Eleven large health insurers have sent a letter to the federal government urging it to examine an expanded dataset in hopes it could lead to a wider recognition of telehealth services. The action taken by the insurers further emphasizes the validation and promise the healthcare industry as a whole sees in broadening the use of the technology.
Insurers signing the letter include Aetna, Anthem, Blue Cross Blue Shield of Tennessee, Cambia Health Solutions, CareSource, EmblemHealth, HMSA – Blue Cross Blue Shield of Hawaii, Horizon Blue Cross Blue of New Jersey, Humana, Molina Healthcare, and MVP Health Care.
They offered to share outcomes data and their experiences with the Congressional Budget Office (CBO) in hopes of impacting telehealth policy changes in Medicare. CBO was chosen as the recipient because a budget impact analysis is required before congressional action can be taken to reduce barriers to Medicare reimbursement.
A more effective analysis could be done by the CBO if it looked at the data available in the insurers’ commercial programs, as well as other public programs, to assist in cost estimates when measuring the impact of telehealth, the letter stated.
The MCOs pointed to a 2014 report as an example where telehealth resulted in savings. The public actuarial study examined data from five leading telemedicine platforms and concluded that, on average, 83 percent of telehealth visits resolved the health issue without additional follow-up care being required. This means other healthcare services like urgent and emergency room treatment that can be costly are not necessary if a patient can be diagnosed and cared for proactively.
By examining a broader dataset from the insurers, it should become clearer to the CBO and the Department of Health and Human Services (HHS) that despite embracing telehealth offerings outside of Medicare Advantage, obstacles remain in Medicare that hamper insurers’ ability to make it more widely available to MA customers.
In a report to Congress in August 2016, HHS noted that Medicare spent approximately $14.4 million on services delivered via telehealth in 2015, or less than 0.01 percent of total spending on healthcare services.
But there are indications this level could rise soon. HHS’ legislative proposal for fiscal year 2017 encourages wider delivery of telehealth services by eliminating Part B requirements that certain services be covered exclusively through face-to-face encounters. Expect to see more policy changes and recommendations like this as the telehealth market is projected to grow considerably over the next few years.
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