Technology firms see a bright future in home-based telehealth services and are pushing for provisions to encourage their use in the health reform legislation now being considered by Congress.
Chronic illness is on the rise and baby boomers are aging, dynamics which have the tech companies betting on increased demand for telehealth home technology and services.
For example, in April, General Electric and Intel announced they were forming a “healthcare alliance” and would invest $250 million to develop and market technologies that help people with chronic illness manage their conditions at home.
“The market for telehealth and home health monitoring is predicted to grow from $3 billion in 2009 to an estimated $7.7 billion by 2012,” company officials said when they announced the joint venture.
According to federal projections, the number of Americans age 65 and older will nearly double by 2030 to about 71.5 million people or about 20 percent of the population. Chronic illnesses such as heart disease, diabetes and hypertension already account for seven of every 10 U.S. deaths, according to the Centers for Disease Control and Prevention.
According to CongressDaily reports, Intel, GE, Cisco Systems, IBM and the trade group Tech America are urging legislators to include provisions in the health reform bill so that government health programs would reimburse providers for in-home, virtual medicine consultations.
They also are supporting inclusion of a plan by Sen. Ron Wyden, D-Ore., to create a three-year pilot program in 26 states that would provide in-home, telehealth primary care to Medicare beneficiaries with multiple chronic conditions.
Jane Kelly, lobbyist for the Kansas Home Health Association, said her group’s member agencies also have their eyes on the federal legislation, hoping it will include provisions to help them deploy the home telehealth technology.
“One of the things that we’re hoping national health reform will do is allow agencies to buy equipment, especially in the rural areas,” she said. “In the western part of the state, agencies are small and few and far between and they’re driving lots of miles to take care of their patients. So, if there are things they can monitor remotely, that would help a lot.
“Right now, (home-based telehealth) is not as widespread as we’d like it to be,” Kelly said, “mainly because the equipment is expensive and the episodes that Medicaid and Medicare reimburse for are not that many. There’s not a lot that they can do right now.”
Kelly said that the home health agencies rely more on Medicare and private-pay reimbursements than they do Medicaid.
According to the Kansas Health Policy Authority, state Medicaid reimbursements for home telehealth services have dropped from about $250,000 a year to less than $125,000 a year between fiscal years 2005 and 2008. Agency officials attribute the sharp decrease primarily to a policy put in place in November 2007 that required the agency’s prior authorization of skilled nurse visits resulting from the telemonitoring of patient conditions.
But Kelly said the decline also could be the result of fewer home health agencies accepting Medicaid patients.
“We’ve had a lot of agencies over the last five years that have just dropped doing the (Medicaid) waiver programs because of lack of reimbursement,” she said. “They can’t meet expenses with the reimbursements they get. So, if there are any more cuts to that, what you’re going to see are less and less agencies to provide the care. And if people can’t get the care that way they’re going to be going on the Medicaid rolls in institutional settings. That obviously is going to cost the state.”
Kelly said her association includes 130 of the estimated 185 home health agencies operating in Kansas.
Medicaid in Kansas reimburses for certain types of telemedicine. For example, it will pay for doctor consultations such as a specialist’s remote review of an MRI. It also will reimburse for limited home telehealth services, those involving a skilled nurse visit. But Medicaid does not pay for routine home telehealth monitoring of the sort being done as part of a Kansas Department on Aging pilot program.
-Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at mshields@khi.org or at 785-233-5443, ext. 123.