Expanding Coverage for Virtual Health Care: The Path to Improved Access and Adoption

Digital health tools have the potential to revolutionize the healthcare industry providing expanded access to care for patients and reducing administrative burden for providers. However, a new report from the American Medical Association and consulting firm Manatt Health highlights a disconnect in coverage for these tools among insurers.

The report reveals that Medicare, both traditional and private Medicare advantage plans, are leading the way in covering virtual health care. These plans are paying doctors for services such as remote patient monitoring, remote therapeutic monitoring, digital evaluation and management, and interprofessional consultations.

On the other hand, coverage for virtual health care services Medicaid and private insurers varies significantly. While 34 states cover remote patient monitoring under Medicaid, coverage for other areas is limited. Private insurers also differ in their coverage policies, with some offering extensive coverage for digital health work and others providing limited coverage.

The lack of coverage in Medicaid and private insurance is seen as a barrier to the adoption of digital health tools. The AMA believes that if insurers want more doctors to adopt these tools, they need to start paying for them. The report suggests that expanding coverage for virtual health care services would not only benefit patients increasing access, but also support healthcare providers in delivering more efficient and effective care.

In conclusion, the report underscores the importance of expanding coverage for virtual health care services among insurers. Medicare has set a positive example, but there is a need for Medicaid and private insurers to catch up. By covering remote patient monitoring, remote therapeutic monitoring, digital evaluation and management, and interprofessional consultations, insurers can pave the way for improved access and adoption of digital health tools.

Sources:
– American Medical Association
– Manatt Health