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Videoconference Expansion of Medicare Reimbursements Ahead?

As part of the ongoing effort to increase the efficiency and manage the costs of health care, The Medicare Telehealth Parity Act of 2014 was introduced in July by Reps. Mike Thompson (D-CA) and Gregg Harper (R-MS). If passed, reimbursement for treatment conducted via video conferencing will expand in three phases over four years beginning in more rural areas and then expending to more populated counties.

While the majority of this effort is directed to remote monitoring of chronic diseases, the bill would also expand telehealth reimbursement to occupational therapists (OTs) , physical therapists (PTs) , and speech therapists (SLPs).
The bill has drawn support from the American Physical Therapist Association (APTA), which this year, passed a resolution supporting the adoption of telehealth in PT as an effective way to deliver PT services when provided in ways that meet APTA standards of care guidelines.

While Medicare currently allows some reimbursement for telehealth reimbursements, the impact is limited to rural areas and requires patients to travel to “originating sites” with no provisions for remote monitoring. The newly proposed bill eliminates these problems and puts video conferencing and other forms of remote patient-provider interactivity into the mainstream of our health care delivery system. Particularly exciting for allied health professionals, the bill also requires the General Accountability Office (GAO) to study the use of remote monitoring for outpatient therapy. If the bill passes and this provision remains, we may be looking towards a time when OTs, PTs, and SLPs can increase their productivity via improving virtual interactivity to offer remote treatment on parity with their in-person healthcare visits.

Telehealth expansion for direct patient care could prove to be a real benefit to allied health professionals just as much as to their patients. Physical wear- and -tear and injuries would all but disappear. If telehealth improves the ability to conduct treatment via home offices, the time spent commuting to and from work or between patient settings could be dramatically reduced as well.

As exciting as these new opportunities could prove to be for PTs, OTs, and SLPS, the prospect of a large expansion of telehealth reimbursement poses new risks as well. Can the rapport and camaraderie often required to motivate clients to go that last strenuous, and often painful mile be far more difficult to achieve within a remote clinical sessions? Will a different kind of personality for techniques be needed for establishing the necessary rapport via telecommunications? No one knows how to address these challenges until telehealth expansion arrives. What we do know is that the use of technology to improve patient care while also lowering costs has been embraced by both political parties. Whether this particular bill passes or not, the expansion of telehealth services is likely to be inevitable.


Robert Hoyt, Ph.D.


Allied Health Professionals, LLC

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