Report: State-by-state policy analyses for telemedicine regulations, reimbursement

By Brian Dolan
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American WellThis week the American Telemedicine Association's annual event is taking place in Los Angeles and apart from the important pair of policy-focused reports the ATA published (more on that below), the other news coming out of the event so far is that American Well has expanded its scope and is now working to convince physicians to use its platform to connect with their existing patients.

While American Well has long worked with partners to power their video visit offerings (like UnitedHealth's NowClinic) in white-label agreements, it also offers its own video visits service direct-to-consumer. Now its pushing to drive adoption at the physician level to become the de facto video visits app that all providers use with their patients.

American Well CEO Roy Schoenberg explained the new tack to Forbes: “We [want to] take telehealth that was used as a convenience measure for patients, and put it in the hands of physicians."

Patients typically book video visits with doctors via services like American Well's when they have a relatively minor problem and it's not convenient to book an in-person office visit. American Well hopes physicians will start using its services not just for convenience calls but for follow-up care with existing patients. 

ATA's state-by-state telemedicine analyses: Even though recent months have seen headlines suggesting the sorry state of telemedicine regulation in states like Texas and Alabama, a new state-by-state analysis conducted by the American Telemedicine Association finds that the two states with the worst overall marks for reimbursement and allowable telemedicine services are Connecticut and Rhode Island. Those two each scored "Fs" in the ATA analysis. Texas and Alabama did receive the lowest remarks in a second ATA analysis, however. That one was focused on professional licensure portability and practice standards for providers using telemedicine -- both Texas and Alabama received overall scores of "C".

"Based on 13 indicators related to coverage and reimbursement, our analysis reveals that decades of evidence-based research highlighting positive clinical outcomes and increasing telemedicine utilization have been met with a mix of strides and stagnation in state-based policy," the ATA writes. "When considering the numerous payment and service delivery options that enable telemedicine adoption, overall five states maintained the highest composite score suggesting a supportive policy landscape that accommodates telemedicine adoption. Maryland and Mississippi have dropped from an ‘A’ to ‘B’ as a result of additional restrictions being placed on telehealth coverage under their Medicaid plans. Connecticut and Rhode Island continue to average the lowest composite score suggesting many barriers and little opportunity for telemedicine advancement."

The report is a great resource for healthcare providers and any telehealth company operating in the US. Here's one of many state-to-state comparisons from the report:

"Forty-eight state Medicaid programs have some type of coverage for telemedicine. Only four states and D.C. scored the highest grades by offering more comprehensive coverage, with few barriers for telemedicine-provided services," the ATA writes. "Maryland dropped from an ‘A’ to ‘B’ due to restrictions enforced in its regulations. Connecticut, Hawaii, Idaho, Rhode Island, and West Virginia ranked the lowest with failing scores in this area. Iowa, Nevada and Utah have improved their failing scores to ‘C’ by expanding coverage for telehealth under their Medicaid plans."

Read the ATA's state-by-state coverage and reimbursement analysis here and the separate state-by-state report on licensure portability and practice standards for telehealth providers here.

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