Who Pays for Telemedicine and Telehealth

Thanks to the major advancement in technology in the medical world, it now means that no matter where a radiologist, nutritionist or physician is in the world, they can get access to a patient’s data via digital images, live presentations, and even one on one chat.

The question is, why are we not seeing this kind of technology widely adopted?

One reason has been the total cost of the equipment. However, as more healthcare providers are now adopting it, prices are starting to drop making it more affordable. Another reason is the way that healthcare gets reimbursed.

All healthcare systems around the world are monetized, and ours is no exception. No matter what goes on, it has an associated fee to go with it. How much the fee is depends on what services are used. For instance, a session with a brain specialist will cost more than one who deals with wounds. The problem with this kind of costing is that it leads to continuously increasing prices.

Due to current reforms, better use of push per-patient payments. The likely incentives that come from this will keep costs down.

When we are talking about a telemedicine model of business, then this means that physicians will be paid for a number of interactions that do not actually have the patient present. This includes things like video chat, data transfer, and emails.

Insurance Policy Changes

Although, keeping an eye on patients while they are still at home will save money, there still needs to be a charge for services so that the practice does not lose any money.

If this cost is then covered by the patient, then savings are passed on to the insurance company. This in turn will have an effect on the way that the market moves forward with this kind of technology.

The best way to cater for fee-per-patient care, is for the insurance companies to include in their policies, an additional option to cover telemedicine. This would then allow the technology to be used more widely.

The first push is up to the US government, and its Medicare Program. This will help bring telemedicine to the masses, and it will not be long after the private insurers will get involved.

Another possible way of the costs being covered is with ‘capped payment’ health insurance plans. Thanks to an increase from 2005-11 of around 26% on managed care plans, it is more than likely that these will help with the costs of the new technology. This would ensure that physicians are paid the correct amount of money.

Thanks to legislation in 12 states, passed from 2011 onwards, private insurers now have to include an option for telemedicine. Each state law differs though, so the details need to be looked into.

Although Medicaid, Medicare and the private insurers are helping bring this technology to the masses, certain areas are still falling short. One of them is for people with chronic diseases.

Eventually, the industry will catch up with the technology, and the majority of physicians will start to make use of telemedicine.

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