Telehealth: Bringing Health Care Patients Where They Are
This is the first in a four-part series of articles on consumer-focused health care. These articles are adapted from a Health Law Update presentation Attorney Tyler Wilkinson gave at the State Bar of Wisconsin’s annual Health, Labor and Employment Law Institute in August, 2015.
There have been a number of legal developments in 2015 that have the potential to accelerate the health care industry’s move towards greater patient empowerment and engagement in their own care. This move has been spurred by recent legislation, primarily from the Affordable Care Act and its ripple effects, by patients and advocacy groups, and from increasing competition from health care providers of all sizes. Health care providers have responded to these forces in creative and innovative ways. This series looks at four ways in which the health care industry is working to increase patient empowerment and engagement in their health care and the legal developments which should accelerate these advances.
The most visible approach is the growing acceptance and use of telehealth. Broadly defined, telehealth is the delivery of health care services through communication technologies rather than through in-person communication. Health care services can be provided to patients remotely through four modalities:
- Live video where the patient and provider can interact in real-time;
- Store-and-forward communications where a provider records a message for a patient to listen to or watch at a later time;
- Remote patient monitoring, where the patient sends data (like blood glucose levels) to a provider and the provider monitors that data over time; or
- Mobile health, where providers send health information and educational materials through mobile apps on cell phones and tablets.
Telehealth has been around for years, but it continues to grow in patient, provider and payer acceptance and use. This trend should continue as health care providers become more adept at delivering health care services to remote patients and as patients become more comfortable interacting with their providers through video rather than in-person.
There are three legal developments that should accelerate the use of telehealth services. First, the Medicare Telehealth Parity Act of 2015 was introduced in Congress in July. Currently, federal law only allows providers to be reimbursed for providing telehealth services if they are providing services in a qualifying rural area. The federal Act proposes changes to the current Medicare telehealth payment methodologies and expands coverage over time to include both rural and urban areas. The proposed Act has bipartisan support and should gain momentum in the next few months.
Second, 29 states plus Washington D.C. have enacted commercial payment parity laws that require commercial health plans to cover medical services provided via telehealth to the same extent they cover medical services provided in-person. This means that health plans are required to provide the same coverage for care whether it is delivered in person or remotely.
Finally, a number of states are considering the adoption of an Interstate Physician Licensure Compact. This proposed compact will create an alternative, voluntary and expedited path for physicians with a medical license in one state to obtain licenses in other states that have adopted the compact. This means that a physician in Wisconsin could easily and quickly obtain a license to practice medicine in other states that have adopted the compact and thus provide services to patients in those other states through telehealth. This proposed law has broad bipartisan support in Wisconsin.
These legal developments should make telehealth a safer and more appealing investment for health care providers. Based on the growing acceptance of telehealth and the legislative steps mentioned above, one financial analyst estimates the telehealth industry will be valued at $34 billion by 2020.
The money aside, telehealth provides a more convenient and engaging way for patients to receive care from their providers. Telehealth allows providers to treat patients where they are, rather than only treating them in a clinical setting.