States Moving to Mandate the Payment of Telehealth Usage, Not Always for Home Health

Expansion of mandating telehealth payments has been making the news recently.

  • 19 states have mandated private insurers to reimburse healthcare providers for telehealth services on the same basis as in-person services.
  • Many state’s Medicaid programs are currently or proposing reimbursement.
  • Centers for Medicare & Medicaid Services (CMS) has been discussing expanding some telemedicine coverage for Medicare recipients.

TeleHealth OperatorTelehealth services are focusing on physical and mental health evaluations, counseling, chronic disease monitoring, and more.  Physician practices, rural clinics, etc. appear to be included in many of the state changes, but home health coverage is included for some states.  Every state is different and you will need to stay up to date with the new rules and regulations. You may want to consider partnerships.  Reach out to physician practices without telehealth capabilities, demonstrate your expertise, and share a business case for sub-contracting to your agency.

Also, many private insurers (and some state Medicaid programs) have been paying for telehealth reimbursement in many states. Open the dialogue with insurers and demonstrate your outcomes. Also annually renegotiate price based upon outcomes and savings.

IHI Triple Aim logoHealthcare is changing, and telehealth supports the Institute of Healthcare Improvement (IHI)’s “Triple Aim” framework :

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

See additional articles on recent telehealth coverage changes and check with your local state government.

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