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News Roundup: July 2, 2015

Telehealth Services Recommended for Elderly Patient Population

Published by mHealth Intelligence
Vera Gruessner
July 2, 2015

Some of the patient population across the nation resides in rural areas where hospitals and medical clinics are hard to come by. Instead of having sick patients travel for two hours to reach their physician, telehealth services allow certain medical conditions to be diagnosed via camera and treated more quickly. However, according to Kaiser Health News, less than 1 percent of Medicare beneficiaries are using telehealth services.

Currently, there are only two Medicare Advantage insurance companies providing this type of teleconferencing technological services. Additionally, the Medicare program has put forward more limits on telehealth services throughout certain rural areas.

Telehealth Services
The Congressional Office Budget has stated in the past that offering telehealth services to the elderly will only lead to more services being used instead of reducing the amount of emergency room visits or urgent care center visits. One study published in the journal Telemedicine found that the Medicare program paid only $5 million toward telehealth services in 2012 out of its total healthcare spending of $466 billion.

“The very advantage of telehealth, its ability to make care convenient, is also potentially its Achilles’ heel,” Ateev Mehrotra, a Rand Corp. analyst, told a House Energy and Commerce subcommittee in 2014. “Telehealth may be ‘too convenient.’ ”

However, experts from the telemedicine industry feel that telehealth services would in fact reduce the number of emergency room visits and even primary care visits. Both the American Hospital Association as well as the American Medical Association have spoken out about how Congress should expand use of telehealth services for Medicare beneficiaries.

“Medicare is still laboring under a number of limitations that disincentivize telemedicine use,” Jonathan Neufeld, clinical director of the Upper Midwest Telehealth Resource Center, told the news source. “But ACOs and other alternative payment methods have the possibility of changing this dynamic.”

The American Association of Retired Persons (AARP) is also pushing for Congress to expand telehealth services for the elderly patient population. Along with seeing their primary care providers, the AARP feels that telemedicine will allow seniors to be better engaged and committed to their overall health and wellness.

“It’s also about the consumer experience and giving consumers convenience to be able to be face to face with a doctor in less than 10 minutes, 365 days a year,” John Jesser, an Anthem vice president, told the source.

Those who are concerned that telemedicine may not be adequate for more serious medical conditions among the elderly patient population will need to understand that the physician on the other side of the camera will let a patient know whether they need an in-person doctor’s visit or a specific screening.

As technology continues to evolve across the healthcare landscape and the federal government begins to understand the benefits of teleconferencing capabilities, the elderly patient population may be able to utilize telehealth services to address any minor health concerns.

More Healthcare Providers Are Making House Calls With Telemedicine

Published by Care2
Crystal Shepeard
July 2, 2015

One of the unintended, but not surprising, impacts of millions more people covered under the Affordable Care Act is the shortage of doctors to treat everyone. Many more people are also eligible under expanded Medicaid coverage, but the number of doctors that accept it is even smaller. For people in rural areas, the challenge is greater as there is often not a doctor in town and they must travel long distances to see one even if they are able to get an appointment. This has led to a rapid expansion of the use of telemedicine across the nation.

Telemedicine has been in existence in some form for approximately 40 years. As defined by the American Telemed Association, telemedicine refers to “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.” The form of electronic communication has evolved from a simple phone conversation to current technologies of closed circuit video conferencing, laptop computers and smartphone apps.

Telemedicine allows for consultations between medical professionals as well as with patients. It provides convenient access to experts, delivery of vital medical information, and for patient follow up. It is used by the military to treat soldiers with traumatic injuries and allows patients in China to have access to expert medical teams in the United States.

Two major health insurers are joining the push by expanding their already existing telemed services. UnitedHealth Group and Blue Cross-Blue Shield will offer non-emergency, 24 hour services to 40 million more people by the end of next year. This will give their customers access to such things nurse lines, often as an included service at no charge. Registered nurses, who are available 24 hours a day, will be able to discuss symptoms over the phone and offer advice, including going to the nearest doctor or emergency room if necessary. They also follow up with the patient to make sure their issue was resolved.

