New Medicare Telehealth Reimbursement Bill to Expand Coverage

Medicare Telehealth bill 2014Medicare is getting another chance at expanding its telehealth coverage.  Representative Mike Thompson from California has written a new Medicare Telehealth Parity Act of 2014 which would dramatically expand Medicare reimbursement for many more kinds of telemedicine. Most states tend follow Medicare’s lead when setting their Medicaid policies and determining what private insurers must cover.  So if this new telehealth reimbursement  law succeeds, it will have a ripple effect with positive implications throughout the country.

In 2012, Rep Thompson tried introducing a similar telehealth bill that died in committee. That bill would have made a sweeping revision to the Social Security Act, removing all restrictions on Medicare telemedicine reimbursement at once. Currently, Medicare restricts reimbursement for telemedicine services to a) certain types of services provided to patients in b) qualifying “rural areas” by c) eligible facilities and d) eligible healthcare practitioners. The 2012 bill attempted to eliminate these restrictions and require coverage for all telehealth services in which the corresponding in-person treatment would be covered. Thompson’s new effort is much more conservative.

Now he takes a phased approach, in which telemedicine reimbursement coverage would be gradually expanding over in 3 stages:

Phase 1 – Six months after the Medicare telehealth bill becomes law

  • Medicare covers telemedicine in areas with populations up to 50,000.
  • Retail clinics are added to list of approved providers.

Phase 2 – Two years after the bill becomes law

  • Medicare covers telemedicine in areas of 50-100,000 people.
  • In-home telehealth joins the list of approved care locations.
  • Outpatient services like speech and physical therapy are included.

Phase 3 – Four years after the bill becomes law

  • Telemedicine becomes fully reimbursable, regardless of population.

The proposal keeps the definition of telemedicine as live face-to-face video conference visits, but expands the definition to include remote patient monitoring technology.  However, it still does not address services provided by telephone or email. This limitation is similar to the telehealth rules set by the American Medical Association (AMA) and Federation of State Medical Boards (FSMB). This could bad news for companies like Teladoc and Zipnosis, which focus on care by phone and email.

How Likely is Medicare Telehealth Expansion?

Will this bill pass? True, Thompson found a co-author from across the aisle, so he has a little bipartisan support. And they have the backing of industry groups like the Alliance for Connected Care. Still, Congress has defeated reform multiple times. This latest proposal offers the same reforms as in 2012, only on a delayed schedule. It’s hard to see why legislators would be persuaded by a longer timeline.

Besides, the government is seriously divided. Any expansion of Medicare reimbursement, even one that saves money in the long run, means a change in the federal budget. Right now, Congress is incapable of agreeing on any changes to Medicare spending, as we saw with the budget stalemate over the last few years.

So while we welcome Thompson’s efforts and encourage his efforts in fighting for telehealth reform, we’re not holding our breath on this latest bill becoming law.

3 Case Studies Showing Telemedicine’s Return on Investment

Telemedicine Tipping Point

Telemedicine Tipping Point

Telemedicine has clearly already passed the tipping point. Consider:

  • The Affordable Care Act has created millions of new health care consumers, stretching doctors even further, leading them to seek new ways to serve more people.
  • The recent scandals with the Veterans Affairs Medical Centers have proven the urgency of delivering health care quickly and efficiently, which telemedicine can do.
  • The rising cost of health care is driving doctors and patients to seek more affordable solutions, including telemedicine.
  • Thanks to new technology like WebRTC and Vidyo, better video technology has greatly improved the user experience for both patients and doctors.
  • “The global telehealth market is expected to grow by more than a factor of 10 from 2013 to 2018,” according to IHS Technology.

Telemedicine ROI

Most importantly, when you consider telemedicine’s return on investment (ROI), it becomes clear that telemedicine’s time is now. Take for instance the cost of intensive care. This article in Executive Insight makes the case for replacing round-the-clock patient monitoring with frequent check-ins through video:

In the US, the “bunker” approach to providing continuous intensive care unit (ICU) monitoring and intensivist services has lost favor due to the high cost of monitoring technology and redundant manpower. A far less costly model — intensivist “round and respond” — is being adopted in many hospitals, making program ROI easily achievable. A Florida hospital providing nighttime “round and respond” services to three community hospitals has lowered ICU patient length of stay (LOS) by 0.6 days, resulting in savings of over $2 million per year.

In another case, the St. Vincent Health System recently implemented a telehealth network, connecting providers with patients in virtual environments across 26 facilities in Pennsylvania. The result? “The program achieved a 100 percent return on investment within two months by expanding the reach of Saint Vincent’s bariatric services,” say Saint Vincent officials.

