In response, practices greatly expanded telemedicine services during the long months of shelter in place and recurrent surges of COVID-19 infections, and patient use of telehealth services blossomed. Reimbursements for telehealth services is lower than for in-person servicesĪll telehealth visits, including audio-only, will be reimbursed as if the service was furnished in personĭata from CARES Act AMA Covid-19 Fact Sheet ( ) and Medicare Telemedicine Healthcare Provider Fact Sheet ( ). Providers may waive cost-sharing for telehealth paid for by federal programs Medicare coinsurance and deductibles apply to telehealth visits Must be audio-visual (ie, video technology)Įxpanded approved platforms, including FaceTime, Skype, and Zoom Telehealth can now be provided to patient in another state (state-specific restrictions may still apply)
Physicians may conduct telehealth from home Physicians must conduct telehealth from their place of practice Telehealth may originate and be conducted from any site, including patient’s home Only at prespecified sites (ie, designated rural areas, certain medical facilities) No preexisting relationship will be required Patients and providers who have a preexisting relationship 15Īny type of clinician can bill for Medicare services Nonusers were also more likely to cite lack of training, equipment costs, liability concerns, and inadequate reimbursement as barriers to telehealth. Family medicine providers (N = 1630) surveyed about the reasons behind their nonuse of telehealth were more likely than current users to feel it was an inefficient use of their time, and to express concerns about the overall quality of care and the liability potential. 11 Approximately one-third of those clinicians also stated that the overall quality of the visit was better in person. About half of clinicians surveyed in one setting (respondents largely consisting of psychiatry providers) who were actively using both telehealth and office visits in their practices were concerned that the personal connection through telehealth was inferior to office visits. 14 The telemedicine appointments assessed in these studies were almost entirely video-conferencing rather than telephone-only owing to reimbursement restrictions on the latter.Ĭlinicians had a more variable opinion of telemedicine, perhaps driven by inexperienceas most were not using it before the pandemicand those who did use it still conducted most of their visits in person.
9 Patients also expressed some concerns about telemedicine, such as data security. 8, 9, 10, 11, 12, 13 In a systematic review on the topic, the most frequently cited factors associated with patient telehealth satisfaction included improved outcomes (defined a variety of ways owing to heterogeneity of the 44 included studies), preferred modality over face-to-face visits, ease of use, low cost, improved communication, and elimination of travel time. Of the patients who were able to access telemedicine before March 2020, their overall impressions were positive. 5 Systems factors, such as technology capability of the electronic medical record and other characteristics driven by reimbursement policies (such as rural location), influenced which hospitals or clinics were more likely to offer telehealth, 6, 7 further limiting which patients had the option of using this service. 4 Despite these hurdles, 76% of US hospital systems used some form of telemedicine as of 2018, with radiology, psychiatry, and cardiology noted as the highest users of the modality. Providers were (and often still are even in a postpandemic landscape) limited from treating traveling patients by interstate licensing restrictions, and juggled miscellaneous rules about prescriptions, types of visits, and types of patients that were or were not acceptable for telemedicine. 2, 3 Patients and providers who desired to use it navigated inconsistent and often inadequate reimbursement for services, restrictions on where each party must be located and what sort of technology interface they must use, and privacy regulations that necessitated costly investments in secure telecommunication technology. Telemedicine in the United States before March 2020īefore March 2020, telemedicine use in the United States was on a steadily increasing trajectory, but its absolute integration remained low, and the logistics were complex.
0 kommentar(er)
