Policies across federal programs vary, with those serving active military and veterans having fewer barriers than Medicare.
Telehealth and remote patient monitoring have the potential to boost access and quality of care for patients in federal health programs, especially if they live in remote areas. However, very few beneficiaries receive care this way, according to limited data reviewed by the Government Accountability Organization (GAO).
While barriers persist, the GAO report finds that could change as payment reform takes hold.
“While Medicare currently uses telehealth primarily in rural areas or regions designated as having a shortage of health professionals, in the future emerging payment and delivery models may change the extent to which telehealth and remote patient monitoring are available and used by Medicare beneficiaries and providers in other areas,” the report stated.
The GAO report, issued Friday, found that less than 1% of Medicare beneficiaries and about 12% of those who get healthcare through the Department of Veterans Affairs (VA) receive care through telehealth or remote patient monitoring, for reasons from a lack of available codes to Medicare rules for where care can take place.
Policies for telehealth vary:
So far, the Congressional Budget Office (CBO) has not pinned down what the cost would be to federal programs if telehealth took flight. Experts believe giving providers more flexibility to see patients remotely could improve the ability to monitor patients with chronic conditions or increase the availability of mental health care in areas with shortages of psychiatrists or counselors.
But, the report said, “the financial impact of expanding telehealth and remote patient monitoring in Medicare is difficult to predict—it may reduce federal spending if used in place of face-to-face visits, but it may increase federal spending if used in addition to these visits.”
Advocates for telehealth say the fears of overutilization and opposition from some physician groups have kept telehealth from achieving its potential. There are also some connectivity hurdles to overcome. But some experiences in Medicaid, a program that gives states the last work on telehealth rules, show the potential to reach hard-to-serve populations.
Mississippi, one of nation’s poorest states with high rates of diabetes and obesity, is a telehealth leader. The University of Mississippi Medical Center has produced early results that show remote monitoring of high-risk patients can improve health indicators and reduce trips to the emergency department or specialists.