New CMS rule for the promotion of telehealth: what to expect?


2016 it was not a year dedicated to health software for remote chronic disease management and telemedicine in general. However, a new initiative from the Centers for Medicare and Medicaid Services (CMS) could make 2017 a year in which telehealth began its march of victory. We have criticized the conservatism of CMS that could not motivate providers to widely adopt telemedicine technologies, but the centers have proposed a new rule which has the potential to cut criticism.

At the 2018 Medicare Physician Fee Chart, CMS introduced a number of new qualified telehealth services for reimbursements, such as:

  • health risk assessments,
  • planning chronic care management programs,
  • psychotherapy for crisis situations along with interactive complexity,
  • virtual visits to decide if a patient is eligible for a low-dose CT scan.

To claim reimbursements, caregivers must meet the usual conditions, in particular, a physician or other licensed physician must use an interactive telecommunications system (audio and video equipment that allows two-way interaction in real time) and provide services to an eligible located patient. in a place of origin of telehealth. Under the proposed rule, in this case, “Medicare pays an installation fee at the home site and makes a separate payment to the professional from the remote site offering the service.”

By extending the range of services to chronic disease management planning and health risk assessments, CMS offers providers a way to communicate with patients more about their changes in health status and close treatment. Because multiple patients cannot opt ​​for frequent office visits, CMS makes life easier for these patients with new types of covered services.

The rule states once again that the amount of the reimbursement for the provision of a telehealth service must be equal to the amount of the same service provided in person. Hopefully, when the range of reimbursable services is wide enough, telemedicine technologies will successfully increase in various healthcare organizations. In fact, they are starting to evolve next to the bed, according to the news.

How CMS initiatives align with reality

In a recent press release, the U.S. Department of Veterans Affairs of the Midwest Health Care Network announced a partnership with the Air Force Medical Operations Agency to provide five facilities of military treatment with access to VA Tele-ICU capabilities.

The Tele-ICU is a telemedicine technology that includes:

  • Telecommunications equipment in a patient’s ICU room (speaker, microphone, high-resolution two-way video camera on the ceiling and video screen).
  • Tele-ICU software that monitors a patient’s vital elements in real time (e.g., blood pressure, heart rate, and critical lab data) and then sends algorithm-based alerts to nurses and doctors about changes in l patient’s health status.
  • Off-site Tele-ICU monitoring and support center that can be located anywhere, equipped with patient census screen, vital and laboratory alerts, patient profiles, live audio and video feed, medical record electronic (CPRS), digital imaging (PACS) and ICU Clinical Information Systems (CIS).

This solution allows patients to interact with Tele-ICU-licensed physicians (Tele-Intensists) and VA critical care nurses, who can see a patient directly and access their health data, including chart review. , in a 24/7 mode. Doctors can prescribe medications, request tests and procedures, confirm diagnoses, and discuss the treatment plan with the patient and their family members remotely. The agreement aims to extend the scope of care to Air Force patients in Las Vegas; Biloxi, Mississippi; Hampton, Virginia; Dayton, Ohio; in Anchorage, Alaska.

The VA secretary, Dr. David Shulkin, hopes to improve the quality of care and reduce costs through the Tele-ICU allowing real-time monitoring and follow-up of critical patients. He stated that the technology “improves the quality of care, lowers costs by supporting evidence-based practices, and improves patient outcomes by decreasing ventilation days, ventilator-associated pneumonia, and reducing length of stay “.

“Collaborative partnerships, such as this agreement with VA, help us provide the best possible care to our service members, military relatives and retirees receiving health care through the Department of Defense,” said the deputy secretary of Defense for Health Affairs in office, Dr. . David Smith.

The future of telehealth is not yet determined

As CMS published the rule for comments and suggestions, we anticipate that the final version of the rule may be even more rewarding for the evolution of telehealth. However, even without regulatory updates, healthcare organizations are moving toward providing remote care and collaborating to enable technology support for real-time patient health monitoring. So, we look forward to seeing what the new rule will be and review the opportunities that will open up.

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