Becker's Hospital Review

76 CIO / HEALTH IT 4 Bills Hint at Bigger Medicare Reimbursement for Telehealth By Jessica Kim Cohen F our bills that may be signed into law during the next year may improve Medicare reimburse- ment for healthcare services delivered via tele- health, according to an analysis by Reuters. The bill furthest along, the Creating High-Quality Re- sults and Outcomes Necessary to Improve Chronic Care Act of 2017, aims to improve at-home care, increase Medicare Advantage flexibility, give ACOs more options and expand telehealth capabilities for stroke and dialysis patients. The CHRONIC Care Act passed the U.S. Senate in September 2017. Here are five things to know about telehealth reim- bursement. 1. Under current Medicare guidelines, the govern- ment payer does not recognize remote medical consultations as equivalent to an in-person consul- tation, and therefore does not provide equal reim- bursement. Cowen financial analyst Charles Rhyee estimates $135 billion in Medicare's annual spend- ing could be done more cost-effectively via tele- health, according to Reuters. 2. In recent years, private insurers — which cov- er healthcare costs for almost 70 percent of U.S. adults under age 64 — have begun to incorporate telehealth reimbursement, and even encourage its members to receive services via remote technolo- gy. Mr. Rhyee estimates the average telehealth visit costs roughly $50, compared to $150 for an urgent care visit or $1,500 for an emergency room visit. 3. American Well CEO Roy Schoenberg, MD, told Reuters revenue in the telehealth industry might grow 10-fold if restrictions related to reimbursement and state lines were lifted. "There is a big black line between the availability of telehealth services to Americans under the age of 65 and Americans that are above the age of 65," he said. "This [legislation] would be an earthquake." 4. However, while telehealth visits are cost-effective, some experts speculate remote care will supple- ment — not replace — in-person consultations, lead- ing to higher healthcare costs overall. "The health- care system is still being educated in terms of the value of telehealth and where it's best suited," Mat- thew Gillmor, an analyst with brokerage firm Baird, told Reuters. 5. Telehealth-focused legislation is still making its way through Congress. However, whether legisla- tors agree to pass the bills or not may depend on a report from the Medicare Payment Advisory Com- mission, which is slated for release in March. n Harvard Spinout Creates AI Coach to Field Patient Questions Between Medical Visits: 4 Things to Know By Jessica Kim Cohen M emora Health, a startup based in the Harvard Innovation Labs at Cambridge, Mass.-based Harvard University, developed an artifi- cial intelligence-powered virtual coach to answer patients' ques- tions, AmericanInno reported. Here are four things to know about the startup. 1. e virtual coach, named Felix, supports patients who develop follow-up questions about their condition or treatment aer returning home from a hospital visit. Memora Health co-founder and CEO Nisarg Patel told Amer- icanInno Felix is "built to talk [to a patient via text message] the way a nurse would talk with a patient over the phone." 2. Mr. Patel, a fourth-year doctor of dental medicine candidate at the Har- vard Medical School and the Harvard School of Dental Medicine, both based in Boston, co-founded Memora Health with two recent graduates from At- lanta-based Georgia Institute of Technology. Mr. Patel developed the idea for the startup after noticing many patients who regularly visited the hospital didn't have the support system to man- age a chronic condition at home. "They were even given the term 'fre- quent flyers,'" he said. 3. Memora Health sells the virtual coach to private practices and hospital departments, which in turn offer the service to patients, primarily by adding the Felix phone number to discharge papers so patients are able to text the line directly. e virtual coach also integrates with the organization's EHR system to ensure Felix has access to relevant patient information. 4. Memora Health is working on paid pilot programs with Boston-based Brigham and Women's Hospital and Atlanta-based Grady Memorial Hospital. n

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