Posted by Rene Quashie
on May 09, 2017
A recent telemedicine industry benchmark survey published by REACH Health provides great insight into where the industry has been and where it is headed. The survey was conducted among U.S. healthcare executives, physicians, nurses and other professionals. Organizations represented in the survey were diverse and included representatives from organizations with a $1 billion or more in revenue (about a third of respondents), and almost half with revenues under $50 million.
In reviewing the survey report, there were some significant takeaways:
- Telemedicine is evolving from a specialty offering to a mainstream service.
- More than half of respondents consider telemedicine to be a top or high priority.
- Patient-oriented objectives—including improving patient outcomes, improving patient convenience, and increasing patient engagement and satisfaction—are the three top objectives for telemedicine programs.
- There is an emphasis on better leveraging specialists with a large majority of respondents ranking this a top or high priority.
- Nearly half of hospital and integrated delivery network respondents who began their telemedicine programs/initiatives with a departmental approach are transitioning to an enterprise approach.
- The maturity of telemedicine programs varies widely among service lines and settings of care. Generally, settings requiring highly specialized treatment continue to be more mature than those requiring generalized treatment.
- Telemedicine technology, reporting and analytics, as well as in-house physicians are viewed as highly important to the success of a program, whereas outsourced physician coverage services less so.
Posted by Rene Quashie
on February 28, 2017
Amidst all the interesting legal and regulatory issues implicated by telemedicine, one issue less discussed is the potential liability exposure associated with telemedicine. Many critics have argued that the nature of how telemedicine services are provided will naturally lead to increased risk for malpractice. Available data does not support the argument—at least not yet.
While not a lot of data exists, the Physician Insurers Association of America (“PIAA”) published a July 2015 article comparing telephone treatment medical professional liability (“MPL”) claims versus overall MPL claims reflected in the PIAA Data Sharing Project (“DSP”)—a very large database of MPL claims. Here are the numbers:
- Of the 94,228 total claims in the DSP during the period from 2004-2013, a total of only 196 claims were linked with telephone treatment.
- Of those 196 reported claims, 56 resulted in some form of claim payment.
- The total indemnity loss related to telephone treatment was only $17 million, compared to $8 billion for the total of all MPL losses.
- Telephone treatment claims represented only about 0.21% of all MPL losses.
- The average indemnity loss was also lower for telephone treatment at $303,691, compared to $328,815 for all MPL claims within the DSP.
Posted by Rene Quashie
on February 17, 2017
Telemedicine is now mainstream. Surprisingly, however, one area in which telemedicine has not been used to its fullest capability is drug addiction treatment. As you are aware, the country is in the midst of an addiction crisis. The statistics are daunting:
Adding to the woeful statistics are the fairly dismal rates of addiction recovery—assuming that such recovery services are even available. Relapse rates are over 50 percent for certain drugs, and higher for opioid addicts. According to one survey, almost 9 percent of the population needs treatment but only 1 percent actually receives it. The National Institute on Drug Abuse notes that effective substance abuse treatment combines treatment medications with behavioral therapy—and traditional treatment is limited by the availability of treatment professionals who often are not available outside of in-person care settings. Continue reading…
Posted by Rene Quashie
on February 16, 2017
Over the past year, the Federation of State Medical Boards (FSMB) and the American Telemedicine Association (ATA) have published documents regarding telemedicine that shed some new light on how state regulatory bodies view telemedicine. Taken together, the documents are generally cause for optimism underscoring the trend towards greater acceptance of telemedicine—but there are some notes of caution as well. By way of quick background, the FSMB represents 70 state medical and osteopathic boards and helps support member boards around the country. The ATA is the largest telemedicine-focused trade association made up of industry leaders and health care stakeholders.
According to a survey report issued in December 2016, telemedicine is currently the most important regulatory topic to state medical boards. The survey was completed by 57 of the 70 medical and osteopathic medical boards in the country. Interestingly, 75 percent of boards chose telemedicine in their survey responses as one of the most important topics “making it the topic impacting the largest number of boards.” Seventy percent chose resources regarding opioid prescription. The five most important issues were:
- Opioid prescribing (resources related to);
- Physician licensure compact;
- Physician re-entry to practice; and
- Medical marijuana.