Telehealth can also earn big returns on investment by reducing hospital readmission. “Scaling Telehealth Programs: Lessons from Early Adopters,” a paper by the Commonwealth Fund, demonstrates the results. In 2010-11, Centura Health at Home launched a pilot program to see if telehealth could reduce costs for patients suffering from congestive heart failure, chronic obstructive pulmonary disease, and diabetes. The result: 30-day readmission rates dropped 62 percent, saving an estimated $1,000 to $1,500 per patient, according to the report.

If you need to build a business case for telemedicine, check out the Mid-Atlantic Telehealth Resource Center online, which provides a few ROI calculators you can use to demonstrate the value of telemedicine. As you can see, the cost to implement telehealth is much less than the value gained by caring for patients remotely.

Sources:

  • Roeen Roashan. IHS release - World Market on Telehealth 2014
  • Bruce Japsen. Forbes article – “ObamaCare, Doctor Shortage To Spur $2 Billion Telehealth Market”
  • Tim Wright. Executive Insight article – “The Financial Benefits of Acute Care Telemedicine” Advanced Healthcare Network
  • Erin McCann. Healthcare Finance News article -  “Health system builds telehealth network, sees nearly 100 percent ROI”

New VSee OneClick Update 3.2.0 – Webchats with patients

We’re excited to announce the a new update of VSee OneClick Waiting Room to version 3.2.0.

OneClick change list:

  • [New] Providers can now send webchats to patients from the Provider dashboard
  • [New] Patients can get back into the waiting room if she accidentally refreshes the page
  • [Enhancement] Patient intake form customizations
  • Bug fixes and stability enhancement

Now providers can have a secure webchat with a patient by clicking on the chat button. Note: Webchats are not meant to be used for any actual consulting and are not saved or stored.

VSee webchat OneClickProviders can now customize their patient intake form to include helpful information such as reason for visit, date of birth, etc.
1click-patient-3.2

The additional information will show up as a list under the patient’s name.

OneClick intake form display

Please contact us at support@vsee.com if you have any questions or suggestions concerning these new features.  Enjoy!

Vidyo Gets Another $20M Investment to Explore the Wild West of Video Conferencing

Vidyo, VSee competitor, just raised another $20M to bring their total funding to $139M — well ahead of the typical $40M needed to reach IPO stage.  With 300 employees and a monthly burn rate of probably ~$4M, Vidyo’s $20M fundraising at this stage of the game is rather unconventional – companies positioning for IPO normally raise huge rounds. It’s highly likely that Vidyo’s current revenue can cover its expenses, but it needs extra cash to explore new markets.

An expansion into new markets isn’t too surprising considering that video conference companies valuations have been poor cousins to Instant Messaging companies, e.g. Instagram and WhatsApp.  It’s likely that Facebook’s acquisition of WhatsApp for $19B earlier this year has jolted Vidyo investors, pushing Vidyo to explore new markets.  According to Vidyo CEO Ofer Shapiro, Vidyo has its sight set on more than the enterprise video conferencing space – it’s going after consumer markets, and it wants to go big.

This includes going after the booming healthcare space to bring video chats to hospital beds or patients in their homes as well as to the online banking space. But even beyond that, it means taking video conferencing into the “Internet of Things.” We’re not talking smartphones but everyday technology from wearable devices to gaming consoles to household appliances — with the end goal of putting Vidyo technology directly into the hands of consumers.

Vidyo has already gotten a head start on this with Google+ Hangouts video chat which used a Vidyo plugin until recently.  Even now with Google Hangouts moved onto the VP8 video codec and getting ever closer to a completely WebRTC implementation, the Vidyo and Google partnership continues with deals such as Vidyo’s work to add its scalable video codec (SVC) into VP9 (which will eventually be used by Hangouts and all WebRTC platforms) and the VidyoH2O video conferencing bridge for Google Hangouts.

VSee, on the other hand, has taken the strategy of focusing exclusively on healthcare and developing workflows to make healthcare customers happy. The question is: Will VSee’s strategy will knock Vidyo out of healthcare market.  Is Vidyo spreading itself too thin to make you happy?

In any case, congratulations to Vidyo on the another round of successful fundraising!

VSee Celebrates OneClick with iFly

Telemedicine is very hot right now, and vsee OneClick virtual waiting room is the perfect product :)  The VSee team took half a day off to chill with some indoor skydiving. Have a look at our team having fun!

Becky Best pic milton - the flying frog Sam Willow