Value of Telehealth Monitoring a Story that Needs Telling

Posted On:

By Karen Utterback, 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Telehealth Monitoring Value

Thirty-nine states offer reimbursement for all types of telehealth monitoring, but only 11 of those offer reimbursement for home health monitoring.

With state health exchanges on the horizon and new information showing the value of home health, now is the time to lobby your legislators to expand this vital service, says Melanie Schoenberger, marketing specialist at Robert Bosch Healthcare, makers of the Health Buddy telehealth system. Schoenberger was the featured speaker for a McKesson webinar on telehealth payment strategies.

“States need cost-saving solutions, now and in the near future as more Medicaid beneficiaries enter the market with health exchanges open in 2014,” Schoenberger says. “We have to demonstrate how states can achieve cost savings after an up-front investment in home telehealth monitoring.”

Eligibility requirements, maximum length of engagements, payments for equipment installation/removal and reimbursement rates vary widely from state to state, but three of the more robust programs can be found in New York, Pennsylvania and South Carolina. California recently updated its telehealth statutes, although it does not set reimbursement rates. Projections in California states that Medi-Cal could save more than $900 million annually by using telehealth to monitor those with chronic heart failure (CHF) and another $400 million by monitoring diabetes patients, according to a report from Blue Sky Consulting.

Texas will launch a three-year telehealth pilot in 2012 that will be used to gather information on its usefulness to help the state save money and improve health outcomes.

The Center for Telehealth and e-Health Law (CTeL) is a valuable source of information on all aspects of telehealth, including access and reimbursement issues, Schoenberger says.

Webinar participants also heard from Estelle Brickner, vice president of clinical services, and Kelli Denton, director of clinical operations, from McAuley Seton Home Care in Buffalo, N.Y. The pair described their experiences with telehealth working with Medicaid, a physicians’ group, an insurance company and an HMO. The agency currently monitors 170 patients through all avenues, receiving reimbursement for 122 of those.

The agency is working with the physicians’ group because the medical director and CEO saw the benefits of keeping patients out of the hospital, which affects their incentive payments from third party payors. The Health Buddy’s education component, accredited by the National Committee for Quality Assurance, was a selling point in the care coordination model. Since the program started, the agency indicates that readmissions have decreased by 42% among the target population, with a total readmission rate under 12%.

McAuley Seton also works with Blue Cross/Blue Shield on extended telemetry, reviewing those cases bi-weekly, and with a major HMO provider for CHF patients in its group. The agency also monitors Medicare patients when clinicians believe it’s required, but the agency does not receive reimbursement in those instances.

“We’ve been hoping that Medicare (reimbursement) would catch on, but that hasn’t happened yet,” Brickner says. “Still, nursing visits for that population have decreased.”

With the coming of accountable care organizations, Brickner believes the importance of telehealth for hospital clients will greatly increase.

Listen to the telehealth payment strategies webinar in its entirety.


Leave a Reply

Your email address will not be published. Required fields are marked *