If you think that payers are the ones who will answer all the sticky questions about implementation and reimbursement for telemedicine, you are doomed to disappointment.
That was the consensus among several industry leaders at an Industry Council Executive Session yesterday at the ATA’s annual conference in Baltimore.
Dr. Joe Peterson, the CEO of Specialists on Call, said that 2013 was the tipping point for telemedicine when the conversation moved from “if” to “when.”
“There is still enormous inertia but the focus is going up the corporate food chain,” he said. “Everyone waiting for payers to figure this out is on a fool’s errand. We need telemedicine to reduce the total care burden on people and systems.”
Peterson is now helping hospitals provide specialist coverage via telemedicine, but he has been on the payer side of the business as well. He has experience in hospital services, call centers, third-party claims administration, lab services and hospital services. He practiced emergency medicine before switching to the business side of healthcare.
Julee Thompson, the chief healthcare executive at Sprint, said that when a client starts talking about reimbursement for telemedicine, she tries to bring value into the conversation instead.
“We try to work out what we’re trying to solve for and focus on how this will bring value and growth to the business,” Thompson said. “Once they start talking about who is going to pay, we know we are in for a long conversation.”
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Another panelist in the session predicted that large self-insured companies will soon stop waiting for payers.
“We are working on the regulations, but I think you will start seeing self-insured companies start offering telemedicine services as a benefit,” said Satyanarayana Parimi. He is the group vice president for product management for Time Warner Cable Business Class.
George Tremblay is the director of telehealth at OptumHealth Public Sector – the only speaker in the session with a direct link to a payer. He said that he expects to see insurance policies that include specific telemedicine services within the next year.
Nima Mozwoon’s prediction for 2014 was that we would see standardization of care in telemedicine. He is the CEO of Telespecialists and Virtual Neurology and a practicing neurologist.
“Payers won’t pay until it is standardized, but that is coming,” he said.
