June 23, 2015
Telemedicine is gaining ground, as more people get used to the idea of receiving health care via video or phone.
For employers, the main appeal of telemedicine is that it can reduce the time employees miss from work driving to and from appointments and sitting in doctors’ offices. But telemedicine consultations also can save money because they replace expensive emergency and urgent care visits. And, for employees in rural or remote areas, telemedicine enables employers to give them access to specialists and other care providers that might not be available to them in any other way.
However, legislative and legal hurdles exist that must be overcome before telemedicine can become commonplace.
For a recent article on the Society for Human Resource Management (SHRM) website, Dr. Allan Khoury, senior consultant at Towers Watson, explained these hurdles. Central among them is the problem of interstate licensure. Physicians currently must be licensed in each state where they practice and many states require that physicians be licensed in states where they provide telemedicine as well. This licensing issue would make telemedicine consultations impossible except when the physician and the patient are in the same state.
Another barrier is that some states require that an in-person visit precede telemedicine consultations. This defeats the purpose of telemedicine as a means to treat people who cannot get to a doctor’s office that would provide the care they need.
Telemedicine also raises questions about privacy and security law setting because of the sensitive nature of the personal health data generated, transmitted and stored.
Despite these issues, according Towers Watson research, 36% of employers already offer telemedicine as a part of health benefits; by 2017, that number could grow to two thirds.
As Dr. Khoury explains, “Telemedicine is a great triage service, has low costs and is an employee-pleaser.”
To read the complete article, click here.
The Department of Health and Human Services (HHS) announced in March that it will roll out a new accountable care organization (ACO) initiative called the Next Generation ACO Model, in January 2016. The new initiative improves on the existing Pioneer ACO Model and the Medicare Shared Savings Program by setting more predictable financial targets. This will give providers and beneficiaries to offer coordinated care and achieve the highest quality standards of care.
The goal of the new model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries. A significant focus of the new model will be telehealth: participating organizations will be asked to provide access to both telehealth and home visits.
Medicare ACOs are comprised of groups of doctors, hospitals, and other health care providers and suppliers who come together voluntarily to provide coordinated, high-quality care at lower costs to their Original Medicare patients.
The Centers for Medicare and Medicaid Services (CMS) anticipates that 15 to 20 ACOs will participate in the new model. While it is unknown what kind of savings the new model will generate, savings from the Pioneer model could be a good indicator. In early May, it was revealed that the Pioneer ACO Model had generated approximately $384 million in Medicare savings in just two years. According to the CMS, the Next Generation ACO model could be a source of even more potential savings.
For other recent OneExchange posts on ACOs, see below:
Confident that onsite or near-site health centers improve the health and productivity of their employees, nearly four in 10 (38%) employers that already have one or more plan to add new centers in the next two years.
This is according to the Towers Watson 2015 Employer-Sponsored Health Care Centers Survey of 120 employers, the majority of whom have onsite or near-site health facilities with the remaining planning to.
Onsite health centers are one way employers seek to improve employees’ access to health services and reduce health care costs. They also have the potential to improve employee productivity, by reducing the time employees spend driving to doctors appointments and sitting in offsite waiting rooms.
Onsite centers provide variety of services, including immunizations, care for acute conditions like upper respiratory and urinary tract infections, and blood draws. Many offer wellness services (86%) and lifestyle coaching (63%) to make behavioral changes. Half offer some kind of pharmacy services as well.
Looking to the future, 66% of employers surveyed plan to expand or enhance the services they already offer by 2018. Changes ahead include increased telemedicine services, outsourcing to vendors, and calculating health center ROI.
To read the press release announcing the availability of the full survey report, click here.