The field of 'telemedicine' has grown over the last few decades. Initially, it was utilized by hospitals to reach patients in remote locations. Over the years, the technology expanded, and is currently being used as a means of convenient medical care where patients can get immediate care for minor but urgent ailments without having to wait in the doctor's waiting room. Many primary care providers have begun to provide an on-call doctor- 24/7 service, along with added staff and specialists. While telemedicine refers to only clinical services, it's 'telehealth' which comprises of a broader spectrum in addition to clinical services as that of provider and medical education, and administrative meetings.
With the ongoing changes in the US healthcare industry, the latest addition to the fluctuating reforms is the push for the American Health Care Act (also known as Trumpcare) by the United States House of Representatives. The ACHA is being looked at as a replacement and repeal to the Affordable Care Act or Obama care. The words 'telehealth' and 'telemedicine' though have not been included in the text of the Act, here's a look at what it just might mean for telemedicine.
The administration is in support of the telemedicine technology as of today. Many states and insurance providers have begun to reimburse for telemedicine services. Presently 31 states have the 'parity laws' in effect with five more states proposing the legislation; with states expanding the telemedicine program in schools. More than half of the country's school based telelmedicine visits are being paid by Medicaid programs.
• The Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act (CONNECT) – This law would widen the scope of Medicare reimbursement of telemedicine services, especially for Medicare beneficiaries.
• The Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2016 (CHRONIC) – This law would revise Medicare payment protocols for telemedicine-delivered treatment of chronic medical conditions at the patient's home.
• HR 766 – This bill aims to introduce a telemedicine pilot program for Medicare patients residing in public housing.
• The Furthering Access to Stroke Telemedicine Act (FAST) – The legislation would increase Medicare beneficiaries' access to telestroke resources.
On The Hindsight:
Passing of this bill might mean that 23 million more Americans would be uninsured in 2026 than if the Affordable Care Act remains in place. Further, 74 million Americans could be affected who have Medicaid (many are children) where schools rely on Medicaid for using the telemedicine technology (for buying equipment etc.). Senate's Obamacare repeal bill would also cut money (almost 26% cut to Medicaid planned) for projects using telemedicine which could go on to hurt students in rural schools who could otherwise get medical experts' advice.
The Medicare Telehealth Parity Act of 2017 is also targeted towards removing restrictions, increasing access and includes coverage by Medicare. This is especially vital in the case of The Chronic Kidney Disease Improvement in Research and Treatment Act of 2017 (CKDIRT) which would allow for kidney patients to be treated via telemedicine at their residence. Further, The Helping Expand Access to Rural Telehealth Act (HEART Act) opens up the idea of adopting telehealth services in rural clinics (areas) along with an expansion in Metropolitan Statistical Areas of 70,000 people or lesser; and also add Medicare coverage for patients who require monitoring in cases of congestive heart failure and chronic obstructive pulmonary disorder in remote areas.
Telemedicine is an efficient way to extend access to care in many areas along with it being affordable. Practices must look towards implementing telemedicine in their program as its future is evidently realistic.
