Eleven major health insurers have offered their non-Medicare data to the Congressional Budget Office as a resource for demonstrating the effectiveness of telemedicine in the hope the CBO will include the data in future calculations around the cost savings generated by the use of telehealth technology.
The payers, some of the nation’s largest health insurance companies including Aetna, Anthem and Humana, are making the data available in response to CBO’s concerns that changing Medicare reimbursement policy regarding telemedicine could dramatically increase healthcare spending.
“As you know, there is significant congressional interest in breaking down barriers to telemedicine access in Medicare, and we believe our experience in the commercial market can inform estimates of the impact of policy changes in Medicare,” the insurers state in their letter to CBO Director Keith Hall. “We view telemedicine as an important tool in increasing consumer access to high quality, affordable healthcare, improving patient satisfaction and reducing costs.”
According to the health insurance companies, data demonstrates the value proposition of telehealth and reveals that there are substantial savings to be gained—even as it increases access to care.
As a result, the payers encouraged CBO to “look to data available in our commercial programs and other public programs to assist in informing utilization and cost estimates when evaluating potential cost impacts of removing barriers to utilizing telemedicine in Medicare.”
Jonathan Linkous, CEO of the American Telemedicine Association, is a longtime critic of Medicare restrictions on telehealth calling the Department of Health and Human Services a “laggard” and late adopter of the technology. However, he said ATA appreciates and strongly supports the efforts of insurers to inform CBO about the value of telehealth, especially in payment methods that shift the financial risk to providers such as through the Medicare Advantage program.
“For over five years, ATA has been asking CMS to make similar changes with all Medicare value-based payments including Medicare Advantage and with Accountable Care Organizations,” according to Linkous. “Our work with Congress on this issue has consistently been thwarted by CBO with unfounded concerns over cost. We look forward to a congressional committee of jurisdiction to officially request CBO analysis of over 15 years of Medicare data and these more experienced payers so that we can finally bring telemedicine to those in need.”
Late last year, Sens. Cory Gardner (R-Colo.) and Gary Peters (D-Mich.) introduced the Telehealth Innovation and Improvement Act which would require HHS to allow eligible hospitals to test telemedicine services through the Center for Medicare and Medicaid Innovation (CMMI).
In addition, the proposed legislation directs CMMI to review and independently evaluate telehealth models for cost, effectiveness, and improvement in quality of care without increasing the cost of delivery. If they meet the criteria, then the model would be covered through the greater Medicare program.
“Telehealth services have the potential to save lives and save money, and we’ve seen evidence of this in the private sector,” said Sen. Peters in a written statement. “We must explore every option to ensure that access to quality healthcare isn’t hindered by a patient’s geographic location or level of mobility. I was proud to introduce bipartisan legislation with Sen. Cory Gardner that would pave the way for Medicare to cover telehealth services that can help prevent expensive hospital visits and help patients get access to the care they need conveniently and safely. This private sector data could offer important insight into the potential for telehealth to bend the long-term healthcare cost curve and expand access to treatment.”
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