Telemedicine has found itself at the forefront of innovative health care delivery legislation, with successful passage of the Expanding Capacity for Health Outcomes (ECHO) and 21st Century Cures Act in December 2016, setting an optimistic tone for further government buy-in. The newly reintroduced Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 seeks to establish federal standards for telemedicine reimbursement and expand such services for management of chronic disease and home care coordination.
The bill promises to:
• Extend for two years the Centers for Medicare & Medicaid Services’ Independence at Home demonstration, which establishes home-based primary care teams for Medicare beneficiaries with multiple chronic conditions, and increase the cap on the total number of participating beneficiaries from 10,000 to 15,000;
• Add the patient’s home freestanding dialysis facilities, without geographic restriction, to the list of originating sites for monthly telehealth assessments with a nephrologist, beginning in 2019, though Medicare would not provide a separate originating site payment if the service was conducted at home;
• Eliminate geographic restrictions on telestroke consultation services, beginning in 2019; though the hospital where the patient is located and the location of the physician providing the telemedicine consult would not receive separate originating site payments;
• Expand telehealth coverage under Medicare Advantage Plan B, beginning in 2020; and
• Give Accountable Care Organizations more flexibility to use telehealth services.
Roughly half of all American adults manage one or more chronic health conditions, and approximately $0.71 of every health care dollar is spent treating patients with such conditions. Hopefully with bipartisan support behind the likes of Senators Ron Wyden (D-OR), Johnny Isakson (R-GA), and Mark Warner (D-VA), the CHRONIC Care Act will see success this legislative session.
