The evolving policy landscape of telehealth services delivered in the home and other nonclinical settings
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Milbank Memorial Fund)
- Author(s):
- Lazur, Brittany, author Bennett, Andrea, author King, Valerie, author
- Contributor(s):
- Milbank Memorial Fund, issuing body.
- Publication:
- New York, NY : Milbank Memorial Fund, August 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Home Care Services -- economics Insurance, Health Insurance, Health, Reimbursement Telemedicine -- economics Health Policy Insurance Coverage Medicaid Medicare Privacy State Government Telemedicine -- standards Humans United States
- Genre(s):
- Technical Report
- Abstract:
- The rate of telehealth use, in which patients receive a virtual health care visit, in the home or other nonclinical setting has outpaced the release of research about this model of care. As a result, state agencies are developing new policies for home-based telehealth services with little evidence to guide them. This brief identifies key findings for state officials considering such policies, as follows: (1) Payers with established telehealth programs employ approaches that are consistent with their organizational goals and resources. (2) State Medicaid programs cover home-based telehealth through a variety of approaches. (3) State Medicaid programs require home-based telehealth services to meet the same standard of care as in-person visits, including patient privacy and provider scope of practice. (4) State Medicaid programs usually reimburse telehealth-delivered services and in-person clinical and primary care–delivered services equally. (5) Medicare generally does not cover telehealth in the home, but is incrementally covering telehealth services in certain circumstances. (6) Commercial coverage varies based on state laws and how they use third-party vendors. The brief reviews state Medicaid, Medicare, and private payer policies on home-based telehealth and draws on interviews with policymakers from two Medicaid agencies, two individuals from health care organizations that implemented telehealth programs for patients at home, and a medical officer from a managed care organization (MCO) that offers virtual visits to all of its members. This brief is based on a report developed for the Medicaid Evidence-based Decisions Project (MED), a research collaboration of 21 state Medicaid programs based at the Center for Evidence-based Policy at Oregon Health and Science University.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (16 pages)).
- NLM Unique ID:
- 101755059 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101755059