Monday, July 13, 2015

Telemedicine becoming more popular among rural residents; visits not always covered by Medicare

Smartphones and tablets have made it easier for people living in rural and remote areas to connect with medical professionals from the comfort of their homes, Abby Goodnough reports for The New York Times. "Health systems and insurers are rushing to offer video consultations for routine ailments, convinced they will save money and relieve pressure on overextended primary care systems in cities and rural areas alike." (NYT photo by Evan McGlinn: an employee at CHI Franciscan Health’s telemedicine center in Tacoma, Wash., monitoring far-flung patients’ vital signs)

"Advocates say virtual visits for basic care could reduce costs over the long term," Goodnough writes. "It is cheaper to operate telemedicine services than brick-and-mortar offices, allowing companies to charge as little as $40 or $50 for consultations—less than for visits to emergency rooms, urgent care centers and doctors’ offices. They also say that by letting people talk to a doctor whenever they need to, from home or work, virtual visits make for more satisfied and potentially healthier patients than traditional appointments that are available only at certain times."

Not everyone is in favor of the service, Goodnough writes. "Telemedicine is facing pushback from some more traditional corners of the medical world. Medicare, which often sets the precedent for other insurers, strictly limits reimbursement for telemedicine services out of concern that expanding coverage would increase, not reduce, costs. Some doctors assert that hands-on exams are more effective and warn that the potential for misdiagnoses via video is great."

"Legislatures and medical boards in some states are listening carefully to such criticisms, and a few, led by Texas, are trying to slow the rapid growth of virtual medicine," Goodnough writes. "But many more states are embracing the new world of virtual house calls, largely by updating rules to allow doctor-patient relationships to be established and medications to be prescribed via video. Health systems, facing stiff competition from urgent care centers, retail clinics and start-up companies that offer video consultations through apps for smartphones and tablets, are increasingly offering the service as well."

Dr. Ateev Mehrotra, a professor of health policy at Harvard Medical School, who has studied telemedicine, told Goodnough, "But I think it’s very plausible, and probably likely, that a lot of people who do a virtual visit would otherwise have stayed home. So it could increase health care spending over all.” (Read more)

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