Medicare and Telemedicine

Telemedicine is a rather complicated issue. It can be quite helpful but then again it may be an added cost. The CBO is examining this to some degree and it is worth following.

As CBO states:

Whether expanding Medicare coverage for telemedicine services would increase or decrease federal spending is difficult to predict, but doing so depends on two main considerations:

• The payment rates that would be established for those services, and
• Whether those services would substitute for (or reduce use of) other Medicare-covered services or would be used in addition to currently covered services.

If all or most telemedicine services substituted for or prevented the use of more expensive services, coverage of telemedicine could reduce federal spending. If instead telemedicine services were mostly used in addition to currently covered services, coverage of telemedicine would tend to increase Medicare spending. Many proposals to expand coverage of telemedicine strive to facilitate enrollees’ access to health care. Therefore, such proposals could increase spending by adding payments for new services instead of substituting for existing services.

Many Medicare patients are with chronic diseases such as Type 2 diabetes, COPD, congestive heart failure and the like. Even cancer patients just need monitoring, not face time. There development of methodologies to do this remotely is exploding.

However, this is with an elderly population. They generally are not adept at the use of the new technologies, especially ones requiring a modicum of expertise, or patience.

Thus there is both an opportunity and a challenge. It is worth following.