Surprising in these survey results is the degree to which telemedicine continues to be top of mind for state boards despite the slew of state activity that generally facilitates greater use of telemedicine (discussed more below in the ATA Gaps Report section). A reasonable explanation is that despite all the recent progress in law and policy, many state boards continue to be uneasy about telemedicine. What that ultimately means for the industry will bear watching. Continue reading…
Posted by Marc Goldsand
on February 05, 2016
Consistent with what we have been seeing in our own practice, and consumers’ growing demand for better access to telemedicine services, a bi-partisan movement is growing in both houses of Congress to expand telehealth services, improve health outcomes, and reduce healthcare costs. On Wednesday February 5, 2016, U.S. Senators Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.), Thad Cochran (R-Miss.), Ben Cardin (D-Md.), John Thune (R-S.D.), and Mark Warner (D-Va.) introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (s. 2484), which seeks to overhaul Medicare’s treatment of the practice of telemedicine and its related technologies. Companion legislation was introduced in the House of Representatives by U.S. Reps. Diane Black (R-TN), Peter Welch (D-VT), and Gregg Harper (R-MS). According to the Senate bill’s sponsors, the CONNECT for Health Act would:
- Create a bridge program to help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and RPM without most of the 1834(m) restrictions contained in the aforementioned Senate bill;
- Allow telehealth and Remote Patient Monitoring to be used by qualifying participants in alternative payment models, without most of the aforementioned 1834(m) restrictions;
- Permit the use of remote patient monitoring for certain patients with chronic conditions;
- Allow, as originating sites, telestroke evaluation and management sites; Native American health service facilities; and dialysis facilities for home dialysis patients in certain cases;
- Permit further telehealth and RPM in community health centers and rural health clinics;
- Allow telehealth and RPM to be basic benefits in Medicare Advantage, without most of the aforementioned 1834(m) restrictions; and
- Clarify that the provision of telehealth or RPM technologies made under Medicare by a health care provider for the purpose of furnishing these services shall not be considered “remuneration.”
So far, the following organizations have publically endorsed the bill:
- ACT | The App Association
- Alliance for Aging Research
- Alliance for Connected Care
- Alliance of Community Health Plans (ACHP)
- Alzheimer’s Foundation of America
- America’s Essential Hospitals (AEH)
- America’s Health Insurance Plans (AHIP)
- American Academy of Neurology (AAN)
- American Academy of Physician Assistants (AAPA)
- American Association of Diabetes Educators (AADE)
- American Heart Association/American Stroke Association (AHA)
- American Medical Association (AMA)
- American Medical Group Association (AMGA)
- American Nurses Association (ANA)
- American Occupational Therapy Association (AOTA)
- American Osteopathic Association (AOA)
- American Psychological Association (APA)
- American Society of Nephrology (ASN)
- American Telemedicine Association (ATA)
- American Well
- Association for Ambulatory Behavioral Healthcare
- Association for Behavioral Health and Wellness (ABHW)
- Federation of State Medical Boards (FSMB)
- Hawaii Medical Service Association (HMSA)
- Health Care Chaplaincy Network
- Healthcare Leadership Council (HLC)
- Healthcare Information and Management Systems Society (HIMSS)
- Kaiser Permanente
- National Association for Home Care & Hospice
- National Association for the Support of Long Term Care (NASL)
- National Association of ACOs (NAACOS)
- National Association of Community Health Centers (NACHC)
- National Council for Behavioral Health
- National Council of State Boards of Nursing (NCSBN)
- National Health IT Collaborative for the Underserved
- Personal Connected Health Alliance (PCHA)
- Population Health Alliance
- Qualcomm Incorporated (and Qualcomm Life)
- Telecommunications Industry Association (TIA)
- The ERISA Industry Committee (ERIC)
- The Evangelical Lutheran Good Samaritan Society
- The Jewish Federations of North America
- Third Way
- University of Mississippi Medical Center (UMMC) Center for Telehealth
- University of Pittsburgh Medical Center (UPMC)
- University of Virginia (UVA) Center for Telehealth
The full text of the bill can be found here.
Posted by Ryan Blaney
on July 09, 2014
Recently, the American Medical Association (AMA) released a report on telemedicine (Report) that, among other things, (i) outlines coverage and payment rules; (ii) summarizes various specialty society practice guidelines/position statements; and (iii) presents its own position and recommendations regarding the role of telemedicine in the provision of health care. The Report provides a current overview of barriers (e.g., reimbursement and licensure) that prevent further implementation of telemedicine in the provision of health care in our society, and it also emphasizes the importance of ensuring quality of care, patient safety, and coordination of care. The AMA’s publication of this Report will hopefully continue the important dialogue regarding the promise of telemedicine.
Look for an upcoming more detailed client alert analyzing this Report, other updates concerning telemedicine, and the general role of telemedicine in our healthcare system.