Telemedicine Opens Clinical and Financial Pathways

Back in the day, AT&T built a hugely successful ad campaign around the slogan, “Long distance, it’s the next best thing to being there.”

Today, that slogan could be the rallying cry for the telehealth and telemedicine industries, where optimism and excitement are hallmarks.

“Some areas of the healthcare industry are experiencing frustration over additional documentation, or lamenting restrictions on payment reimbursement,” explains Nathaniel Lacktman, a partner at the global law firm Foley & Lardner. “In contrast, telehealth entrepreneurs really have a lot of optimism and energy because they see so many opportunities for the future.”

And with good reason. Several telemedicine bills have been recently introduced in the Senate — and re-introduced in the House – aimed at expanding Medicare’s reimbursement of telemedicine services. The bills would also extend reimbursement eligibility to urban areas.

“We see a lot more activity in telehealth as a way to improve care and efficiency, as well as save money,” Lacktman says.

Not unlike EMRs

Lacktman explains that some physicians see telehealth and telemedicine as a threat, rather than a way to complement and augment their existing methods of healthcare delivery. He compares the long-distance technology to electronic medical records.

“[EMRs] was a change, and a lot of people didn’t want to do it,” Lacktman says. “There are some financial incentives and cost associated with it, but increasingly it’s basically the norm. It’s a standard. And as physician practices get more acclimated, they’ll get more comfortable with it. Telehealth is the same.”

New physician fee schedules in 4 areas—psychotherapy, psychoanalysis, prolonged evaluation and management services, and annual wellness visits—can also be a boon to a medical practice’s bottom line when combined with telemedicine, especially for primary care practices.

“You already provide wellness visits and you do E and M services with patients,” Lacktman says. “You may or may not offer psychotherapy, right? If you are primary care and want to diversify and be aware of comorbidities, you could hire a psychiatrist and do some psychotherapy or psychoanalysis, and associated types of services. Those could be done via telehealth. Well, now you can also do annual wellness visits via telehealth. That will allow you to reach out to a larger patient population and bring them in, and you’ll get paid for it.”

Added revenue

Lacktman recommends that physicians stay aware of telemedicine opportunities as they relate to their specific skill set or specialty. For example, the Centers for Medicare and Medicaid Services recently revised telehealth regulations allowing for a more refined definition of included geographic locations.

“Let’s say you’re a primary care physician and you’re in a metropolitan area, and there’s some rural areas nearby certainly within driving distance,” Lacktman explains. “You offer these telehealth services, make them available to the patients, and then all of a sudden, you’re their doctor for a lot of their needs, not just the scope of the telehealth services.”

Opportunities also exist for specialists who would like another avenue to generate income for their practice, but don’t want to make the investment required to set up a telemedicine system of their own.

“You draw on your specialty expertise, and there are entities out there that provide online second opinion programs to patients all around the country,” Lacktman says. “You can contract with different businesses and you are able to become sort of a consulting network. People will reach out to you for second opinions, and you’re paid for that, on a contract basis, through telemedicine.”

ACO and ACA impact

Lacktman also believes that the Affordable Care Act and the growth of Accountable Care Organizations (ACOs) signal opportunity for physicians where telemedicine is concerned. For example, as a provider in an ACO, you are taking on risk and have a direct financial incentive to reach out to patients.

“You want to lower the thresholds as much as possible, and telemedicine is one way to lower the threshold, by making it available to patients who live farther away and may be less likely to hop in their car,” Lacktman says. “You can also do the same thing through telehealth remote monitoring technologies. You can make chronic care management services more economically viable.”

Lacktman says that, more and more, healthcare professionals are realizing the cost-benefit associated with telehealth and telemedicine services. Physicians are better able to understand their patients’ health status and conditions, and that leads to provide more accurate treatment.

And, he adds, the best is yet to come.

“Physicians, in particular primary care physicians, who can sort of see this vision in the future, they’ll be best positioned to reap the benefits of those endeavors.”