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Telemedicine Wrap Up -- Industry Happenings in July 2018

Posted by James Baker, Chief Medical Officer | August 15, 2018 |
James Baker, Chief Medical Officer


Another month has passed with some interesting and revelatory happenings in the world of telemedicine. This is our third in the series, with a look back at an industry that’s moving at the pace of digital change, creating its own form of disruption in the traditional field of healthcare delivery.

Here’s what happened in July.

Deloitte Releases Physician Survey Showing Some Telemedicine Foot-Dragging

Deloitte’s 2018 annual Survey of US Health Care Consumers and Physicians was released last month and it held a bombshell for telemedicine applications. The study sought to quantify attitudes toward telemedicine from the consumer and physician perspective. They found that 64% of healthcare consumers view the convenience and improved access to care in telehealth applications the biggest benefit:

Virtual care programs will likely become increasingly important to health systems that want to retain and attract customers – consumers, employers, and health insurers – who will likely demand more connected, coordinated, and convenient care.

Physicians agree and the participants in the survey cite the following three benefits of the virtual visit:

  • Improved access to treatment for patients – 66%
  • Higher patient satisfaction scores – 52%
  • Staying better connected with caregivers and patients – 45%

However, the study also found that adoption is lagging, with only 23% of consumers regularly using video visits – so far – but another 57% are willing to try these applications. But physicians are lagging even further behind consumer interest; the survey showed that 14% of doctors have a telemedicine service line in their practices and another 18% plan on adding it in the next two years.

So, where is the disconnect between consumer interest in this technology and physician reluctance to capitalize on it? The study suggests the following barriers are perceived by physicians to be keeping them from adopting telehealth applications in their practice:

  • Reimbursement challenges.
  • Licensing complexities.
  • High costs of the applications.
  • Technology reliability.
  • Security and privacy.
  • Medical errors.

However, Deloitte added their own rebuttal to the survey findings, with this important recommendation:

That said, the market increasingly supports new care models. Our view is that with the changing reimbursement models, growing consumer demand, and advances in digital technologies, virtual care is a must-have for health systems, and they will now need to help physicians adopt virtual care capabilities.

The study concluded that helping physicians experience the benefit of telemedicine helps them envision it’s potential for their practice. They stated, “Physicians with experience of virtual care technologies tend to feel good about them.”


Virtual care infographic_MASTER


Credit: Deloitte Center for Health Solutions 2018 Survey of US Physicians and 2018 Survey of US Health Care Consumers.)

Manatt Health Releases Study on State Medicaid Policies and Telehealth Laws

A new study by Manatt Health tracked the ever-changing landscape of state telemedicine law, concluding:

The use of telemedicine services is growing nationwide as providers and payors seek to improve access and better manage patient care, while reducing health care spending. State laws and Medicaid1 policies related to reimbursement, licensure and practice standards are rapidly evolving in response to the proliferation of technology and the growing evidence base demonstrating the impact of telemedicine on access, quality and cost of care.

Manatt’s analysis took into account all 50-states, looking closely at Medicaid reimbursement and state laws governing telemedicine applications, including:

  • Licensure and practice standards.
  • Coverage and reimbursement.
  • Patient settings and eligibility.
  • Provider type eligibility.
  • Appropriate covered technologies.
  • Potential service limitations.


Based on their survey, they grouped states into three categories: Progressive, moderate, or restrictive in regards to their coverage of telehealth applications.

Some of the most “progressive” states, which signified wider reimbursement for telemedicine, included:

  • Alaska
  • California
  • Colorado
  • Florida
  • New Jersey
  • New York

Restrictive states included:

  • Arkansas
  • Georgia
  • Massachusetts
  • Maryland
  • North Carolina
  • North Dakota
  • New Hampshire
  • Ohio
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • Texas

The remaining states were called “moderate.”

The Manatt survey found:

  • That most states provide telemedicine reimbursement of some sort.
  • That the majority of states allow multiple types of providers to administer treatment via a telemedicine application.
  • Very few states limit the specific types of services that can be offered via telemedicine applications.

While there has been some loosening of Medicaid restrictions, some barriers to reimbursement remain, including:

  • Delivery site
    Only 26-states allow reimbursement when the home is the delivery point for service.
  • Live video only reimbursement
    While almost all states reimburse for live video conferencing, many states still do not pay for remote patient monitoring, email, phone, or store and forward technologies. 29 states reimburse for one of these “alternatives,” while 16 states reimburse for three of the four. Colorado is the most liberal reimbursement state, paying for all telemedicine services.
  • Patient/doctor relationship
    Nine states still require the clinician to have a prior relationship with the patient before a telemedicine visit – and reimbursement can occur. Mississippi is very restrictive in this area requiring a “valid physician-patient relationship” with a prior (in person) physical exam.
  • Limits on visit frequency
    Nine states also still limit the frequency of telemedicine visits for Medicaid patients. In Georgia, hospitals can only provide telemedicine visits every three days and nursing units can only provide one every 30-days.
  • Limits on geography
    The study found that nine states place locational restrictions on the distance between the originating site and the patient. Indiana is one of these states, and they only reimburse if the gap between doctor and patient is at 20 miles (and up).


The study concludes by noting that there is “a growing body of evidence” that suggests telemedicine will play a pivotal role in the future as a cost-reducer in the healthcare space. As more clinical data shows cost savings and higher outcomes, “Medicaid policies are evolving…to accelerate adoption of telemedicine models.”

Click here to view the survey.

OrthoLive Telehealth Application

Into this rapidly changing, volatile space, comes OrthoLive, a telemedicine application designed specifically for orthopedic providers. Our service is designed especially for the small to mid-sized orthopedic practice. It’s an affordable, HIPAA compliant option that helps these clinicians extend their practice and streamline their workflows.

If you’re ready to explore telemedicine, contact us today for a free demo of our service.

Topics: "telemedicine", healthcare, digital trends, 2018 trends

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