Covered by Medicaid

Colorado signs a new bill that reimburses health-care providers for telemedicine services.

by / July 12, 2006

Some people have a hard time getting to the hospital when they need emergency care, especially if they have to make several trips. Others can't seem to make it to the doctor's office as often as their health requires because they live too far away.

With telemedicine, health-care providers can merge technology with medicine to provide remote diagnostic services to patients in need of immediate or constant medical evaluation.

Although an increasing number of physicians use telemedicine services for their patients, receiving reimbursement still proves a challenge.

In June, Colorado Gov. Bill Owens signed SB 165 into law, allocating Medicaid reimbursement to health-care providers who supply telemedicine services to Medicaid patients.

Prior to SB 165, Colorado law did not mandate Medicaid reimbursement for telemedicine services. Now, telemedicine services are on the same level as in-person visits and receive reimbursement the same way, said Nate Strauch, Owen's deputy press secretary.

"A lot of rural communities in Colorado have had to rely on telemedicine to receive the same level of care as those in suburban or urban communities," Strauch said. "This bill makes sure everyone is on equal footing."

SB 165 ensures that Medicaid patients in Colorado can experience the advantages of telemedicine services without worrying about who's going to pay the bill. Additionally SB 165 includes a "best practices" pilot program for chronically ill patients who need constant care. This program will provide patients with the medical equipment they need to combat their illness and monitor their condition while reducing costly visits to the emergency room.

Telemedicine services can reduce expenses for everyone involved -- including private insurance companies, Medicare and Medicaid. Although Colorado is not the first state to enact Medicaid reimbursement for telemedicine services, said Jonathan Linkous, executive director of the American Telemedicine Association, Colorado's new bill is important.

"Colorado is taking a step forward," Linkous said. "It's tremendous to have a state like Colorado take this position."

Remote Monitoring
Telemedicine services include distance examination, diagnosis and even surgical assistance, and require that the necessary equipment be installed at the remote location, such as a patient's home. Equipment varies and is usually supplied by the participating health-care provider.

Some of the available devices for remote monitoring include blood pressure monitors, digital stethoscopes, video cameras and digital cameras. Data collected with telemedicine devices can be sent to the remote health-care provider via video conferencing, which transports video and audio across broadband Internet connections. If broadband service is unavailable, information can be sent with store-and-forward technology, which stores data and sends it to providers via a dial-up connection.

With remote examination, patients in distant rural areas have equal or potentially better access to medical care than those living near a doctor's office.

Why it Works
Telemedicine is growing in popularity because it offers three major benefits over traditional medical care, Linkous said.

The first benefit is increased access to medical treatment. People in rural areas may not be able to get to the doctor when they need to, Linkous explained, adding that even in the inner city, patients may not see their doctor on a regular basis because they are homebound. With telemedicine, patients can see a nurse via video conferencing or send frequent vital signs to their doctor's office for evaluation.

The second benefit is improved quality of care. Specialists are often hard to find in rural areas, said Linkous, however telemedicine broadens the search and allows patients the opportunity to find knowledgeable specialists who can prescribe the appropriate medication or treatment.

"You get improved quality of care by getting access to someone who has a specialized knowledge," Linkous said.

Through increased contact with health-care providers, telemedicine also improves the quality of patients' care because the patients get more frequent attention than through intermittent office visits. Patients can send information over the Internet or see a nurse at the press of a button, Linkous explained. Some conditions, such as diabetes, require constant monitoring, because a patient's condition can deteriorate very quickly.

"The more often we measure and monitor our vital signs, the more accurate we're going to be," said Linkous. "We do that with cars -- we know how much gas is in the tank, or if the car is overheated, but we often don't monitor our human bodies the same way."

Finally telemedicine offers more efficiency by driving down cost. Keeping a patient at home instead of in the hospital saves a substantial amount of money for everyone involved, Linkous said.

For those patients struggling with constant medical issues, such as diabetes or congestive heart failure, consistent proactive monitoring can potentially increase good health and reduce the need for expensive medical care over the long haul, Linkous explained.

"One of the biggest problems we have in our health-care system is hospital over-utilization -- particularly in the emergency department," Linkous said. "If we can keep people out of the hospital and in their own homes, not only will they be happier and better off, it's a lot more efficient."
Sherry Watkins Contributing Writer