Currently 25 states allow the use of telemed, with many requiring services to be covered by insurance. However, even without insurance, using the service can be a substantial savings to an office visit. The extent of the types of services available to patients varies by state. Doctors in some states are permitted to prescribe medications, while others don’t or limit the kinds that can be prescribed. Others only allow the use of these services during follow up appointments, requiring that the doctor sees the patient in person for initial diagnoses.

In December, Walgreens began testing a telemedicine smartphone app which linked participating doctors and patients via the telehealth service provider MDLIVE. The pilot program began in California and Michigan and allowed patients 24/7 access to U.S. board certified doctors. This month, Walgreens announced that the app is now available on laptops and tablets and will expand to the all 25 states that allow the use of telemedicine by the end of this year. Legislation has also been introduced in Congress to have telehealth services covered under Medicare, as well as for veterans.

While telehealth services expands access, it is not appropriate in all cases. Furthermore, in most cases, follow up is required with an office visit. However, being able to consult with a nurse or doctor via webcam or phone can improve patient health and safety in many areas, especially for chronic conditions. It can improve relationships with healthcare providers, much like house calls did decades ago.

Seniors Requesting Help Seek Home-Based Services

Published by Home Health Care News
Cassandra Dowell
July 2, 2015

Home-based services rank as one of the top needs of seniors reaching out for help, new data show.

In 2014, seniors nationwide made more than 271,200 requests for assistance from the Eldercare Locator, a referral service providing information about care resources available in communities around the country.

The average caller is age 60 or older, is a first-time caller and— while the organization was originally conceived as a service for caregivers—over 70% of those contacting the center are reaching out on their own behalf, according to the 2014 Eldercare Locator Data Report: A Snapshot of Older Adult Issues & Needs in America.

“As people age, services that enable them to continue to live independently in their homes tend to be the first outside resources they seek out,” the report said.

Of those who contacted the center in 2014, 18% were seeking information about home and community-based services, just below 19% of seniors seeking transportation assistance, data show.

Of those seeking home and community-based services, 38.6% expressed a need for help with chores; 35.4% expressed a need for help with personal care; 11.8% needed case management services; 11.6% needed home health care; and 2.6% needed financial assistance for services.

“Home-delivered meals, personal care, chore services and home maintenance are just a few of the services requested,” the report notes. “Unfortunately, inadequate funding for these programs means that too many older adults will struggle to access the services and supports they need.”

Telehealth Poised for Huge Growth, Analysts Say

Published by Health Data Management
Greg Slabodkin
July 2, 2015

According to new research from market intelligence firm Tractica, telehealth video consultation sessions will increase from 19.7 million in 2014 to 158.4 million per year by 2020.

Though clinical consultations currently account for more than three-quarters of the market, the firm predicts that growth over the next several years will be especially strong in non-clinical settings. In fact, Tractica forecasts that non-clinical video consultations will outnumber clinical consultations by 2019.

“While many elements of digital and mobile health technologies are still emerging, the market for telehealth video consultations (TVCs) is one that has a firm foothold and is poised for strong and stable growth in the coming years,” states the report. “TVCs, also referred to as eConsults, eVisits, remote video consultations, or even the broader term telemedicine, are expanding in terms of use cases, deployments, and adoption.”

At the same time, Tractica principal analyst Charul Vyas cautons that the market “still faces a variety of challenges, including the high initial cost of deploying services, inconsistent reimbursement models for telehealth consultations, and some continuing resistance by physicians, patients, and regulatory bodies.”

In related news, an initial public offering on Wednesday of Dallas-based Teladoc—one of the largest telehealth companies—jumped 50 percent in its first day of trading on the New York Stock Exchange. RBC Capital analyst David Francis initiated coverage of Teladoc with an outperform rating, arguing that the company has the potential to “revolutionize” healthcare delivery with virtual medicine (VirtMed)—currently a $250 million market that could grow to more than $20 billion over the next decade.

