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Research & Commentary: Pennsylvania Should Embrace Expansion of Telemedicine

September 25, 2018

In this Research & Commentary, Matthew Glans examines a bill moving through the Pennsylvania General Assembly that would expand telemedicine access and create reimbursement parity with in-person services.

The Pennsylvania House will consider a bill that would expand telemedicine access by clearly defining telemedicine and the wide range of technologies and services it comprises. The bill, introduced by Pennsylvania state Sen. Elder Vogel (R-Beaver), would allow for a practitioner-patient relationship to be established remotely and require the patient’s insurer, corporation or health maintenance organization to provide reimbursements for telemedicine services at the same rates for similar in-person services. The bill, which has already passed the Senate, would enact substantial reforms that would increase health care access to thousands of Keystone State residents.

Telemedicine—the use of information technology to remotely diagnose, treat, or monitor patients —can transform health care delivery by making it more affordable and available. The main barriers preventing telemedicine from expanding further in many states are government regulation and the inability of the current system to properly reimburse doctors providing telemedicine services. Strict licensing standards have become a significant barrier to entry in the health care industry. In many instances, states control licensing standards, professional discipline, and the various costs associated with the licenses.

Telemedicine services can have an especially positive effect on patients with chronic conditions—such as diabetes, irritable bowel disease, and multiple sclerosis—that affect about 133 million Americans, according to ChironHealth.com. Additionally, the U.S. Department of Veterans Affairs (VA) was able to reduce “the number of bed days of care by 25% and the number of in-hospital admissions by 19% using home-based video visits,” as noted in a recent VA study.

Currently, 200 telemedicine networks with 3,500 service sites are in operation across the United States, according to the American Telemedicine Association. The number of telehealth providers is only expected to grow. In fact, a 2017 report on the global telemedicine market estimated the telehealth market is poised to grow at a compound annual growth rate of around 16.3 percent over the next decade to reach approximately $78.3 billion by 2025, according to Accuray Research LLP.

Furthermore, telemedicine is popular with patients. For example, among telehealth patients receiving services on a mobile app, 80 percent preferred telehealth over a traditional in-office encounter, a 2016 study by West Monroe Partners revealed.

Several states have already passed or considered legislation unleashing the telemedicine market so that providers can use this new technology to expand their reach. In 2017, New Jersey and Vermont passed laws providing telemedicine payment parity. In Texas, where telemedicine has historically faced significant backlash, rules were passed in 2017 that enable Texas practitioners to use telehealth services.

Telemedicine has the potential to provide routine health care services to more people at a lower cost than traditional in-person delivery. Unfortunately, unnecessary and burdensome government regulations continue to stifle access to telemedicine services for many Americans. Sen. Vogel’s telemedicine reform efforts are a good step to make telemedicine more widely available to Pennsylvanians.

Telemedicine reform efforts in states such as New Jersey, Texas, and Vermont are a positive move toward making telemedicine more accessible. Additional states should pass similar legislation, thereby increasing health care access and simultaneously reducing costs.

The following documents examine telemedicine and various barriers blocking its expansion.
 

AHRQ Finds Telemedicine Clinically Effective
https://www.politico.com/newsletters/morning-ehealth/2018/06/01/ahrq-finds-telemedicine-clinically-effective-238848
Mohana Ravindranath of Politico Morning eHealth examines a new study from the Agency for Healthcare Research and Quality that found telemedicine is clinically effective. The study was unable to find conclusive evidence to determine if telemedicine is more cost effective.

The Promise of Telehealth For Hospitals, Health Systems and Their Communities
https://www.aha.org/system/files/research/reports/tw/15jan-tw-telehealth.pdf
This study from the American Hospital Association examines the promise of telehealth, focusing on how telehealth is being used by hospitals and the benefits for patients and providers.

Telemedicine Facts that May Surprise You
https://chironhealth.com/blog/telemedicine-facts-may-surprise/
In this article, Lauren Cranford of Chiron Health examines several research studies and polls that prove telemedicine’s popularity and effectiveness.

Telemedicine… Across State Borders
https://www.cato.org/publications/commentary/telemedicine-across-state-borders
Shirley Svorny, professor of economics at California State University (Northridge) discusses the value of using telemedicine services, how allowing telehealth care across state lines would improve the availability of care, the barriers to telehealth expansion, and some reforms state and federal legislators should consider that would expand telemedicine services.

The Traveling Doctor: Medical Licensure across State Lines
https://www.americanactionforum.org/insight/the-traveling-doctor-medical-licensure-across-state-lines/
Brittany La Couture of American Action Forum examines the licensing process for doctors in several states and argues for reform. “Though it is important to recognize the right of states to protect the health, safety, and welfare of their citizens, mutual recognition and portability would still largely give states the ability to continue to monitor the care that is provided by physicians licensed in their state while creating incentives for states to build competitive regulatory systems that will attract physicians to those states,” wrote La Couture.

Telemedicine: Changing the Landscape of Rural Physician Practice
http://www.nejmcareercenter.org/article/telemedicine-changing-the-landscape-of-rural-physician-practice/
Writing in the New England Journal of Medicine, Bonnie Darves argues new applications of telemedicine have enabled rural physicians to manage a wide range of acutely ill patients, improve accessibility to specialists, and reduce barriers to care in underserved regions: “With advances in technology, plummeting costs, and governmental health care system partnerships, telemedicine is now used by more than half of U.S. hospitals and has reduced rural practice isolation. Be sure that health plan and hospital credentialing, privileging, licensure, and malpractice issues are addressed before practicing telemedicine.”

Physician Care and Telemedicine
http://heartland.org/policy-documents/physician-care-and-telemedicine
Devon Herrick of National Center for Policy Analysis examines the benefits of telemedicine in providing health care at a lower cost and outlines the current barriers to expansion: “Entrepreneurs are using the telephone, the Internet and personal computers for innovative solutions to traditional problems of health care delivery. These advances are not only making care more accessible and convenient, they are also raising quality and containing medical costs.”

Convenient Care and Telemedicine
http://heartland.org/policy-documents/convenient-care-and-telemedicine
This study examines the contribution of telemedicine and other information technology to innovative solutions to some of the problems patients and health care providers encounter under the traditional model of health care delivery. It also identifies obstacles to progress and the public policy changes needed to remove them.

3 Solutions for Major Telemedicine Barriers
http://www.beckershospitalreview.com/healthcare-information-technology/3-solutions-for-major-telemedicine-barriers.html
This article from Becker’s Hospital Review discusses a recently published study in Telemedicine and e-Health which found three major barriers to telemedicine implementation and use that must be addressed.

Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced?
http://heartland.org/policy-documents/crossing-telemedicine-chasm-have-us-barriers-widespread-adoption-telemedicine-been-
Widespread telemedicine adoption has been stymied by unnecessary technological, financial, and legal barriers for 40 years. In addition, business strategy and human resources have contributed to the delay of implementation. Cynthia LeRouge and Monica J. Garfield canvass recent events and activities in these areas and overall U.S. health care reform that might help to break down these barriers.

 

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this subject, visit The Heartland Institute’s website, and PolicyBot, Heartland’s free online research database.

If you have any questions about this issue or The Heartland Institute’s website, contact Lindsey Stroud, a state government relations manager at The Heartland Institute, at lstroud@heartland.org or 312/377-4000.

Author
Matthew Glans joined the staff of The Heartland Institute in November 2007 as legislative specialist for insurance and finance. In 2012, Glans was named senior policy analyst.
mglans@heartland.org @HeartlandGR