The Practice


A Medical Group Management Association poll shows that a slightly higher percentage of physician practices are offering telemedicine services to patients in 2019, but the majority are still wary of virtual services.

Physician practices currently offering telehealth services increased three percentage points compared to 2017. Of the nearly 1,300 respondents, 26 percent said they are offering telemedicine to patients this year.

However, just 15 percent of practices plan to offer telemedicine services in 2018, down from 18 percent in last year’s survey. And despite telemedicine’s growing popularity throughout 2017, most providers have not been persuaded to implement programs: 39 percent said they would not provide care via telehealth and 20 percent were still unsure.

Respondents cited physician buy-in, reimbursement and lack of need for their specialty as the primary reasons they haven’t planned any telehealth initiatives.

Some small physician practices have begun embracing telemedicine to reach patients at home and provide follow-up care. Practices in Maryland and South Carolina have found success by offering virtual services for certain specialties, such as pediatrics or genetic counseling.

Hospitals and health systems like telemedicine, with the majority of executives planning to expand their program. Concerns about reimbursement have obstructed the industry’s growth, but support for telehealth legislation over the past year signals a willingness from lawmakers to expand Medicare reimbursement.

Department of Health and Human Services Chief Technology Officer Bruce Greenstein said in January that the agency plans to review  telemedicine rules.

“There are a lot of rules that I think are arcane and they definitely deserve looking at,” Greenstein said, responding to a question at StartUp Health at the J.P. Morgan Healthcare Conference in San Francisco that lamented the Health Resources and Services Administration restrictions.

He added that there is “a lot of friction” between government regulations and virtual care innovations. But he also acknowledged that while the technology is readily available, the telemedicine industry is still searching for a dominant business model. He urged companies to continue working with state Medicaid programs to experiment with different approaches to reimbursement.

Greenstein also cautioned that when the Centers for Medicare & Medicaid Services (CMS) has previously paid for off-site services, it has been accompanied by fraud, abuse, overbilling and upcoding. “That’s something that I think would cripple telemedicine if the launch went too early and without a really good sense of making that business work tight,” he said.

Beyond telemedicine reimbursement, Greenstein stressed the importance of private sector collaboration. HHS has planned a series of 13 events in different cities across the country over the next two years. The first “Startup Day” was Feb. 5 in the Great Hall at HHS headquarters in Washington, D.C, and included senior administrators at the Food and Drug Administration (FDA) and CMS, offering companies a chance to interact with government officials to help solve problems related to health data and analytics.

The events look to resolve a long-standing hesitancy from startups and private companies to collaborate with the government because it’s too slow or convoluted, he said.

HHS is also creating an opportunity for companies to undergo a parallel review by FDA and CMS and tap into a fund of money from investors seeking some assurance that new technology will be covered by CMS.

“I want to compete with the private sector and get that innovation in HHS,” he said. VTN


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Camden Lawless

Camden Lawless