Telemedicine presents the opportunity to increase access to healthcare in a number of scenarios, including rural areas and among patients with restricted or limited access to healthcare facilities, but a research letter in JAMA finds this service is highly underutilized.
Analyzing claims from a sample of Medicare beneficiaries, researchers found less than 1 percent of those living in rural areas received a telemedicine visit in 2013. Researchers note this is even less than the 12 percent of veterans receiving telemedicine services in the Veterans Administration.
Reimbursement for telehealth services significantly varies between commercial and government payers. While many commercial payers fully reimburse for telehealth services, Medicare reimbursement is dependent upon certain parameters, including a requirement that the patient be at a clinic or facility in a rural area to receive a telemedicine consultation.
States are increasingly considering parity laws — requiring commercial payers to reimburse telemedicine visits at the same rate as they would an in-person visit — and researchers theorized such laws may encourage overall interest in telemedicine and boost utilization rates among Medicare patients.
However, their research indicated this is not the case. "We found that state laws that mandate commercial insurance reimbursement of telemedicine were not associated with faster growth in Medicare telemedicine use," according to the authors.
They suggest federal legislation to expand Medicare reimbursement may help encourage telemedicine use and increase access to care and improve care quality.
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