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MedPAC Members Push for Expansion of Telehealth Services

By Kerry Young, CQ Roll Call

March 4, 2016 -- Advisers to Medicare urged greater acceptance of telehealth services in the federal program for the elderly and disabled, although they are not yet at the point of issuing formal recommendations to spur greater use of computers and phones in delivering medical services.

Medicare Payment Advisory Commission (MedPAC) commissioners said they are concerned that current reimbursement policies are limiting access to more convenient access to their doctors.

"I worry that we are being far too conservative" about the use of telehealth in Medicare, said Scott Armstrong, a MedPAC member who is chief executive officer of Seattle-based Group Health Cooperative, which serves about 650,000 people.

Medicare now largely limits telehealth payments through its traditional fee-for-service program to cases where people live some distance from providers, thus largely restricting this service to rural areas. Medicare Advantage programs and demonstration programs such as accountable care organizations also can provide medical consultations via computer or phone.

The Medicare policies lag the expectations that many people have for their medical care, Armstrong said. Many of the new enrollees conduct much of their shopping and business online, and also have grown accustomed to the convenience of contacting their doctors electronically as well, Armstrong said. In some cases where telehealth is widely used, 60 to 70 percent of people’s contact with their doctors is handled remotely, he said.

"If we are going to be relevant to the customers who will age into Medicare one day, we need to be offering these kinds of alternatives," Armstrong said.

MedPAC member Craig Samitt argued that telehealth services would be a superior alternative for handling many tasks that now require people to visit doctors' offices.

"There are a lot of different scenarios where telehealth should replace existing services," particularly in primary care, said Samitt, who is chief clinical officer at insurance giant Anthem.

MedPAC Chairman Francis J. Crosson said he agreed with Samitt's view, and signaled that the commission will continue looking at the issue of telehealth. The remote contact with doctors offers significant convenience to patients, Crosson said, adding that he receives his medical care through an organization that offer telehealth services.

"It's very popular with me as well as other patients," he said.

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