Slow connection: Medicare and telehealth

Using this techology shows promise, but it is hampered by inflexible payment and regulation, wary physicians, and uneven evidence of its value.

By David Glendinning, AMNews staff. Sept. 3, 2007.

Many physicians think that telehealth could be the wave of the future for Medicare, but so far it's registered barely a ripple. Although the program reimburses for some services, it has been too slow to embrace the technology, they say.

Telehealth is relatively new to Medicare. Congressional legislation in 1997 and 2000 largely established the telehealth component of Medicare as it is known today.

In 2006, the program spent only $2 million on medical services conducted electronically, out of more than $400 billion in total spending, according to the Centers for Medicare & Medicaid Services. Some doctors see countless missed opportunities for better care in those figures.

The idea is to improve the health of people in underserved areas by linking them electronically with doctors they would have difficulty seeing otherwise. For instance, a primary care physician could recommend that a chronically ill senior in a rural area come to a nearby satellite clinic to get needed treatment from a faraway specialist. A specialist visit could be conducted using videoconferencing equipment. Medicare coverage of the encounter could save the patient hundreds of miles of travel.

Better yet, problems could be solved before they grow out of control. Medicare payment for a home monitoring device that alerted disease managers and doctors when a patient's chronic disease first started to worsen could prevent multiple office visits, specialist consultations, hospitalizations or emergency department visits down the road.