There may be some reluctance to reimburse telemedicine because there is a feeling that telemedicine costs might be added to overall cost, rather than be substituted, David Brumley, MD, MBA, senior medical director at Tufts Health Plan, explained at the 4th Annual Patient-Centered Diabetes Care Meeting, held April 7-8 in Teaneck, NJ.
There may be some reluctance to reimburse telemedicine because there is a feeling that telemedicine costs might be added to overall cost, rather than be substituted, David Brumley, MD, MBA, senior medical director at Tufts Health Plan, explained at the 4th Annual Patient-Centered Diabetes Care Meeting, held April 7-8 in Teaneck, NJ
Transcript (slightly modified)
Why do you think there has been a reluctance to dive into the telemedicine reimbursement?
Well, part of the concern around telemedicine, even though it has promise, is the concern that it might be additive and not substituted. So, for example, instead of having 3-4 office visits per year, and having 2 office visits and a few telemedicine, we’re concerned that you’ll still have 4 office visits plus the telemedicine. So we just want to make sure that, however it’s structured, that people are getting the value out of that, but not adding costs to the system.
What ways are there to control overutilization of telemedicine?
The way to control that is we’re developing and working on some of those ideas. Some of them would be requirements around what types of visits are reimbursable, some of the requirements around what’s the content. So for office visits, for example, there are criteria around proper coding and that contains certain elements that could potentially be one approach. We also think about adding copays and patient costs to control the unnecessary utilization.
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