Health IT

What makes a state good at telemedicine? What makes a state bad at telemedicine?

What's the difference between a "good" state for telemedicine and a "bad" one? We delve into the American Telemedicine Association's recent report by looking at New Mexico, at the top of the list, and Connecticut and Rhode Island, which got failing grades.

By Neil Versel on May 15, 2015

What’s the difference between a “good” state for telemedicine and a “bad” one?

The American Telemedicine Association released two reports at its annual conference earlier this month in Los Angeles, a state-by state analysis of coverage and reimbursement policies for telemedicine services and another on physician practice standards and licensure in each state.

In terms of coverage and reimbursement, New Mexico was one of five states — six including the District of Columbia — to receive an “A” from the trade association, based on 13 metrics. The Land of Enchantment ranks fifth in total area but 36th in terms of population, meaning that there are vast, sparsely populated regions, making the state a good candidate for remote healthcare services.

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Here are a few reasons why:

  • New Mexico scores an “A” in terms of telehealth parity for private insurance, Medicaid and its state employee health plans.
  • The Land of Enchantment is one of just five states to specify that its Medicaid program must cover telemedicine services provided by substance-abuse or addiction specialists.
  • New Mexico Medicaid also covers telemental health delivered by licensed clinical social workers and licensed counselors as do several others. However, only New Mexico, Oklahoma and Washington do so for behavioral analysts. “This trend is unique because these specialists are critical for the treatment of autism spectrum disorders,” ATA said of the latter category.
  • Its Medicaid program does exclude telephone-based telemedicine and remote patient monitoring. Also, the home-health benefit does not cover skilled nursing, according to the ATA.
  • “Of the 25 states that cover home telemedicine, only Alaska, Arizona, Delaware, Kentucky, Maine, Nebraska, New Mexico and Tennessee reimburse for telerehabilitative services within the home health benefit, even though the same services are covered when provided in-person,” the report said.

The only two states to earn failing grades on coverage policies are neighbors, the small, densely populated Connecticut and Rhode Island. Why?

  • These two New England states each failed the three major categories: parity for private insurance, Medicaid and state employee health plans.
  • Both offer no Medicaid telemedicine coverage at all, according to the ATA. They thus failed most of the the Medicaid-related categories. (Connecticut was called “promising for future consideration of telemedicine coverage” because its state medical board does not require informed consent before providers offer telemedicine options. Rhode Island only calls for informed consent when using e-mail or text messages. Both also allow telemedicine services without a telepresenter or other healthcare professional present with the patient.)
  • Neither got any extra points for innovative payment or service-delivery models, including telehealth at correctional facilities.

Photo: Wikimedia Commons