Which presidential candidate has earned the vote of telehealth providers?

Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Jake DiBattista, a territory manager at SimpleVisit, a video service provider for physicians. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

With jobs being such a hot-button issue in the 2016 presidential race, it is only natural some telehealth providers wonder how the shifting political landscape may impact their career outlook. While telehealth might not be the focus of national debates, it certainly will continue to see political movement as adoption and technology become increasingly widespread.

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The American Telemedicine Association has been working diligently to lobby for greater coverage for telehealth in Medicare and as part of ACOs to create more affordable and accessible care. Telehealth has had notable success early on across the aisle because of its promise to empower patients, in addition to lowering the costs of providing care. Providers now must wonder if political unrest at the executive level will lead to a slowdown in the tide of telemedicine. Let’s take a look at where the top candidates stand on healthcare and how their views may impact the future of telemedicine.

Donald Trump

Donald Trump has promised to completely repeal the Affordable Care Act, or “Obamacare,” if he’s elected on the first day of his term. He has offered an alternative plan, built on broadening the powers of insurers to sell across state lines and consumers by improving price transparency, HSA saving, and tax deductions. He also supports block grant Medicaid which would give states a lump sum to operate and distribute among its people in an effort to avoid waste.

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To forecast the effect of these changes through the lens of telemedicine, it’s important to consider the impact the private market has had on telemedicine. Private insurers were among the first to adapt coverage and plans to include telemedicine. In Maryland and Washington, D.C., the Blue Cross Blue Shield plan CareFirst now is one the most generous in the country in reimbursing claims across specialties for video enabled visits. Moreover, consumers now flock to mobile applications such as Doc on Demand and American Well as they give patients the ability to instantly see a doctor at a low fixed rate. However, the majority of public plans do not allow for telehealth reimbursement, nor do they limit its use.

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Will empowered patients and deregulated markets create an environment for growth in telemedicine? Because of Trump’s lack of stance on telemedicine, it is impossible to tell if he views telemedicine as a major tool in lowering costs for public plans or just another benefit constituents don’t need. Having very straight forward pricing and offering a lower-cost solution for states in a block grant system should position telemedicine favorably in the Trump camp, but it is hard to know for sure. There is much uncertainty when it comes to relying on the free market, but consumer trends point to an increased demand in telemedicine.  So I would not be too fearful, even if providers have to go without Medicare reimbursement in a Trump administration.

Hillary Clinton

Contrary to the Trump platform, Hillary Clinton has actually gone on the record and publicly taken a stance on telemedicine. According to Clinton’s campaign website, “Hillary will explore cost-effective ways to make more health care providers eligible for telehealth reimbursement under Medicare and other programs, including federally qualified health centers and rural health clinics.” This appears to keep pace with the current movement of telehealth legislation, and while it is not overly progressive or detailed, it does give voters confidence her administration views telemedicine as a key part in the progression of healthcare.

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Clinton’s stance can best be summarized as staying on the current path. She favors a gradual adoption of telemedicine in public plans and increased support for it as a tool to meet the needs of rural health and federally qualified patients. This seems to delegate telehealth to what it currently is, a second option for care when none can otherwise be delivered. Increased reimbursement is critical as Medicare is often at the forefront of progressive reimbursement and it could lead to a watershed event of coverage. While it is not flashy or exciting, it is at least a policy stance in favor of increased use of telemedicine at the national level.

Conclusion

Neither candidate’s stance should decide who you cast your vote for come November. Both plans could allow for growth, as telemedicine is increasingly in demand by both patients and providers and is economically feasible. The lack of a statement and desire for system overhaul by Trump should likely raise some red flags for providers. There is considerable uncertainty in the Trump plan that even if it were to stimulate the growth of private telemedicine markets, at what cost would that be? Meanwhile, Clinton’s plan promises slow and steady growth. Having a presidential candidate address telemedicine in itself is a big deal, as it shows just how far the industry has come, and gives hope that regardless of who is in charge of the executive branch it will continue to grow as an alternative to conventional care.

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