Maui AgeWave’s ‘News Stand’ Page is a place for us to share ideas and opinions!  We will post our own views and ideas, as well as share pertinent information about the growing industry of tele-care (with special emphasis on Hawaii.)

Our Opinion?  Approve Reimbursement for Telehealth Systems NOW!

AMA Adopts Position Officially Encouraging Use of - and Reimbursement for Telehealth Systems

                  Center for Connected Health Chief, Dr. Jo Kvedar, Lauds New AMA Policy.

“Electronic devices can help deliver care in a way that is especially vital in remote areas,” says Barbara L. McAneny, MD, an Albuquerque oncologist and chair of the American Medical Association’s Council on Medical Service. “We want insurers and Medicare to recognize this is going to be a true form of health care delivery, not just a convenience.”

McAneny’s committee submitted a report to that effect to the 159th Annual Meeting of the AMA House of Delegates in Chicago.  The house adopted the report as an official AMA stance, including the statement, “All non-face-to-face electronic visits should be adequately paid for.”

The new policy directs the AMA to promote “Pilot Projects of the innovative payment models, structured to include incentive payments for the use of electronic communications such as web portals, remote patient monitoring, real-time virtual visits and e-mail and telephone communications.”

More...www.connected-health.org

Larry D. Carter, PHD
Partner, Maui AgeWave

                         Does Medi---Care about Tele---Care at Home?

Makawao, HI - After reading the new 2010 version of “Medicine and You”, I must conclude that the answer is “no”.  In a booklet of 126 pages there is but one paragraph on Telehealth.  Assuming the paragraph is one fourth of the page, that makes the space allocated to telehealth about .19% of the book.  The content provided is even less impressive than the space allocated.

Here is how it works.  “Telehealth includes a limited number of medical or other health services like office visits and consultations provided using an interactive two-way telecommunications system like real-time audio and video by an eligible provider who is at a different location from the patients”.  So far this makes sense.

“Telehealth is available in some rural areas, under certain condition, and only if the patient is located at one of the following places: a doctor’s office (?), hospital, rural health clinic, federally funded-qualified health center, hospital- based dialysis facility, skilled nursing facility, or community mental health center”. My first thought is, how many of the facilities mentioned would you expect to find in a truly rural area.

The other point that is missed by the policy statement is the omission of consideration being given to a person who is aging in place (at home) or living at home with a disability.  The policy stated requires the individual to be transported somewhere else to receive telecare. This, of course, defeats one of the main purposes of telecare---to eliminate the transport. 

Last, but not least, is the issue of the definition of rural.  The Medicare guideline uses the federal census definition of Metropolitan area to determine rural areas.  For example, on the Island of Oahu there are no rural areas because it has a population center of more than 50,000 and therefore the entire county (island) in which it exists is a metropolitan area.  Contrast this with Maui County which does not have a city of 50,000 or more and hence the entire county is rural.

The conclusion must be, If you want to use Medi---Care for Tele--Care, come to Maui where you will be eligible if you do-not-try-this-at-home.

Home care Technology Report     by Tim Rowan

This week's lead story is about a report that should be required reading for every agency. Judge me guilty of hyperbole if you must but the Medicare cuts looming in the fallout from the healthcare reform debate clearly indicate it is now time for our industry to be heard. This report provides you the bullhorn you have been waiting for. Here is the executive summary but be sure to also read our lead article and download the full report:

The Veterans Health Administration achieved and reported landmark results when it tested the effectiveness of home telehealth systems from 2003 to 2007. 

By spending $1,600 per patient, they avoided over $77,000 in nursing home costs and reduced hospital utilization by 19%. 

If you imitated their methods and achieved their results, your savings would accrue to the hospitals and payers you work with, not to you. 

Cutting the Medicare home health budget was debated in the Senate. The question is not "whether or not" but "how much." It needs to be turned so that "whether or not" is back on the table.

Sticking this VHA report under your Senator's nose would make him or her realize that the way to reduce Medicare expenditures is to increase home care spending so that you can afford to invest in home telehealth technologies. Cutting home care will increase overall Medicare costs.

Therefore, this VHA report should be required reading for all home care providers and their lobbyist of choice.

This is the strongest proof yet that it is time to stop looking at the cost of home health care -- including the technologies that improve home care delivery -- as an island of activity that does not directly impact the costs to government and private payers across all care centers. We have known that forever. No one has yet adequately explained why our elected officials do not understand it as well as we do. Perhaps you have not been telling them often enough. Perhaps you yourself have not been fully convinced.  Now you have proof.