Navigating The Modern Medicare-Digital Care Landscape

Telemedicine is rapidly defining the modern medical landscape, with thousands of patients moving away from in-person meetings to video consultation. Statistics reported by the CDC identify that up to 30% of all medical visits are now conducted remotely, via digital means, underlining the importance of digital healthcare in the modern medical ecosystem.

One area in which this has created questions is the provision of Medicare. How does the preference for digital medical care change billing? And how has technology impacted medical insurance and its applicability to medicare-eligible groups? Telehealth is, at the very least, improving access to healthcare to those groups eligible for Medicare.

Coverage is there

The good news is that there is, in the majority of cases, telehealth coverage for Medicare users. Research published by the KFF indicates that over 65% of medicare recipients state that there is availability of telehealth checkups. What’s more, many Medicare recipients are using their services more proactively given the relative ease of access to the system. With more ease of access, this has seen a greater number of appointments taken. In turn, this has increased pressure on supplemental insurance plans. Various options such as Plan F insurance are often recommended to Medicare recipients who take a significant number of consultations on top of their routine care. This is likely to be more commonplace with the openness of telemedicine.

Claims processing

The rapidity with which consultations have had to be undertaken has seen inefficiencies appear in the services. One report published by the federal HHS service established that many providers had billed for telehealth services that did not meet Medicare standards. There is significant potential for abuse of the system and the awarding of frivolous claims in providing access to Medicare through digital means, and federal regulators must be aware of this. Equally, healthcare providers have a self-interest to ensure that their patients meet the regulations as stipulated and that they are being billed accurately.

The telehealth cliff

There is potential yet for considerable upheaval, according to the American Academy of Family Physicians. An early August 2021 report published on their website highlights the prospect of the telehealth cliff – a situation in which virtual healthcare would be restricted for Medicare recipients due to a recess in congress. Due to the transient nature of legislation in this area, there is always the risk that coverage can fail – and that’s exactly what the current prospect is for Americans eligible for Medicare. Given the importance of telehealth in the modern American healthcare system, and the benefits that Medicare recipients are deriving from it, it’s important that legislators and lawmakers put into place a more consistent system that guarantees access to these interventions throughout the year.

When paired with a more effective reporting and payment system for insurers, this will create the blanket coverage that Medicare recipients need. Telehealth has been a wonderful force for good, and preserving those benefits is important to the public health of the nation as a whole.

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