Payers make moves toward remote health

Wed Apr 18 22:39:49 PDT 2012

Description: Description: Description: Description: Description: CAL/AAEM:
California Chapter of the American Academy of Emergency Medicine

April 18, 2012

Payers make moves toward remote health

FierceHealthIT
<http://www.fiercehealthit.com/story/payers-make-moves-toward-remote-health/
2012-04-11> 

By Gienna Shaw 

As remote health grows in popularity--and as organizations come to see the
cost-savings it can produce--a number of insurers are launching telehealth
and remote monitoring programs for their members.

Pittsburgh-based Highmark Inc., for example, has launched a virtual
physician visit pilot program for about 10,000 of its members at three
Western Pennsylvania companies and one company in West Virginia.

Highmark members participating in the pilot can contact a Teladoc physician
about minor illnesses. The physician has access to the member's electronic
health record and patients will get a call back from the physician within an
average of 22 minutes for a fee of $38, according to a Highmark
announcement. This service also facilitates sharing the member's EHR with
his or her primary care physician.

"We need to make sure our members get the right care in the right setting,
and we believe this service can be an alternative to care in an emergency
room or urgent care setting for those persons with minor, non-emergency
medical problems," Mary Goessler, a Highmark medical director, said in a
statement.

The service is not intended to replace a member's regular physician and "is
set up to ensure members are connected with their regular physician,"
Goessler said. "We encourage members to seek follow-up care through their
primary care physician, if it's necessary."

Meanwhile, more than 1,600 Humana Medicare members with congestive heart
failure (CHF) have been set up with interactive remote monitoring devices.
The in-home devices allow a registered nurse to track a member's key vital
signs daily.

The pilot program allows nurses to focus on important clinical issues while
telehealth vendor, Trapollo, manages the logistics of installing the
equipment in members' homes and providing training and technical support,
Kate Marcus, program manager for Humana Cares, who oversees the national
remote monitoring program, said in a statement.

UnitedHealthcare announced that it is putting funds behind remote health, as
well--this week it donated $700,000 to the California Telehealth Network
(CTN) to help expand telemedicine training and provide technical support for
rural and medically underserved clinics and hospitals in California. The
Minnesota-based insurer has more than 95,000 members in the Sacramento
region, according to the Sacramento Business Journal.

This is the second grant UnitedHealthcare has given CTN. In 2010,
UnitedHealthcare donated $600,000 to help launch CTN and its goal of
connecting telehealth devices across the state.

Payers also are working on payment models for telehealth visits. Highmark,
for example, plans to offer telehealth as a covered benefit in the third
quarter of 2012.

And, as FierceHealthIT reported yesterday, the U.S. Department of Veterans
Affairs is planning to waive patient co-pays for remote visits, saying it
aims to make "the home a preferred place of care," whenever appropriate.

Bryan Sloane
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

Contact us at: calaaem.news.service1 at gmail.com

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