News Feature | March 13, 2017

States Demonstrate Uneven Telemedicine Progress

Christine Kern

By Christine Kern, contributing writer

Follow-up Visits Using Telehealth

ATA says while medical coverage of telehealth services is up, gaps still exist.

While all state Medicaid agencies now cover at least some form of telemedicine, not all coverage is created equal with states showing mixed progress with virtual services, according to the American Telemedicine Association.

Analysis on gaps in coverage and reimbursement showed while Medicaid coverage of telehealth-based dental services, substance abuse treatment, and counseling has increased, 19 states still don’t specify the type of care-provider allowed to provide telehealth services as a condition of payment.

“As federal and state lawmakers reevaluate the current health policy environment, they cannot ignore telemedicine’s potential as a valuable and cost saving tool”, says Gary Capistrant Chief Policy Officer, ATA.

The ATA published draft guidelines for telestroke, pediatric telehealth, and child and adolescent telemental health in an effort to help providers who are adopting new digital health platforms. These three sets of practice guidelines are designed to help healthcare providers with both direct-to-consumer and provider-to-provider services.

ATA offers annual report cards grading each state on physician practice standards and licensure efforts and telemedicine coverage and reimbursement policies, and added a state-by-state analysis of telemental health standards and licensure last year.

The ATA analysis found seven states (Connecticut, Florida, Hawaii, Idaho, Rhode Island, Utah, and West Virginia) have adopted policies that have strengthened the use and accessibility of telemedicine-provided services in the past year, while Delaware, South Carolina, and Washington, D.C. have restricted telemedicine coverage. Five states — Idaho, Missouri, New York, North Carolina, and South Carolina — bar the use of cell phone video for telehealth visits which further reduces access to healthcare services in remote areas.

Since the ATA’s initial analysis in 2014, 10 states and D.C. have enacted telemedicine parity laws, bringing the total to 24. Telemedicine adoption and usage scores for Connecticut, Florida, Hawaii, Idaho, Rhode Island, Utah and West Virginia rose compared with 2015, with Connecticut and Rhode Island going from “F” to “B,” according to the ATA. States rating an “A” include Hawaii, Maine, Mississippi, Nevada, New Mexico, Oklahoma, Tennessee, Utah, and Virginia. 

Telemedicine holds particular promise, especially in extending access to medical services to underserved and rural areas, but it also has some unique challenges and burdens, as Health IT Outcomes reports. Issues of connectivity and reliability, as well as questions about interstate licensure and accountability, remain obstacles to the more even adoption of telehealth services nationwide.