Inside Angle
From 3M Health Information Systems
Why won’t health plans pay for telehealth visits?
How long will it take until health plans catch up with the evidence? Non face-to-face visits can:
- be done well
- provide excellent care
- improve outcomes
- improve satisfaction
- reduce healthcare costs
The biggest impediment to delivering care this way is “Insurance won’t pay for that.” It makes me want to bang my head on the wall.
Dr. Travis Bias (a colleague) forwarded me a newspaper article describing the benefit of telehealth visits. The article describes how some specialists can provide stroke services over wide geographic areas, which can reduce the time to effective diagnosis and treatment. This should lead to improved outcomes, saved lives and reduced unnecessary costs.
Eight years ago, a group of researchers at UC Davis published a paper describing the feasibility of using simple web cameras and secure file transfer to delivery psychiatric services to underserved populations in California. They found that it is feasible, accepted well by patients and doctors, and confirmed in a follow up study to be quite cost effective. I had the chance to hear the principle investigator describe the findings that primary care providers (PCPs) and patients could have in an asynchronous consultation recorded while the patient was in the PCP office. This pretty much eliminated the problem of attrition, when people leave the PCP office with a referral to psychiatry that they must then negotiate.
Twenty six years ago, John Wasson et al reported in JAMA that telephone calls provided very good follow up as a substitute for routine clinical visits. The results were improved patient satisfaction, improved health outcomes and lower healthcare costs.
These are just some of the points of evidence supporting non visit-based care. There are reasonable concerns about just turning on new payment streams, but the evidence for supporting these streams is good and with thoughtful crafting of policy we can mitigate the concerns. It’s long past time to align payment policy with advances in care delivery.
L. Gordon Moore, MD, is Senior Medical Director, Clinical Strategy and Value-based Care for 3M Health Information Systems.
2 thoughts on “Why won’t health plans pay for telehealth visits?”
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L. Gordon Moore, MD
Former Senior Medical Director, Clinical Strategy and Value-based Care
L Gordon Moore, MD, is the former senior medical director of clinical strategy and value-based care for 3M Health Information Systems. In this role he bridges the intersections of quality,…
My son’s family is on a health plan that allows texting and photos in communication with their PCP. They used it recently to triage their daughter’s rapidly changing skin appearance/symptoms. Encouraged to come in after several exchanges within a few hours and was admitted for anaphylactoid reaction. Very grateful to their open mindedness in common day communications.
Gordon, teleheath and alignment to healthcare policy is a much-needed discussion. Thank you for bringing forward this important topic for discussion.
Teleheath, very often, provides critical health care needs. I recall patient care stories from far-flung areas in Alaska, where telehealth services offer quick access, responsive medicine and comfort to families that are integral part of our quintessential American landscape. Recently, a team and I facilitated psychiatrist telehealth infrastructure in Louisiana, where waiting lists for the local community psychiatrists were several months. Mental health services are a core component of well-being and necessary in reframing of life after major health events.
Telehealth can be a very creative expression of expanding excellent medical care- and scope can vary based on need and resources.