Colorado Bills Aim to Improve Medicaid Primary Care Through Telemedicine
Colorado lawmakers are proposing a bill to expand telemedicine in an effort to improve health care access for Medicaid patients.
Under current Colorado law, health care providers are not reimbursed by Medicaid for “remote visits.” But Colorado House Bill 20-1092, which has state senate sponsorship, would change that, allowing telemedicine to qualify as an office visit.
The bills states telemedicine could save Medicaid money in the long run.
“Telemedicine helps connect Medicaid enrollees to health care providers through live video and audio, enabling enrollees to receive the care and consultation they need without traveling to visit a provider in another city or area of the state,” the bill stated. “Telemedicine visits can lead to cost savings for the Medicaid system by improving access to primary care and helping to avoid unnecessary trips to emergency departments.”
The Future of Health Care
Telemedicine is the future of health care, says Matt Glans, senior policy analyst at The Heartland Institute, which publishes Health Care News.
“It allows physicians to offer quality care to patients anywhere they are needed,” Glans said. “Currently, 200 telemedicine networks with 3,500 service sites operate across the United States, according to the American Telemedicine Association, and the number of telehealth providers is only expected to grow.”
The one thing holding back telemedicine growth is state regulation, but concern over “quality of care” has been unwarranted, Glans says.
“While some critics are concerned about the quality of care provided through telemedicine, telehealth patients have been found to be less prone to suffer from chronic depression, anxiety, and stress,” Glans said. “And, telehealth patients have a 38 percent lower hospital admission rate, according to a study from the American Journal of Managed Care. A 2018 study from the Agency for Healthcare Research and Quality also found telehealth is clinically effective. Competition will also quickly weed out bad actors and most patients receive high quality care via telehealth already.”
Telemedicine Saves Consumers Money
Telemedicine can lower costs for patients, says Linda Gorman, director of the Health Care Policy Center at the Independence Institute.
“People don’t have to travel, so it lowers patient cost,” Gorman said. “It is widely used in private sector specialist consults, so actually having Medicaid pay for it, might improve the care that Medicaid provides.”
Sometimes, opposition to telemedicine is driven by special interests, Gorman says.
“People who are against telemedicine are often protecting their markets—pharmacists in other states can be very sticky when an out-of-state physician wants to prescribe through them—and physicians can be concerned about national competition,” Gorman said.
Gorman says the challenge is determining the best role for telemedicine.
“Will an elderly person who is deaf and computer illiterate be well-served?” Gorman asked. “How about a homeless drug addict or surgery using a robot and an internet connection a good idea? Are there medical disciplines in which a physical exam is irreplaceable? We simply don’t know.”
Such questions do not seem to be stopping patients, especially those who lack transportation or live in rural areas, where a remote visit with a doctor can be highly convenient, Glans says.
“Telehealth is very popular with patients,” Glans said. “For example, among telehealth patients receiving services on a mobile app, 80 percent preferred telehealth compared to a traditional in-office encounter, a 2016 study by West Monroe Partners reveals.”
Colorado’s interest in expanding telemedicine in Medicaid follows action in California last fall when Medi-Cal introduced a policy which would allow providers to determine if such a visit would be appropriate. The state is now considering a bill that would remove the requirement that a telemedicine visit would have to be preceded by a face-to-face visit.
Ashley Herzog (firstname.lastname@example.org) writes from Avon Lake, Ohio.
Colorado House Bill 10-1092: https://leg.colorado.gov/sites/default/files/documents/2020A/bills/2020a_1092_01.pdf