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Next Generation ACOs will be a boost for telemedicine

CMS yesterday unveiled a new model for ACOs as part of an attempt to make […]

CMS yesterday unveiled a new model for ACOs as part of an attempt to make such coordinated care organizations more predictable and enticing for providers, and with that will come increased coverage of telehealth services.

According to the American Telemedicine Association, the development is no small deal.

“The decision is particularly significant because under this new model, Medicare telehealth services can be covered without regard to longstanding rural and institution restrictions, requiring a beneficiary be located in a rural area and served at a health facility,” the group said in a statement. “For the first time, telehealth coverage will be extended to 80 percent of Medicare beneficiaries living in metropolitan areas and from any service originating site, such as their home.”

The move to increase coverage of telehealth means that the payment mechanisms are finally catching up to the technology, Russell Branzell, president and CEO of CHIME, told FierceHealthIT.

“The concept of technology readiness for telehealth and telemedicine is not the issue here, but rather encouragement to move to a payment reform model and a patient care flow model that can utilize that technology,” he said.

In a blog post explaining the new model, CMS Deputy Administrator for Innovation Patrick Conway said the model is “one of many innovative payment and care delivery models developed by the CMS Innovation Center.”

These models are designed to set clear, measurable goals and a timeline to move the Medicare program — and the health care system at large — toward paying providers based on the quality, rather than the quantity of care they provide to patients,” he added.

Commercial insurance plans have likewise been tilting toward telehealth coverage, but with CMS taking further steps, it could go a long way in setting a benchmark for payers across the country.

The new ACO model stems from lessons gleaned from the Pioneer and Shared Savings models, as well as the goal of reducing fee-for-service payment models in healthcare. The hope is that by 2018, alternative payments such as bundled payments and ACOs will account for 50 percent of all payments.

 

 

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