Newswise, May 31, 2016 — Although the number of Medicare
telemedicine visits increased more than 25 percent a year for the past decade,
in 2013, less than 1 percent of rural Medicare beneficiaries received a
telemedicine visit, according to a study appearing in JAMA.
Medicare limits telemedicine reimbursement to select live
video encounters with the patient at a clinic or facility in a rural area.
Federal legislation has been proposed to expand Medicare telemedicine coverage.
Ateev Mehrotra, M.D., of Harvard Medical School, Boston, and colleagues
examined trends in telemedicine utilization in Medicare from 2004-2013 using
claims from a 20 percent random sample of traditional Medicare beneficiaries.
The researchers found that telemedicine visits among rural
Medicare beneficiaries increased from 7,015 in 2004 to 107,955 in 2013 (annual
visit growth rate, 28 percent); 0.7 percent of rural beneficiaries received a
telemedicine visit in 2013.
Most visits occurred in outpatient clinics; 12.5
percent occurred in a hospital or skilled nursing facility. Mental health
conditions were responsible for 79 percent of visits.
Rural beneficiaries who
received a 2013 telemedicine visit were more likely to be younger than 65
years, have entered Medicare due to disability, have more illnesses, and live
in a poorer community compared with those who did not receive a telemedicine
visit.
“Proposed federal legislation would encourage greater use of
telemedicine through expanded reimbursement. In contrast to others, we found
that state laws that mandate commercial insurance reimbursement of telemedicine
were not associated with faster growth in Medicare telemedicine use.
Our
results emphasize that nonreimbursement factors may be limiting growth of
telemedicine including state licensure laws and restrictions that a patient
must be hosted at a clinic or facility,” the authors write.
Editor’s Note: This article was supported by an unrestricted
gift to Harvard Medical School by Melvin Hall and CHSi Corporation. All authors
have completed and submitted the ICMJE Form for Disclosure of Potential
Conflicts of Interest and none were reported.
