Telemedicine received a boost in national visibility with Medicare’s announcement of the new Next Generation Accountable Care Organizations.
These ‘Next Gen’ ACOs have significant experience coordinating care, according to the Centers for Medicare & Medicaid Services (CMS), and are expected to assume higher levels of risk. In essence, they represent souped-up versions of previous ACO incarnations, which are the Pioneer and Shared Savings programs.
To that extent, they are expected to enable providers and beneficiaries greater opportunities to coordinate care, of which telehealth availability is an integral component.
Current Medicare payment regulations have some restrictions on telehealth services for certain rural areas, but they are waived for the 21 organizations that are participating in the Next Gen ACO model in 2016.
That is a key component to both the success of the Next Gen program, as well as the further advancement of telehealth services, advocates say. The technology is expected to play an instrumental role in healthcare moving forward, as more reimbursement and delivery systems move away from fee-for-service and embrace risk-based, quality measures.
The American Telemedicine Association, the best known advocacy group when it comes to tabulating telehealth support, said the Next Gen ACOs and the waiver represent “an important day for Medicare beneficiaries getting access to value-based telehealth care.”
The waiver clears a hurdle that is sometimes imposed on what are deemed rural Health Professional Shortage Areas, where Medicare beneficiaries are not covered if they are receiving telehealth services from home. In addition to an ease on telehealth rules for home care, providers will have greater latitude with home visits and skilled nursing facilities under the Next Gen ACO model.
Provider participants will have the opportunity to take on higher levels of financial risk – up to 100 percent in some circumstances. The model, therefore, is truly accelerating the concept of population health management. That telehealth is a central part of this innovative Medicare program bodes well for its future in terms of usability and accessibility.