Large employers increasingly are taking more control over how health care is accessed and delivered to their employees in an effort to curb health care costs, according to the 2017 Health Plan Survey ...sponsored by National Business Group on Health (NBGH). To temper these anticipated increased costs, the NBGH study reports that in 2017, 90% of employers will make "telehealth" services available to employees in states where telehealth is permitted, which is a sharp increase from 70% in 2016. By 2020, virtually all large employer survey respondents will offer telehealth services to their employees. While the definition of telehealth varies significantly, it generally is defined as the delivery of health care services via technology. Telehealth is not a separate medical specialty but is the use of technology by a health care professional as a tool to deliver care. According to the NBGH study, in 2015, only 1% of employees who had access to telehealth services used it, and this percentage had only risen to 3% in 2016.
Medicare has covered the provision of telehealth services if the beneficiary is seen: * At an approved "originating site" (for example, physician offices, hospitals, or skilled nursing facilities) ...that is located within a rural Health Professional Shortage Area (HPSA) that is either outside of a Metropolitan Statistical Area (MSA) or in a rural census tract, or a county outside of a MSA; * By an approved provider (for example, physicians, nurse practitioners, and clinical psychologists); * For a small defined set of services, including consultations, office visits, pharmacological management, and individual and group diabetes self-management training services; and * Using certain telecommunications technologies. ...the June 2015 MSSP final regulations cite the role of telehealth as a means to improve care and avoid unnecessary costs.3 CMS also added a new eligibility requirement in the final regulations requiring each ACO to describe in its application how it will encourage and promote the use of technologies that improve care coordination for beneficiaries, citing telehealth and remote monitoring services as two examples.4 CMS and the Office of Inspector General also have stated that telehealth financial arrangements are eligible to receive protection under specific MSSP ACO fraud and abuse waivers, for example allowing the provision of home health monitoring of blood pressure to a hypertensive patient for free or under fair market value.
In light of the impending “Cadillac Tax,” the high cost of employer-sponsored coverages and employee demand for more accessible health care solutions, employers are increasingly offering employees’ ...access to care via telemedicine as a potential solution.
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