New Medicare Payment Model for Telemedicine
The US Department of Health and Human Services (HHS) planned a new Medicare payment model for telemedicine that reduces Medicare costs.
HHS is hoping to direct patients to alternative options for health care such as telemedicine or urgent care. This is more cost-effective than using the emergency room as a form of health care.
The HHS proposed an idea for ambulance providers; giving the same financial incentive to bring patients to the Emergency Department or connect them with urgent or telemedicine care if the situation is suitable.
This idea proposal should ignite more traffic to these two newer service options. If the pilot created by the HHS is successful, it could become a beneficial nationwide program.
Medicare is Looking to Reduce Costs with Telemedicine
The HHS is hoping to save a large chunk of funds by directing patients away from the emergency room and toward telemedicine options instead.
The new Medicare payment model for telemedicine means beneficiaries will have convenient and accessible care, even in remote locations.
ER visits are responsible for about 7% of the rising cost in healthcare across the country.
The HHS stated that the new model of payment could potentially save Medicare $500 million a year by using telehealth or urgent care services.
Fewer Hospital Visits for Less Serious Conditions
The first interaction a patient has before pursuing hospital care, for a less serious condition, is a process that’s still under construction.
However, the demand for telemedicine and urgent care services is growing at a rapid rate.
Hospitals should be seeking new options to provide patients with more efficient care and direct them to telemedicine services instead.
The younger generations seem to prefer a nontraditional healthcare service route such as virtual care and urgent care clinics.
It’s also noted that consumers have been using urgent care clinics more frequently.
Providers need to be more Diverse
The HHS idea is to convince ambulatory providers to transport more patients to lower-cost, non-hospital related care facilities.
A new Medicare payment model for telemedicine will help reduce hospital admissions and save patients as well as hospitals’ money.
Therefore, healthcare service providers should consider being more diverse in their approach to reaching their patients to use these alternative options.
What is the New Medicare Payment Model for Telemedicine?
Telemedicine is a new way for patients to connect with their doctors virtually. During these virtual visits, you can be treated and diagnosed in a separate location than your doctor.
Remember, this is still a relatively new service to Medicare. However, it’s predicted that telemedicine will lessen the cost of health treatments for beneficiaries.
Telemedicine is also expected to improve the way health care is being looked after for seniors. Although it is a newer service, telemedicine is well recognized.
This option is becoming more popular when seeking out health care services, as it allows you more freedom and flexibility following up on doctor visits.
What are the Benefits of the New Medicare Payment Model for Telemedicine?
For some patients, getting to and from the doctors’ office is too physically demanding. Telemedicine has 5 major benefits aside from being able to stay remote.
These benefits include:
- The convenience of having health care available to you whenever it’s one of the biggest upsides that telemedicine has to offer.
- Not having to sit in a waiting room also lessens your chance of receiving or spreading illnesses.
- Telemedicine can strengthen the relationship between you and your doctor, by giving more options for communication.
- This service provides the opportunity to connect with your physician no matter how far away you might be.
- When a doctor decides to use this option, it allows them more time for necessary medical activities. This service allows your doctor to care for you in a more efficient manner.
The New Telemedicine payment Model and Medicare Coverage
Medicare Part B beneficiaries will qualify for most telemedicine services. Beneficiaries make co-payments for in-person doctor visits; you have the same co-payments for telemedicine services.
For Medicare Part B enrollees, after meeting your Part B annual deductible, you pay 20% of the approved Medicare amount for telemedicine services.
This is the same system used for in-office visits.
The cost of telemedicine healthcare will remain the same as the cost of an in-person health visit.
Medicare covers telemedicine services such as (but not limited to):
- Consultations with providers
- Health check-ups
- Counseling for mental health
It’s important that you contact your telemedicine provider first, to see if they participate in Medicare. This will ensure coverage will apply to services offered or needed.
Should your provider not take part in telemedicine technology and you’re seeking that option, you should look for an office near you that does participate with Medicare.
How the New Medicare Payment Model for Telemedicine impacts Beneficiaries
Telemedicine provides Medicare beneficiaries with a more comfortable and convenient medical health care experience.
This includes saving money by eliminating travel expenses for regular check-ups; which, is another plus to this newer healthcare service option.
Medicare extended its beneficiary coverage to multiple new telehealth services back in 2015.
While the demand for these services is on the rise, the telemedicine industry is sorting out some challenges and improving the system.
When you’re enrolled in a Medigap policy, it’s possible you don’t pay out of pocket for your telemedicine visit.
Give us a call and talk to a licensed Medicare agent today. We help you enroll in a plan, or you can compare plan rates online here.