News Feature | June 7, 2016

Healthcare Organizations Want CBO To Use Alternative Data To Evaluate Telemedicine For Medicare

Christine Kern

By Christine Kern, contributing writer

Virtual Telehealth Doctor

Letter from more than 20 organizations calls for expansion of evaluation data.

In a letter to Congressional Budget Office (CBO) Director Keith Hall and Medicare Payment Advisory Committee (Med PAC) Executive Director Mark Miller, 22 healthcare organizations asked alternative data sources for making cost estimates and analyses of telemedicine use in the Medicare program be considered. They write there is “substantial experience utilizing telemedicine outside Medicare,” and this experience should help to inform the reimbursement policies of BCO and Med PAC.

According to the letter, there currently exists a lack of Medicare data on telemedicine due to outdated statutory restrictions on its use.

A study published by JAMA found that, while telemedicine visits among Medicare beneficiaries increased from 2004 to 2013, less than 1 percent received a telemedicine visit in 2013. According to that study, while telemedicine has great potential for expanding access to healthcare — particularly in rural and underserved areas — Medicare has not kept up with the reimbursement policies that can make that happen. The study found 29 states have passed telemedicine parity laws mandating reimbursement of telemedicine visits, while Medicare limits reimbursement to select live video encounters with the patient at a clinic or facility in a rural area.

Signatories of the letter to the CBO included Ascension Health, the University of Pittsburgh Medical Center Telehealth Program, Elizabeth Krupinski, Ph.D., of the University of Arizona, and Joseph Kvedar, M.D., of Partners HealthCare.

According to the authors of the letter, while it is hard to find “sufficient Medicare data” for telemedicine, “Alternative data sources can and should be used to inform and produce an analysis of providing Medicare beneficiaries access to telemedicine.” These data sources include the commercial sector, the Department of Veteran Affairs, and the Medicaid program.

The letter urges CBO not to let narrow investigation of data tether the use of telemedicine because it is difficult to isolate its impact.