Physician Resistance to Telemedicine Growth

17 Apr

Physician Resistance to Telemedicine Growth

Telemedicine is one of the greatest growth opportunities for health systems, but physicians aren’t fully embracing the concept.

The Deloitte 2018 Survey of US Healthcare Consumers and Physicians reported that:

  •   90% see the potential benefits, but only 14% have video visit capabilities
  •   Only 18% of the remainder plan to add video visit capabilities in the next couple of years
  •   Of those with capabilities, only a third are regular users

The primary physician concerns lie in limited reimbursements, licensing requirements, and the high cost of technology.

A study published in Health Affairs found that Medicare and Medicaid, the two largest insurance programs administered by the Centers for Medicare & Medicaid Services (CMS) accounted for 59% of revenue for the top 5 US commercial health insurance companies. CMS is the largest single payer in the US healthcare industry, and in 2019, CMS has implemented changes that will have a drastic impact on the telemedicine industry.

The changes differentiate “communication technology-based services” and “remote patient monitoring” from the original definition of “telehealth” services. 

A suite of new codes promise to have the most significant impact on the adoption and use of telemedicine by providers and patients in 2019:

HCPSC code G2010: Outlines reimbursement for “remove evaluation of recorded video and/or images submitted by an established patient

HCPSC G2012: Outlines reimbursement for “brief communication technology based-service, e.g. visual check=in”

CPT Codes 99453, 99454, 99457: Outline reimbursement for “Chronic Care Remote Physiologic Monitoring”

HCPSC codes G0513 and G0514: Extend telehealth services related to “beneficiaries with end-stage renal disease (ESRD) receiving home dialysis an beneficiaries with acute stroke”

As of July 1,2019, CMS will remove the “originating site geographic requirement for telehealth services targeting treatment of substance abuse disorder or a co-occurring mental health disorder.” This legislation could double the number of individuals who have received care via telemedicine for opioid addiction. 

Mei Wa Kwong, Executive Director of the Center for Connected Health Policy states that, “I think we’ll see more changes on the policy side that would address some of the continued barriers for telehealth.” 

Other concerns include:

  •       36% are concerned about errors
  •       35% practice in a workplace that doesn’t offer the technology
  •       33% have concerns about data security and privacy
  •       23% indicate patients are not interested or lack the required technology to connect
  •       22% report that it doesn’t fit into current workflow
  •       18% are concerned about increased practice costs
  •       8% are not interested
  •       5% do not see a need

Physicians affiliated with hospital and hospital systems (62%) are more likely than independent physicians (49%) to have implemented at least one virtual technology. Driving factors include capital, strategic priorities, and a greater proportion of independent physicians being exempt from meaningful use requirements.

A survey by American Well found that 65% of consumers wantto use telehealth, and 7% would consider leaving their primary care physician for one that offered telehealth services. As consumer demand for convenience continues to drive change in the landscape of goods and services, consumer demand will drive physician adoption of telemedicine.

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