Analyzing Policy – Telehealth Reimbursement Policies in the State of California Essay

How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?

Citations: At least one high-level scholarly reference in APA from within the last 5 years

Analyzing Policy – Telehealth Reimbursement Policies in the State of California

The assessment of the reimbursement policies of the United States government indicate that they are yet to catch up with the implementation of innovative healthcare technologies. Specifically, telehealth services and artificial intelligence (AI) have not been universally covered by reimbursement as it should be. There are some states that have come up with favorable reimbursement policies for telehealth; but there are also a good number of others that have not. For this reason, challenges are still being faced by providers that offer these crucial services. Telehealth is instrumental in addressing cost and accessibility in US healthcare services that have been deemed as the most expensive in the developed world (Sultz & Kroth, 2018). Oregon, Massachusetts, Kentucky, and New Jersey are some of the states that updated their reimbursement policies towards telehealth. Among those states that are still restrictive in terms of reimbursement for telehealth services is the state of Arizona. Virginia, Michigan, South Carolina and several other states have not passed any laws regarding telehealth or the reimbursement for those services (ATA, 2019). This paper looks at the reimbursement policy for telehealth in the state of California.

Impact of the US Government Reimbursement Policies on the Use of Telemedicine for Healthcare Providers in the State of California

According to the American Telehealth Association (ATA, 2019), coverage for the remote monitoring of patients varies widely across states in the US. In the state of California, telehealth is reimbursed because it is recognized by law as a way of delivering services particularly to those vulnerable populations that are underserved. The California Telehealth Advancement Act of 2011 attests to this fact (State of California, 2021). The Department of Healthcare Services (DHCS)’s Medi-Cal telehealth policy is one of the most favorable to providers as it allows them flexibility to choose to employ telehealth services to deliver much needed healthcare and get reimbursed.

The US does not have Universal Health Care (UHC) policies or even a single payer system that would have eased the burden of healthcare costs (Cai et al., 2020). The Patient Protection and Affordable Healthcare Act or ACA 2010 attempted t address this but a huge coverage gap still exists (Kominski et al., 2017). It is for this and various other reasons that the coverage of telehealth services would be a relief for vulnerable populations as the cost of healthcare would go down a bit.

The impact on providers in California of these favorable policies on telehealth coverage and reimbursement includes the following:

• Rapid investment and acquisition of telehealth and AI technologies in California by healthcare providers.
• Reduced healthcare costs in the state of California for underserved vulnerable populations because of the use of telehealth.
• A comparatively lower rate of medical errors due to the rapid implementation of innovative healthcare technologies like telehealth and AI in the state of California.

 

Conclusion

The US government (both federal and state) policies on the reimbursement for telehealth services are not uniform across the country. There are states that have passed favorable policies, but others have not. California is one of those states that have recognized telehealth and AI as useful technologies that help to reach underserved marginalized populations and hence reimburses for those services. This has had a positive impact on healthcare providers and their ability to reap from innovative healthcare technologies in the state of California.

 

References

American Telemedicine Association [ATA] (July 19, 2019). Telehealth policy and reimbursement vary widely from state to state, ATA report finds. https://www.americantelemed.org/in-the-news/telehealth-policy-and-reimbursement-vary-widely-from-state-to-state-ata-report-finds/

Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J.S., & Kahn, J.G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine, 17(1), 1-18. https://doi.og/10.1371/journal.pmed.1003013

Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. https://doi.org/10.1146/annurev-publhealth-031816-044555

State of California (December 28, 2021). Medi-Cal and telehealth. https://www.dhcs.ca.gov/provgovpart/Pages/Telehealth.aspx

Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9^th ed. Jones & Bartlett Learning.