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Can State Medicaid Programs Drive Remote Monitoring Reimbursement?

March 30th, 2006 |  Published in Uncategorized

The state of Indiana will begin providing Medicaid reimbursement for telemedicine consultations starting May 1, 2006.

“It is definitely exciting news. I think that this policy will go a
long way toward increasing adoption among providers,” said Greg Beck,
director of the telemedicine department at Clarian Health Partners.
“Providers will begin to realize this is actually a technology they can
incorporate into their business practice.”

Beck said Clarian has been expanding its
telemedicine offerings, which began with experts from Riley Hospital
for Children in Indianapolis meeting with patients and parents at
Deaconess Hospital in Evansville. The Clarian program now includes
hospitals in Bedford, Fort Wayne, Terre Haute and South Bend.

Most
of the telemedicine services have involved pediatrics in areas such as
urology, dermatology and diabetes education, said Beck, adding that
telemedicine meetings also have involved adult oncology and pulmonology.

The current sweet spot for telemedicine is in consultations with specialists.

One of the biggest barriers to remote monitoring adoption is reimbursement. Since most changes in reimbursement are driven by CMS/Medicare, the traditional approach lobbying for expanding reimbursement has centered in Washington DC. The other side of CMS is Medicaid, which is run by the states. The pressure between health care needs and budgets is arguably felt more keenly at the state level. And this change in Indiana shows that states will extend reimbursement when proven to reduce costs. It might even foster private payor reimbursement.

[…] the move by Indiana's Medicaid system could lead to private insurers taking a look at reimbursing for telemedicine costs.

For
instance, Anthem Blue Cross and Blue Shield, which is part of
Indianapolis-based WellPoint, said it has a limited pilot program to
provide reimbursement for telemedicine meetings. Anthem spokesman Tony
Felts said the program has involved pediatric services at Clarian
Health Partners and psychiatric services at St. Vincent Health.

About the author

Gee

After almost 25 years in health care Tim remains with his first love, connectology, the automation of workflow through the integration of medical devices with information systems.


Email Tim | All posts by Tim Gee

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