“With cost pressures escalating, the economics of VirtMed alone create a significant new revenue opportunity in our view. Adding PopHealth and secondary market opportunities, we believe the VirtMed market could ultimately exceed $50 billion," according to Francis.

Analysts at investment firm Goldman Sachs also predicted this week that digital health will transform healthcare, saving the industry more than $300 billion in the near term with major growth opportunities in telehealth, allowing patients to receive medical advice virtually without having to visit a doctor’s office.

Telehealth Skyrocketing to 158 Million Sessions Per Year by 2020

Published by Home Health Care News
Jason Oliva
July 2, 2015

Many studies have projected the enormous growth in store for telehealth in the coming years, and these video conferencing sessions taking place in people’s homes and similar settings will represent the majority of usage within four years, says a new report.

Telehealth video consultations will increase from 19.7 million in 2014 to 158.4 million per year by 2020, according to the report from Tractica, an independent research and consulting firm.

While clinical consultations currently represent more than three-quarters of the market, Tractica finds growth over the next several years will be especially strong in non-clinical settings, including within patients’ homes.

Specifically, the market intelligence firm forecasts that these non-clinical telehealth consultations will outnumber those in clinical settings by 2019.

“The flexibility and efficiency of video conferencing is helping health care providers and payers to achieve tangible value in deploying video-based patient monitoring solutions, both in terms of positive patient outcomes and cost savings,” said Tractica Principal Analyst Charul Vyas in a written statement.

The market still faces a variety of challenges, Vyas says, including the high initial cost of deploying services, inconsistent reimbursement models for telehealth consultations, and continuing resistance by physicians, patients and regulators.

Access to telehealth has tripled over the past three years, with more physicians now offering this service than ever before—8% in 2012 to 24% in 2015, according to an April survey by Accenture.

But despite its increasing popularity, doctors are skeptical that telehealth, among other health care technologies, has improved treatment decisions.

As the nation’s aging population grows at the pace of 10,000 Baby Boomers turning age-65 each day that countless studies have forecasted, telehealth adoption shows no signs of slowing down any time soon.

Proposed Law To Reform Face-To-Face Requirement

Published by Home Health Care News
Cassandra Dowell
June 26, 2015

Proposed legislation would improve Centers for Medicare and Medicaid Services’ approach to collecting evidence regarding the eligibility of patients for home health services.

“The existing home health face-to-face requirement is simple in theory, but has proven unworkable in practice,” said Sen. Robert Menendez (D-N.J.) in a statement. “This legislation provides a straightforward process that ensures CMS works with physicians, home health agencies, and beneficiaries to devise a simple to use form that satisfies the existing face-to-face requirement.”

Menendez is one of the sponsors of the bill, “Home Health Documentation and Program Improvement Act of 2015.”

“Currently, home health agencies are often denied payment due to poorly designed and frequently misunderstood Medicare documentation requirements,” said the Visiting Nurse Associations of America (VNAA). “The legislation provides relief from past claims denials and improves the approach used by CMS to collect evidence regarding the eligibility of patients for home health services.”

The face-to-face requirement “endangers access to care for the most vulnerable patient population in the Medicare program,” VNAA said.

Homebound seniors who depend on Medicare home health services are older, poorer, sicker, and more likely to be female, disabled, and a member of an ethnic or racial minority population than all other Medicare beneficiaries combined, said Eric Berger, CEO of the Partnership for Quality Home Healthcare, citing recent data.

“The face-to-face requirement has increased the administrative burden and erected a barrier for patients in need of home health care,” said Teresa Lee, executive director of the Alliance for Home Health Quality and Innovation.

In April, CMS issued updates to clarify the home health face-to-face rule, which went into effect May 11. The new bipartisan legislation would require that CMS develop – in consultation with stakeholders – a standardized form to collect evidence that a beneficiary is eligible for home health services, in addition to other changes.