The Bipartisan Budget Act of 2018 signed into law on February 9 includes the CHRONIC Act (Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care). The goal of CHRONIC is to improve the care of people with serious chronic illnesses or with functional limitations. Theoretically, the bill will not only improve disease management but will lower medical costs.
One of the policies that would help people in this category is the expansion of telehealth services.
Telehealth is defined by the federal Health Resources and Services Administration as “The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.”
States have different definitions of telehealth, which can result in different policies for how its services can be used. However, the intent to expand services in the Budget Act will, hopefully, bring medical services into the 21st century as far as technology is concerned.
What is telehealth?
The term telehealth is applied to a collection of technical methods used to administer care and education. It includes interactive video conferencing, the ability to monitor patients remotely, mobile health, and a category called “store and forward,” which means information can be transmitted from one point to another. Information is not confined to diagnoses of specific patient cases, it also includes educational topics designed for disease prevention.
Video conferencing allows caregivers and patients to interact in real-time without the patient having to travel to an office or hospital. This is particularly an advantage for chronic care or disabled patients for whom travel is a burden.
Mobile health means that care and education can be facilitated through cell phones, tablets, and PDAs. It allows officials to send text messages about medical alerts or outbreaks.
Medicare and telehealth
Medicare traditionally has reimbursed only for a limited set of telehealth services. In the past, for instance, they would not reimburse for the store and forward or for remote patient monitoring services. The Center for Medicare and Medicaid Services (CMS) will decide whether or not to approve reimbursement in two categories. One is if the services are similar to existing traditional services, such as consultation, and are approved for telehealth delivery. The other is if they are not already approved but can be proven to provide a clinical benefit.
Only medical professionals can deliver telehealth services. This means physicians, nurse practitioners, physician assistants, nurse midwives, clinical nurse specialists, clinical psychologists, and registered dieticians or nutrition professionals.
The Health Resources and Services Administration (HRSA) has a program to analyze telehealth payment eligibility for Medicare beneficiaries on its website. Eligibility is updated every year and available on January 1 of the following year.
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