facilitate the use of telemedicine services
Growing Financial Support
Today, the payer response can best be described as a patchwork. Medicare typically doesn’t reimburse for inpatient telemedicine (except in rural areas as Medicaid), and the commercial payers tend to vary from state to state. There isn’t a uniform basis for reimbursements. Many hospitals end up financing most of the costs of inpatient physician services delivered with telemedicine?and we all know healthcare dollars are tight for everybody. However, the physician reimbursement is moving, albeit slowly. The state parity laws will help. So, too, will having more commercial payers recognize the value of telemedicine services. For example, UnitedHealth Group announced plans to expand coverage for virtual physician visits to employer-sponsored and individual plan participants, increasing those covered from approximately 1 million to well more than 20 million. Better reimbursement structures will help fortify hospitals’ financial underpinnings and alleviate some of the burden they’ve been forced to bear.
Significant Moves toward Standardization
There are a number of technology platforms out there, but currently not a lot of standardization. We’re going to see more standardization and equipment requirements to ensure all telemedicine technology within inpatient environments has the security, reliability, and 24/7 support that allows the maximum capacity to engage with the most critically ill patients.
Big Culture Changes
Anyone in healthcare knows medicine moves slowly when it comes to change and innovation. There are obviously good reasons for that, so culture change around something as big as redefining how we interact with patients in hospitals has been a significant challenge. However, our healthcare culture is beginning to make that transition. Eight years ago, telemedicine was often thought of as a “crazy” idea and was a foreign concept to hospital administrators. During the course of the next several years, those conversations changed to: “That’s interesting. I think it’ll work somewhere, for somebody else. We’re just not ready yet here.” Then over the last year or two, the conversation has shifted to: “Telemedicine sounds great. When can we start?” Culture change is there, and is moving in the right direction. Everyone, from physicians to hospital administrators to patients and even healthcare payers, recognizes the value of being able to augment care?whether it’s time-sensitive care for the critically ill or injured, care during the night when staffing is lower, or care in rural hospitals that just don’t have the same specialty support system that large metropolitan areas have. We’ll see continued acceptance?and, eventually, reliance?on having these specialty services available to patients.
Expect to see significant growth in telemedicine inpatient services. Hospitals will increasingly look for ways to leverage telemedicine across their entire service spectrum. We fully expect to see hospitals further integrate telemedicine into their medical staffing, supplementing and complementing what they have on the ground.