FCC to CMS: Reimburse for mHealth

By Brian Dolan
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Brian Dolan, Editor, MobiHealthNewsOne federal agency suggesting ways that another federal agency might better do its job is commonplace in Washington D.C., but it's of particular interest for this editor when the topic is mobile health. Within the FCC's 360 page National Broadband Plan, which it unveiled earlier this week, there is a full chapter and some two dozen pages about healthcare. The FCC calls connected health "eCare" but often refers to mobile health, smartphone apps, wireless sensors and telemedicine.

The FCC had a few suggestions for how the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS) could help eCare services, including mobile health, get to market quicker. As we have noted many times in the past, the business model question is one of the biggest hang-ups for wireless health, especially since reimbursement has been slow to come for many wireless health services. The FCC has a few ideas about that. Here are four suggestions from the FCC:

1. HHS should identify e-care applications whose use could be immediately incented through outcomes-based reimbursement.

2. When testing new payment models, HHS should explicitly include e-care applications and evaluate their impact on the models. Where proven and scalable, these alternative payment models would provide an additional solution for incenting e-care.

3. For nascent e-care applications, HHS should support further pilots and testing that review their suitability for reimbursement.

4. As outcomes-based payment reform is developed, CMS should seek to proactively reimburse for e-care technologies under current payment models.

The FCC recognizes that outcomes-based payment reform is not necessarily coming any time soon, so CMS should "proactively reimburse" for eCare technologies using payment models currently in use under fee-for-service. Here are just some of the ways the FCC thinks CMS can incent the use of eCare services today:

"Collaborating with physicians, researchers, vendors and government stakeholders to design tests that will prove system-wide expenditure reduction under CMS’s fee-for-service model."

"Widening coverage for currently reimbursed use cases where they have been proven to reduce system-wide expenditures."

"Providing feedback to the community of physicians, researchers and vendors who are trying to enact solutions. Through greater decision-making transparency, CMS could provide critical information that allows that community to target its efforts where they matter most."

"Incenting Medicare Advantage plans to invest rebates in the adoption of e-care technologies."

What do you think? Did the FCC's proposal take CMS and HHS to task? Do you agree with the FCC's recommendations or did they miss the mark? The FCC's National Broadband Plan provides some fresh fodder for the conversation taking place at MobiHealthNews wireless health event, Everywhere Healthcare, which is co-located at the CTIA Wireless 2010 event in Las Vegas next week. Hope to see you all there!

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