Virtual medical care has been gaining traction, and now, a recent change to the Medicare Access and CHIP Reauthorization Act (MACRA) just gave it another boost. The Center of Medicare and Medicaid Services (CMS) released its final rule for the Quality Payment Program (QPP) on Nov. 2, which aims to improve Medicare by enabling eligible doctors to focus on providing quality care. The final rule included many provisions for how physicians use information technology, and with these changes came new payment options for telemedicine.
CMS intends to increase the availability of Medicare telehealth services, with an emphasis on rural and unserved areas, by paying for these virtual consults and allowing doctors to more easily bill for telemedicine services. The QPP final rule added a new series of billing codes that reimburses virtual checkups under the CMS chronic care management program.
These changes were heralded by the American Medical Group Association, who issued a statement praising telehealth’s advantages for providers and patients. The new ruling will also allow for better use of remote patient monitoring tools and will prompt physicians to start making the most of this new, patient-generated data.
The MACRA ruling is timely as telemedicine expands around the country. In many ways, telemedicine is the crossroads of the hottest trends in healthcare, from consolidating hospitals to advances in remote-monitoring technology. It follows that the way telemedicine is paid for is also changing.
Mercy Virtual Care Center, an entirely virtual hospital based near St. Louis, Missouri, is one of the most extreme examples of healthcare’s transition to virtual care. There are no patients physically present at Mercy Virtual. Instead, a team of doctors, nurses, and other providers offer round-the-clock monitoring of their patients, who could still be comfortably at home. Mercy Virtual represents the newest ideas on how to care for patients, like communicating virtually to keep chronically ill patients home as much as possible, avoiding expensive hospitalizations that increase patients’ risk for stress and infections.
Beyond the advanced technology and progressive thinking that Mercy Virtual embodies, it also believes its model for care will bring about a paradigm shift in how hospitals and care providers are compensated. Rather than billing fees for administered treatments, the hospital’s administrators forecast a future where insurers and the government will pay Mercy Virtual to keep patients healthy. By promising to deliver better patient outcomes at lower costs, due to fewer hospitalizations, Mercy West is poised to be at the forefront of further changes in payment systems.
Traditional healthcare is being reimagined to change when care is delivered to a patient, ideally before the patient is even aware that there is a problem. The cost-savings potential from such a preventive model of care is substantial, so it is heartening that the CMS is working to accommodate the healthcare industry’s advances. The QPP final rule is a sure sign that the radical approaches that places like Mercy Virtual are implementing are being noticed.
Miliard M. New MACRA rule includes more support for telemedicine, remote patient monitoring. MobiHealthNews. November 6, 2017. http://www.mobihealthnews.com/content/new-macra-rule-includes-more-support-telemedicine-remote-patient-monitoring. Accessed November 8, 2017.
Kylie Jenkins is a medical student in the Class of 2021. She graduated from Barrett, the Honors College at Arizona State University with an economics degree and briefly worked as an analyst before beginning medical school. She is a notorious speed reader and loves writing, bouts of intense physical activity, and planning her next vacation.