Telehealth back in the spotlight


Photo: U.S. Department of Veterans Affairs

On Thursday, Veterans Affairs Secretary David Shulkin, M.D., and President Trump announced three initiatives to expand telehealth and mobile health services for veterans.

The announcement is notable because the initiatives remove some longstanding roadblocks to wider adoption of telehealth services. The VA has the largest telehealth program in the country, with an estimated 700,000 veterans using telehealth last year.

The three initiatives are:

  1. VA Video Connect – a nationwide telehealth network for veterans to connect with their care providers through personal computers and smartphones. The application is being used by 300 providers at 67 facilities and will be available everywhere over the next year.
  2. Veteran Appointment Request – An appointment scheduling app for smartphones and tablets.
  3. Anywhere to Anywhere VA Health Care – A hiring push for physicians in urban centers to conduct video visits with veterans in rural areas. This is especially interesting because the regulation published by the VA eliminates the state-by-state medical licensure requirement so physicians licensed in one state can deliver care to VA patients in other states.

Reaction from telehealth advocates was positive. The American Telemedicine Association, a leading trade group, praised the announcement, especially the medical licensure requirement rule. In a statement, the group encouraged the president to issue an executive order that eliminates the state-by-state licensure requirement for telehealth delivery for all federal programs, including Medicare.

Congress, too, is seeking to expand telehealth services. The Evidence-Based Telehealth Expansion Act of 2017, introduced by Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio) on July 27, would allow the U.S. Department of Health and Human Services to waive current Medicare restrictions on telehealth coverage as long as it saves money.

And the CHRONIC Care Act of 2017, by Sens. Orrin Hatch (R-Utah) and Ron Wyden (D-Oregon), would offer accountable care organizations and Medicare Advantage plans greater flexibility in reimbursement for telehealth services, and eliminate geographic restrictions for telestroke service payments. The Congressional Budget Office determined the bill wouldn’t increase Medicare spending over the next decade.

Lack of reimbursement for telehealth has been for many years an impediment to adoption. As Congress and the president look for health care wins, loosening rules on licensure and reimbursement could gain traction. Here’s a roundup of Congressional bills on telehealth.

Further reading:

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Rebecca Vesely