Telehealth services have been evolving for decades as technology and reimbursement regulations change to meet the growing demand. COVID-19 has accelerated this advancement. Hospitals have been embracing the use of telehealth services as they work to provide quality patient care to underserved areas, manage recruitment challenges for particular physician specialties, and maintain financial viability through this cost-effective modality. In 1999, CMS approved the first means of payment for telehealth services. It was specific to consults for patients who live in underserved rural areas. With recent developments, CMS has expanded telehealth services to broaden eligible providers, bolster reimbursement, permit more sites of service and increase the services offered.
Opportunities for Telehealth Providers
Telehealth provides an opportunity to scale quality, lower costs, and increase convenience for both provider and patient. Consumer-centered telehealth technologies appeal to patient’s expectations of having greater control over their health and data. Interoperability efforts, through the 21st Century Cures Act, are necessary for these new telehealth solutions to ensure patient safety and a seamless healthcare system.
Technology has advanced to the point where telehealth services can be delivered a number of ways. Remote Patient Monitoring involves the use of connected electronic tools to record personal health data of a patient in one location for review by a provider in another location. Live Video utilizes a two-way audiovisual link between distant parties and is used for virtual visits, case collaboration between providers, and training/distance learning. Store and Forward is used when the patient’s personal health history is recorded and transmitted to a healthcare practitioner, usually a specialist. It is currently not utilized to the extent of the other modalities, but many providers intend to expand its use in the coming years. Mobile Health utilized mobile devices to transmit healthcare and public health information to the general public. Information typically includes general educational information, targeted text messages, and notifications about disease outbreaks.
Opinions Rooted in Understanding Regulatory Environment
HMS Valuation Partners has been providing telehealth valuation services for nearly 10 years and has valued complex arrangements involving various payment methodologies for professional services, technology, and equipment. Critical to the accuracy of these opinions are understanding the rules and regulations at the federal and state level, payor source reimbursement policies, and specific subject agreement terms. This has become especially true as telehealth expands exponentially due to COVID-19. HMS is committed to maintaining a close eye on the evolving regulatory and reimbursement landscape for telehealth.
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