How Telehealth Can Improve Patient Care and Outcomes Emerging - - PowerPoint PPT Presentation

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How Telehealth Can Improve Patient Care and Outcomes Emerging Telehealth Evidence & State Health Policy Jennifer Reck, MA Project Director, National Academy for State Health Policy @JReckHlthPolicy Nov. 1, 2018 #PCORI2018 Jennifer Reck

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How Telehealth Can Improve Patient Care and Outcomes Emerging Telehealth Evidence & State Health Policy

Jennifer Reck, MA

Project Director, National Academy for State Health Policy @JReckHlthPolicy

Nov. 1, 2018

#PCORI2018

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2 • November 1, 2018

Jennifer Reck

Has nothing to disclose.

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3 • November 1, 2018

National Academy for State Health Policy (NASHP)

Non-profit, non-partisan
Washington, DC & Portland, ME
31 years serving states
Academy = leaders in state health policy working across agencies

& branches of government

PCORI Engagement Awards:
Roadmap for using PCOR and CER in Policymaking
Learning Collaborative to put the roadmap to work (AL, CO, MA)
PCOR Work Group: exploring policy implications of emerging research

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4 • November 1, 2018

Why are state policymakers interested in telehealth?

High level of interest in telehealth – To improve access & address work force shortages:

In underserved, esp. rural areas
To specialty providers
e.g. behavioral health, substance use, dermatology, psychiatry
In response to opioid epidemic

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5 • November 1, 2018

Snapshot of State Telehealth Legislation

39 state laws related to telehealth passed in 2018 session
Broadband (4)
Demonstrations, grants, and pilots (4)
Medicaid Reimbursement (10)
Regulatory, licensing, & advisory boards (10)
Cross-state licensing (3)
Private Payer Reimbursement (7)
Provider/Patient Relationships (4)
Substance Use Disorder (8)

*bills covering multiple issues are double counted above

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6 • November 1, 2018

Barriers to Adoption of Telehealth Interventions

Payment:
1. Lack of coverage alignment across payers
2. Facility fees

“It’s a little risky to think of telemedicine as a solution to rural health access if you don’t think about the payment for it.”

NASHP PCOR Work Group Member

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7 • November 1, 2018

1. Lack of Alignment Across Payers
State officials report sometime limited uptake of telehealth in

public programs despite coverage

Possible explanation: Lack of coverage alignment across private

and public payers can inhibit use by providers

Policy response:
State lawmakers in 35 states and Washington, DC have passed parity

laws to require private insurers to cover telehealth

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8 • November 1, 2018

2. Facility Fees
Hospitals (or hospital-owned clinics) often charge a facility fee to

cover their overhead costs

Only 32 state Medicaid programs allow payment of a facility fee

(or transmission fee) when telehealth is used

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9 • November 1, 2018

Additional Information Needed to Change Practice

State health policymakers want to know if telehealth results in better patient outcomes, AND -

Are telehealth interventions cost-effective?
Does a telehealth intervention replace existing in-person care? Or

does it create new costs for additional care?

How does telehealth fit into existing payment models?

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10 • November 1, 2018

Learn More

www.nashp.org
https://nashp.org/overcoming-payment-challenges-to-realize-

the-promise-of-telehealth/

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11 • November 1, 2018

Thank You!

Jennifer Reck, MA

Project Director, National Academy for State Health Policy @JReckHlthPolicy November 1, 2018

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12 • November 1, 2018

Moderated Panel Discussion

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13 • November 1, 2018

Questions?

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14 • November 1, 2018

Thank You!

Penny Mohr

Senior Advisor, Emerging Technology and Delivery System Innovation Research Initiatives Healthcare Delivery and Disparities Research November 1st, 2018