Reimbursement
While hospitals and physicians may be willing to jump on the mobile health bandwagon, they need help from governing bodies to be successful. Much like the regulation issues, the reimbursement opportunities for mobile health are falling behind the demand.
Telehealth services, for example, are not necessarily reimbursed through Medicare without some specific criteria. This could be the patient and/or hospital is not located in a Health Professional Shortage Area (HPSA) or in a county that is outside of any Metropolitan Statistical Area (MSA).
In many instances, telehealth services are also only allowed following a face-to-face meeting between the physician and patient. Medicare will also only cover these services if they mimic what would happen during a physical doctor’s visit.
“There is no single widely-accepted standard for private payers,” the HRSA website reads. “Some insurance companies value the benefits of telehealth and will reimburse a wide variety of services. Others have yet to develop comprehensive reimbursement policies, and so payment for telehealth may require prior approval. Likewise, different states have various standards by which their Medicaid programs will reimburse for telehealth expenses.”
Even if providers are completely onboard the telemedicine train, that does not mean the payer is. While the government is working on ways to reimburse telemedicine or mobile devices, not all private payers have systems like this in place, meaning there is no chance at reimbursement.
Connie’s comments: Consumers should influence health insurance companies to reimburse telehealth such as video chat with doctors ($40-$90 per 15min or more minutes or video chat). We should also petition our lawmakers to adopt a one licensure for all states for both nurses and doctors and other allied health care professionals. Telehealth will greatly reduce chronic care costs. Motherhealth – Health Mobile Outpatient application will provide video chats, telehealth for nurses and doctors to be proactive with health monitoring.