For several years, we’ve heard about the surge in popularity for telemedicine, defined as an “interactive audio, video or other telecommunications or electronic technology…to deliver a health care service.” In 2012, Vermont put into place Act 107, which provided direction for how Medicaid, private insurance and Medicare would provide payments. There were limitations, though, with the biggest one being telemed to be administered to someone already in a hospital or other “inpatient” dynamic. In other words, if you’re hospitalized, instead of the doctor making rounds, you can simply contact him for a video conference. Many believed it defeated the purpose. So what does all of this mean and better still, how successful can an avenue for delivering health services be if it’s only limited to those already receiving care around the clock?
The law is clear in that all insurance policies – both public and private – must provide reimbursement and that coverage mustn’t be denied because of the telemed dynamic. If the insurer would pay a claim in a more traditional sense, then it must also honor this latest technological advance.
Like traditional vehicles of delivery, those participating in telemed may face the same deductibles, annual maximum payouts and coverage.
When the law was passed, Vermont’s Medicaid program was required to conduct studies that included literature reviews and how that translated into policies and procedures.
One year in, Vermont lawmakers wanted to know if these same services could be extended to include those not already in an in-patient facility. What those efforts revealed was that only eight providers throughout the state billed Medicaid for telemed services. That reality, of course, makes it difficult to gauge a broader sense of what’s working and what’s not within Vermont.
As more time passes, efforts continue for determining the scope of services that could be delivered via telemedicine outside of an inpatient facility, the costs and savings for Medicaid and ultimately taxpayers and finally, any safeguards that should be put into place if the transition does begin.
There’s no denying the potential, especially considering a much wider reach that would put into place a reliable source of medical advice and treatment even to those in rural areas. The broadband connectivity (and continued technological advances) ensures that.
One of the more interesting realizations comes from the Veteran’s Administration. Even with the ongoing scandals, VA is considered to be one of the driving forces. In 2013, it delivered more than 4,500 video teleconference, or VTC. It also provided a communications avenue from more than 150 VA medical centers and delivered healthcare to an impressive 90,000 veterans who were at home.
Even as telemed is settling in for a long stay, there are still legalities, licensure and reimbursement considerations. Still, once Vermont is able to get past the limitations it’s placed on this avenue, it’s believed it will make a lot of difference for Vermont citizens. Telemed, Medicaid and private insurers have a golden opportunity, especially for the elderly, to change forever the way healthcare is delivered.
If you’re nearing retirement and are concerned about healthcare costs, we invite you to contact our office. We can explore options, including Medicare and Medicaid eligibility while also putting into place strong financial planning that will help you protect everything you’ve worked for.
Ellen LaPlante
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