Stethoscope on top of a keyboard

There is little doubt that telehealth is a key to the future of medicine. One day patients will likely be visited in their homes regularly by virtual doctors or nurses to get immediate diagnoses and care strategies laid out.

But that’s in a future where regulations clear the way for payers and providers to be completely in sync; where the patient is the benefactor of high-quality, user-friendly services.

To get there, it’s going to take some strides in the field of health information technology. Some of those steps will be taken in 2016, including an increase in reimbursement opportunities for telehealth services. Both traditional Medicare and insurers participating in Medicare Advantage will be exploring new payment methods for telehealth this year.

Noting that telemedicine is a key to the further advancement of population health management, the Centers for Medicare & Medicaid Services removed some restrictions to telehealth reimbursement for the 21 health systems that are participating in the new Next Generation ACO Model.

And on the private insurance side, Humana announced it is expanding its telemedicine benefits in 12 states starting in 2016. Expect to see at least one or two other large insurers follow suit and expand their breadth and scope of telemedicine services this year.

We should also see more healthcare providers pooling resources to develop a common clinical IT platform, similar to what Mountain States Health Alliance and Wellmont Health System in the southwest Virginia/northeast Tennessee area are doing. The two entities have stated that sharing information should eliminate duplicity and enhance care coordination. As healthcare payment and delivery continues to move toward population health and risk-based management, expect to see more alliances like this form. We should see at least a few more partnerships on this scale in 2016, and it should be commonplace in the years ahead.

Lastly, we’re likely to start seeing a phasing out of meaningful use in 2016. The rules have guided electronic health record implementation and upkeep since passage of the HITECH Act in 2009. But the standards have proven onerous and some providers have found themselves overwhelmed and playing catch up.

In January, CMS Acting Administrator Andy Slavitt said the agency was in the process of moving to a new system that seeks to reward providers more for the outcomes achieved with their patients rather than being measured on their use of technology. Slavitt added that under the new rules, providers will be able to customize their goals so tech companies can build around the individual practice needs, not the needs of the government.

Chris Silva is an analyst at DRG and a Health IT expert. Follow him on Twitter at @ChrisSilvaDRG.


View the rest of the 2016 Targeted Insights series.


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