Telehealth and remote monitoring services generally enable physicians to treat patients and monitor their health status remotely. Because of advances in wireless communication and biosensor technology these services are increasingly being used in the commercial health care market and as well in the Medicaid program and the VA because research shows these services can reduce acute care visits and lengths of stay, iatrogenic harm and improve patient adherence to care. Nevertheless, the Medicare program restricts reimbursement for these services largely because CMS (the Congress and the CBO) see them moreover as duplicative (v. substitutive) services. For example, in 2014 Medicare spent just $14 million on telehealth service reimbursement. (Total Medicare spending in 2014 was well north of $500 billion).
During this 18 minute conversation Ms. Drobac discusses in part how and why reimbursement for telehealth and remote monitoring services are limited under Medicare, how other payers and providers are using telehealth and remote monitoring, what the research literature suggests regarding clinical effectiveness and cost efficiency, proposed Congressional legislation and related regulatory action to broaden Medicare coverage and chances for legislative and regulatory success.
Krista Drobac leads the Alliance for Connected Care, a 501(c)(6) coalition formed to create a statutory and regulatory environment in which providers are able to deliver and be adequately compensated for providing telehealth and remote monitoring services regardless of delivery location or technological modality. Ms. Drobac was previously Director of the Health Division at the National Governors Association's Center for Best Practices. Prior to that she was senior adviser at CMS, Deputy Director of the Illinois Department of Healthcare and Family Services and spent five years on Capital Hill where she was a Health Adviser to the Senate Majority Whip Senator Richard Durbin and served as a John Heinz Senate Fellow for Senator Debbie Stabenow. Ms. Drobac earned her BA from the University of Michigan and her MPP from the Kennedy School of Government at Harvard.
For information on the Alliance for Connected Care go to: http://www.connectwithcare.org/