Hospitals would be paid to test telehealth under Senate bill

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Expanding Medicare’s coverage of telehealth services has been a favorite cause of major medical associations. A new U.S. Senate bill is taking a different approach to achieving that goal: the Centers for Medicare and Medicaid Innovation (CMMI).

The legislation, introduced by Sens. Cory Gardner, R-Colorado, and Gary Peters, D-Michigan, would allow hospitals to test telehealth services through CMMI in the same manner as its tested other changes to care, like bundled payments and accountable care organizations. CMMI would be directed to have an “independent evaluation conducted to assess the telehealth models for cost, effectiveness, and improvement in quality of care without increasing the cost of delivery.”

“The Telehealth Innovation and Improvement Act would allow Medicare to expand coverage of telehealth services and increase access for people living in rural America,” Gardner said in a statement. “It would also incentivize the healthcare industry to develop new technologies that could potentially reduce costs and improve patient health.”

According to the legislation’s summary, CMS would expand the application of a service once tested if its shown to have improved care without increasing spending or reduced spending without lowering quality, and if the agency’s chief actuary certifies it would reduce net Medicare spending.

If a service meets these requirements, it would be defined by the bill as a "certified enhanced telehealth service."

Medicare would pay for those certified services up to 80 percent of the actual charge for the services or an amount determined by the testing model.

Meeting those standards, however, is no slam dunk for telehealth. A study in the March 2017 issue of Health Affairs found, while telehealth services could decrease spending per episode of care, those savings were outweighed by the increased utilization resulting from those services.

CMS has incentivized rural hospitals to test telehealth models in its Frontier Community Health Integration Project Demonstration, though that model is limited to critical access hospitals in Montana, Nevada and North Dakota.Hospitals would be paid to test telehealth under Senate bill

Expanding Medicare’s coverage of telehealth services has been a favorite cause of major medical associations, and a new Senate bill is taking a different approach to achieving that goal: the Centers for Medicare and Medicaid Innovation (CMMI).

The legislation, introduced by Sens. Cory Gardner, R-Colorado, and Gary Peters, D-Michigan, would allow hospitals to test telehealth services through CMMI in the same manner as its tested other changes to care, like bundled payments and accountable care organizations. CMMI would be directed to have an “independent evaluation conducted to assess the telehealth models for cost, effectiveness, and improvement in quality of care without increasing the cost of delivery.”

“The Telehealth Innovation and Improvement Act would allow Medicare to expand coverage of telehealth services and increase access for people living in rural America,” Gardner said in a statement. “It would also incentivize the healthcare industry to develop new technologies that could potentially reduce costs and improve patient health.”

According to the legislation’s summary, CMS would expand the application of a service once tested if its shown to have improved care without increasing spending or reduced spending without lowering quality, and if the agency’s chief actuary certifies it would reduce net Medicare spending.

If a service meets these requirements, it would be defined by the bill as a "certified enhanced telehealth service."

Medicare would pay for those certified services up to 80 percent of the actual charge for the services or an amount determined by the testing model.

Meeting those standards, however, is no slam dunk for telehealth. A study in the March 2017 issue of Health Affairs found while telehealth services could decrease spending per episode of care, those savings were outweighed by the increased utilization resulting from those services.

CMS has incentivized rural hospitals to test telehealth models in its Frontier Community Health Integration Project Demonstration, though that model is limited to critical access hospitals in Montana, Nevada and North Dakota.