2015 was the year for telemedicine, with 7 new CPT codes allowing for Medicare reimbursements originating from the physician's office and covering psychotherapy, annual wellness checks, remote patient monitoring, and remote chronic care management. However, despite these significant reimbursement wins for telemedicine, there are still drastic limitations on telehealth services originating from the patient's home, a limit on an industry that is estimated to be a $6B industry by 2020.
A newly proposed bill currently receiving bipartisan congressional support, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, would reduce the geographic restrictions (currently, only patients living in rural locations qualify for telemedicine reimbursements) and would make remote patient monitoring and telehealth basic benefits in Medicare Advantage.
What does this mean for the future of not only telemedicine and at-home chronic care monitoring?
SIGNIFICANT SAVINGS TO MEDICARE
- Creating 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 aforementioned 1834(m) restrictions
- Allowing telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the aforementioned 1834(m) restrictions
- Permitting the use of remote patient monitoring for certain patients with chronic conditions
MORE ACCESSIBLE HEALTHCARE
EMPOWERING CHRONIC DISEASE PATIENTSChronic disease patients are the number one driver of rising healthcare costs in the United States, accounting for 15 million office visits per year. But that only takes into account those who have the time and resources to make it to the clinician's office in the first place. By empowering telehealth reimbursements originating from a patient's home, we're empowering the group that needs the healthcare system the most - chronic disease patients - and enabling them to have access to quality and productive care.