CMS recently proposed a rule enabling Medicare Advantage enrollees to have more options for receiving telehealth services beyond what is otherwise available in the traditional program. (Photo: Shutterstock)
The Centers for Medicare & Medicaid Services is supporting more telehealth service options for Medicare Advantage enrollees, though many enrollees aren't even aware of the services currently offered by their particular plan, according to the HealthMine Medicare Survey.
The HealthMine Medicare Survey queried 781 insured age 65+ consumers with a chronic condition who are enrolled in a Medicare Advantage plan, and found that 46 percent of respondents are unsure if their plan offers telehealth, 37 percent say it is not offered, and 17 percent say it is offered.
To remedy this, CMS recently proposed a rule enabling Medicare Advantage enrollees to have more options for receiving telehealth services beyond what is otherwise available in the traditional program, agency administrator Seema Verma told attendees at the Alliance for Connected Care Telehealth Policy Forum for Health Systems.
“We want to increase flexibility for entities, like Medicare Advantage plans, that take accountability for total health care costs,” Verma said. “The proposed changes for Medicare Advantage are a major step towards expanding access to telehealth services because the rule would eliminate barriers for private Medicare Advantage plans to cover additional telehealth benefits for enrollees in MA plans.”
Verma also detailed “the historic steps” that CMS has already taken for the program:
- Starting in January, Medicare will pay for virtual check-ins so that patients can connect with their doctors by phone or video chat.
- Medicare will also be paying for virtual consultations between physicians, and evaluation of remote pre-recorded images and video.
- The CMS recently released home health rule will enhance the ability of home health agencies to use remote patient monitoring for their Medicare patients. This will allow patients to share more live-time data with their providers and caregivers, Verma said.
- Medicare patients receiving home dialysis will be able to receive their monthly clinical assessments via telehealth services while in their homes. Moreover, patients experiencing symptoms of an acute stroke will be able to receive telehealth services from mobile stroke units.
HealthMine cites Cowen and Co. analyst Charles Rhyee, who estimates the average cost of a telehealth call is between $40 and $50, compared to around $150 for an urgent care visit, and nearly $1,500 for a trip to the emergency room. Rhyee also estimates that roughly $135 billion of Medicare's annual $675 billion in spending could be done by telehealth.
Many (43 percent) Medicare Advantage enrollees would like their plan to offer telehealth services, according to the HealthMine Medicare Survey.
Other new benefits that they would like to have offered by their Medicare plan include modification to home for medical needs (62 percent); assistance at the home (57 percent); transportation reimbursement (54 percent); food deliveries (51 percent); and respite care for caregiver (32 percent).
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Katie Kuehner-Hebert
Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.
