Telehealth

Background

TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. uses communications technology to deliver health care, health information, and health education at a distance. Telemedicine generally indicates physician services and telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. is a more universal term for the current array of services provided. These services can also be used in long-term services and supportsLTSS encompasses a broad range of assistance with activities of daily living and health-related tasks for people with functional limitations caused by physical or mental impairments. LTSS may be delivered in institutions or in a person’s home or a residential care setting.  and home- and community-based servicesLong-term services and supports provided in individuals’ homes or in community settings, including adult day services, assisted living and other residential care settings. settings. Examples of services are include remote patient monitoring and live video interactions with health care providers.

While telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services are expanding rapidly in many states, a number of factors limit their ability to reach beneficiaries, including the lack of high-speed broadband service in many sparsely populated areas, the inability of clinicians in some states to work across state lines, and MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant).’s limit on payment for telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services to only when services are provided in a clinical office and by a specialist.

Services provided by telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. have great potential to help consumers more easily connect with various health care clinicians, maintain their quality of life, and remain in their communities longer by providing an opportunity to manage their care. TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. gives people the ability to schedule health-related appointments and request prescription refills. It can remind them to take medications and serve as a method to link to a health care provider when time or distance is a barrier. TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. can also support family caregivers People who provide long-term services and supports to family members, relatives, friends, and neighbors. Some family caregivers are unpaid; others are paid through government programs, private funds, or long-term care insurance policies.  ’ efforts to take care of their loved ones.

TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. uses telecommunications technology to deliver health care, health information, or health education at a distance.

Growing shortages in the primary care workforce and the wide gap between payment for primary care and that for specialist services are issues of concern. Approximately 84 million Americans live in officially designated primary care health professional shortage areas. Experts observe that the disparity in incomes between primary care physicians and specialists discourages medical school graduates from choosing primary care careers. To help address this problem, the ACAThe ACA—the shortened abbreviation for the Patient Protection and Affordable Care Act— is comprehensive health care reform legislation enacted by Congress and signed into law on March 23, 2010. mandated a 10 percent MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). bonus payment for primary care services from January 1, 2011, through December 31, 2015.

Services provided by telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. have great potential to help consumers more easily connect with various health care clinicians, maintain their quality of life, and remain in their communities longer by providing an opportunity to manage their care. TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. gives people the ability to schedule health-related appointments and request prescription refills. It can remind them to take medications and serve as a method to link to a health care provider when time or distance is a barrier. TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. can also support family caregivers People who provide long-term services and supports to family members, relatives, friends, and neighbors. Some family caregivers are unpaid; others are paid through government programs, private funds, or long-term care insurance policies. ’ efforts to take care of their loved ones.

TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. uses telecommunications technology to deliver health care, health information, or health education at a distance.

TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. encompasses four distinct domains of applications:

  • Live video (synchronous): This is a live, two-way interaction between a provider and a patient, caregiver, or another provider using audiovisual telecommunications technology.
  • Store-and-forward (asynchronous): A transmission of recorded health history (for example, pre-recorded videos and digital images such as x-rays and photos) through a secure electronic communications system to a practitioner.
  • Remote patient monitoring (RPM): Personal health and medical data collection from an individual in one location via electronic communication technologies, which is transmitted to a provider (sometimes via a data processing service) in a different location for use in care and related support.
  • Mobile health (mHealth): Health care and public health practice and education supported by mobile communication devices such as cell phones, tablet computers, and personal digital assistants.

While services providing telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. are increasing rapidly in many states, there are restrictions that can limit beneficiary access, as in the following instances:

  • MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). has a narrow definition of “site of origin.” MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). fee-for-service (FFSA payment model in which health care providers are paid a fee for each service furnished. It gives an incentive to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. ) only pays for telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. care when the site of origin, or site of care, is provided in a clinical office and the telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. service connects to a specialist. This definition restricts MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). beneficiaries who have trouble getting to a clinical setting for geographic reasons or the lack of transportation.
  • MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). (FFSA payment model in which health care providers are paid a fee for each service furnished. It gives an incentive to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. ) pays for chronic-care management that is provided via telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. only for those who fit limited criteria. 
  • Various communities across the country lack of high-speed broadband cable.
  • Clinicians are not able to work across state lines when providing care using telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services.. (Interstate licensing compacts can resolve this issue.)

TELEHEALTH: Policy

TELEHEALTH: Policy

Telehealth access

Federal and state governments should encourage coverage and payment of telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services for eligible beneficiaries to improve access and the quality of care. This should include eliminating unnecessary restrictions that limit beneficiary access. They should allow patients to remain safely in the community and assist with care transitions from institutional to community settings.

Congress should remove geographic restrictions on MedicareMedicare is the federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (permanent kidney failure requiring dialysis or a transplant). coverage for telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services.

States should adopt interstate licensure compacts for physicians, Advanced Practice Registered Nurses, Registered Nurses, and other licensed health professionals. It would expand provider networks and reduce interstate barriers to the use of telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services.

Federal and state policymakers and the private sector should provide funding to ensure that low- and moderate-income households can afford high-speed internet service and equipment for telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services, particularly during a public health emergency. For example, interest, as evidenced by applications, has far exceeded available funding for the Federal Communication Commission’s Pilot TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. Program.

Federal and state policymakers should facilitate the adoption of appropriate telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services by providers serving underserved populations. This includes through pilot programs, such as the Federal Communication Commission's 2020 pilot telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. program. Policymakers should analyze the results of any pilot programs to inform future policymaking.

Services provided by telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. should offer quality and ensure that patient-related records and communications are protected from fraud (see Quality Improvement in Medicare; Privacy, Confidentiality, and Security of Health Information).

TelehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. clinicians should be required to follow all standards of care and regulations appropriate to their profession and inform patients of their credentials.

Policymakers should ensure that individuals have access to the technologies that enable telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. (see also High-Speed Internet Services). The mode of care provided to the individual should align with the preferences of the person and family caregiver People who provide long-term services and supports to family members, relatives, friends, and neighbors. Some family caregivers are unpaid; others are paid through government programs, private funds, or long-term care insurance policies. and be appropriate to meet their needs.

Payment for telehealth

Payment for telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. services should be sufficient to incentivize telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. use by providers and raise value for patients.

Public and private payers should thoughtfully consider how to reimburse clinicians and other telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. providers. This includes accounting for the cost of providing telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services., the need to support patients’ ongoing access to telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. with compensation that fairly rewards its use, the need to avoid unnecessary additional costs, and the efficiencies telehealthThe use of electronic telecommunications technologies to deliver health care, health information, or health education at a distance. A related term, Telemedicine, generally indicates physician services. may afford.