Becker's Hospital Review

14 CIO / HEALTH IT Another study in Annals of Allergy, Asthma and Immunology found telemedicine appointments may be just as effective as in-person visits with an allergist. 6. e top reasons consumers report considering telemedicine are follow-up care for an acute illness (44 percent), symptom tracking or diagnosis (44 percent) and medication management (44 percent), ac- cording to a HealthMine survey of 500 insured consumers. 7. e majority of telemedicine users in the HealthMine survey, 93 per- cent, said the service resulted in lowered healthcare costs. However, only a third of respondents said their health plan offered telemedicine as an option. Reimbursement 8. irty percent of telemedicine visits are paid out-of-pocket, accord- ing to the Rock Health survey. is proportion compares to those who have visits covered by insurance (11 percent) or employers (10 per- cent). 9. A 2015 survey from Anthem and the American Academy of Family Physicians' Robert Graham Center suggested poor reimbursement was stunting the growth of telehealth, with 85 percent of the 1,557 surveyed physicians reporting they would consider using telehealth if they were ensured reimbursement. 10. Lack of reimbursement might change in the near future. e majority of large employers, 59 percent, offered telemedicine in 2016, compared to only 30 percent in 2015, according to a Mercer report on employer-spon- sored health plans. Mercer hypothesizes this trend toward telemedicine is to help cut costs in light of recent high-deductible health plans, since the typical charge for a telemedicine visit is $40, while the typical charge for an office visit is $125. 11. Moving into 2017, nine in 10 employers said they plan to make tele- health services available to employees in states where it is allowed, ac- cording to a survey of large employers conducted by the National Busi- ness Group on Health. 12. Forty-seven states and Washington, D.C., have some form of re- imbursement for telehealth in their Medicaid policies, according to a Center for Connected Health Policy report released in spring 2016. Massachusetts, Rhode Island and Utah were the three states that did not have a written reimbursement policy. 13. All 47 of the states provide some Medicaid reimbursement for live video consultations, according to the report. However, the states have a wide range of variation in terms of how they reimburse, including restrictions by medical specialty, services (ex. office visit, inpatient con- sultation), provider (ex. physician, nurse) and the patient's originating site. Market 14. e global telehealth market is projected to reach $9.35 billion by 2021, growing at a compound annual growth rate of 27.5 percent, according to a report published by MarketsandMarkets. In 2016, the market was valued at $2.78 billion. 15. In 2016, North America accounted for the largest share of the global telehealth market, followed by Europe, according to the Marketsand- Markets report. In the United States, a number of factors drove market growth, including rising healthcare costs, a shortage of physicians and a growing geriatric population. Challenges 16. Telemedicine was the top regulatory issue of 2016, according to a survey of state medical and osteopathic boards in the United States. e Federation of State Medical Boards, which conducted the survey, found 75 percent of boards named telemedicine as an important regu- latory consideration. 17. In recent years, telemedicine has become a popular answer to growing concerns about health outcomes in underserved communi- ties. However, there are significant challenges to telemedicine's growth; for example, lack of internet access may inhibit its reach in rural areas, while an overall shortage of healthcare providers may pose a barrier for telemedicine users who require in-person follow-up care. Recent news 18. e newly created National Quality Forum Telehealth Multistake- holder Committee, funded by HHS, is tasked with identifying best practices for measuring the quality of telehealth-delivered care and with improving the future use of telehealth measures. 19. A proposed telemedicine bill, set for a final vote in the Michigan senate, would set standards for the telemedicine industry, such as requiring pro- viders to obtain patient consent before providing telehealth services rather than meeting face-to-face. It will also allow state officials to formulate rules governing telemedicine. 20. e American Heart Association is advocating for Medicare to pro- vide coverage for all evidence-based telehealth services for cardiovas- cular and stroke care, in part because these services can reduce cost and increase accessibility to quality patient care. e association's other recommendations include incorporating telehealth into EHR systems and investing in future telehealth research. n US Supreme Court to Hear Epic Overtime Case By Erin Dietsche T he U.S. Supreme Court will decide whether compa- nies can require employees to sign arbitration agree- ments preventing workers from pursuing group claims in court, according to The New York Times. The Supreme Court took three cases on the issue, one of which involves Verona, Wis.-based Epic Systems, according to the Wisconsin State Journal. The Epic case involves an overtime pay dispute with an employee. In Chicago, a federal appeals court ruled the employee could file a class-action lawsuit against Epic, making the agreement he signed unenforceable. The other two cases, in which employees of gas station own- er Murphy Oil USA and business consulting company Ernst & Young, sought legal action against their employers. In the Mur- phy Oil case, a New Orleans appeals court ruled that arbitra- tion agreements were enforceable. In the Ernst & Young case, a San Francisco appeals court ruled the agreements were not enforceable. All three cases will likely be heard in April. n

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