Groups push to expand telemedicine provisions

While much of the healthcare debate is focused on cost containment and the uninsured, Silicon Valley is leaning on the Senate Finance Committee to consider incorporating new payment methods to spur wider adoption of telemedicine.

In the panel's policy options document released this summer, some members floated a proposal for Medicare to reimburse physicians for certain face-to-face consultations. But companies like AT&T, Cisco Systems, IBM, Intel and the trade group TechAmerica want that language expanded to include in-home and virtual care encounters.

"The horizon of imagination some policymakers have for health IT stops at the hospital doorway," Intel Digital Health Group Innovation and Policy Director Eric Dishman said. "Electronic medical records are the beginning of the healthcare technology story, not the end."

Dishman was on Capitol Hill last week meeting with aides to Finance members and said they were receptive to the tech sector's ideas, even if only incremental changes are likely for now.

The options paper discussed creating an innovation program at the Centers for Medicare and Medicaid Services to test payment processes that foster patient-centered care coordination for high-cost, chronically ill Medicare beneficiaries, as well as ways to reduce avoidable hospital readmissions and encourage greater coordination among acute hospitals and post-acute providers. But it did not mention technology or virtual care in those contexts, Intel lobbyist Alice Borrelli said today.

Nevertheless, Borrelli cited a range of studies showing big wins from embracing telehealth, despite some earlier pilot projects at CMS that indicated otherwise.

The Veterans Affairs Department, for example, has used electronic healthcare strategies to reduce hospital admissions by 20 percent and reduce bed days of care by 25 percent, according to a memo from the 200-member health alliance Continua, which Intel helped launch. The success of any telemedicine provision would also depend on how CBO scored it, lobbyists said.

Intel and others see promise in a proposal by Sen. Ron Wyden, D-Ore., that could be included in a final Senate Finance package. It would create a three-year pilot program in 26 states to bring home-based primary care services to Medicare beneficiaries with multiple chronic conditions.

Rep. Edward Markey, D-Mass., a member of the Energy and Commerce Committee, introduced a companion bill and plans to offer it as an amendment when the House moves its healthcare bill.