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State Telehealth Laws & Reimbursement Policies

The Center for Connected Health Policy, the National Telehealth Policy Resource Center, has released its latest biannual update on state telehealth laws, regulations, and policies, with a primary focus on Medicaid fee-for-service programs. However, managed care/private payer laws are also covered when available.

Telehealth policy trends are briefly summarized from a national perspective, followed by detailed state profiles. Each state profile on telehealth reimbursement includes:

  • Key state agencies/organizations
  • State policy overview
  • Definitions
  • Live video, store-and-forward, and remote patient monitoring
  • Eligible providers, sites, geographic limits, facility/transmission fees, services/specialties
  • Consent
  • Professional regulation/health and safety, including cross-state licensing and online prescribing

States vary considerably on telehealth policies. Overall, the report noted live video Medicaid reimbursement is far more prevalent than reimbursement for store-and-forward and remote patient monitoring. Other trends noted for some states are specific documentation and/or privacy and security guidelines; the addition of home and schools as eligible originating sites; and the inclusion of teledentristy and substance abuse services as qualifying specialties.

State telehealth laws & reimbursement policies; a comprehensive scan of the 50 states & the District of Columbia. Center for Connected Health Policy, Spring 2019. https://www.cchpca.org/sites/default/files/2019-05/cchp_report_MASTER_spring_2019_FINAL.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

MOBILE DEVICES: How wearable technology will change cancer care

The advances in the development of wearable and remote monitoring devices are growing exponentially.”

Monitoring symptoms of cancer patients and their participation with oncologist-recommended physical activity are two potential uses of wearable devices, according to this literature review by the authors – physicians affiliated with the MD Anderson Cancer Center, the Mayo Clinic and other institutions.  Among the challenges related to the collection of data from these devices is how to manage and store the large amounts of information involved.

Source: Liao, Y., Thompson, C., Peterson, S., Mandrola, J., and Beg, M.S. (2019, January). The future of wearable technologies and remote monitoring in health care. American Society of Clinical Oncology Educational Book, 39, 115-121.  Click here for abstract in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31099626  AHA staff members can access full text using the AHA Document Library via RightFind on Inside AHA.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

DISRUPTORS: Redesigning patient care in a ‘facilitated self-service’ model – the bot, the nurse, the PCP

Facilitated self-service means consumers can handle most of their needs without help, but some needs require a higher level of service.

How to redesign care at the physician office visit level is discussed in this brief perspective.  In the facilitated self-service model, patients might first encounter a bot for routine check-ups of chronic conditions.  The second level of care would be the nurse and the third level, the physician, if needed.  The authors maintain that this radically different approach would be better than trying to expand the numbers and availability of primary care physicians for routine care.

Source: Asch, D.A., Nicholson, S., and Berger, M.L. (2019, May 16). Toward facilitated self-service in health care.  New England Journal of Medicine, 380(20), 1891-1893.  Click here for full text (you can sign up as a visitor for 3 full text articles per month):  https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lgPosted by AHA Resource Center (312) 422-2050 rc@aha.org

ROBOTICS: Use in interventional cardiology procedures

…contemporary robot-assisted PCI systems improve operator safety by reducing ionizing radiation exposure and can improve procedural quality and outcomes by offering better accuracy accuracy in stent selection.”

The use of surgical robots for interventional cardiology procedures in the United States is discussed in this review prepared by physicians at the Mayo Clinic.  There is one manufacturer – Corindus Vascular Robotics – and two models.  The equipment is designed to help overcome a significant problem faced by interventional cardiologists, which is exposure to radiation and the need to wear leaded protective garments during procedures.  However, there are barriers which have slowed the adoption of this technology, such as a lack of randomized clinical trials and the price tag for the equipment.

Source: Maor, E., and others. (2017, July). Current and future use of robotic devices to perform percutaneous coronary interventions: A review. Journal of the American Heart Association. 6(7).  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586317/pdf/JAH3-6-e006239.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586317/pdf/JAH3-6-e006239.pdf

TRANSPARENCY: Should you let patients read their notes?

Advantages and disadvantages of allowing patients to read the notes that physicians and other providers write about their office visits and hospital care are explored in this short Modern Healthcare article.  The movement towards greater transparency of care is explored further on the website OpenNotes.  Here are some of the providers that are exploring this concept.

Who is doing this?

  • Geisinger Health System (Danville, PA)
  • Beth Israel Deaconess Medical Center (Boston)
  • Sutter Medical Foundation (Sacramento, CA)
  • MUSC Health (Charleston, SC)
  • Harborview Medical Center (Seattle)
  • Mayo Clinic
  • Kaiser Permanente Northwest
  • Department of Veterans Affairs
  • UCHealth (Denver)

Sources:  Livingston, S. (2017, Jan. 2). Growing number of doctors allowing patients to read their notes. Modern Healthcare, 47(1), 14-15.  Click here for publisher’s website: http://www.modernhealthcare.com/article/20161231/MAGAZINE/312319982; and, OpenNoteswww.opennotes.org   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Health Innovations State Law Database

The Health Innovations State Law Database created by the National Conference on State Legislatures is  a resource for identifying over 800 recently enacted state laws and regulations that address health policy innovations related to access, Medicaid, private and commercial insurance markets, the Accountable Care Act and social determinants of health.. The database supports searching by keyword, state, legislative status, bill number, sponsor, and/or these topics:

  • Exchanges and Health Marketplaces
  • Free Market; Challenges and Alternatives
  • Market-Cost Containment
  • Market-Coverage
  • Market-Delivery Reform [includes accountable care]
  • Market-Health Insurance Reforms
  • Market-Mandates and Essential Health Benefits
  • Market-Network Adequacy
  • Market-Other
  • Market-Payment Reforms
  • Market-Price Transparency
  • Medicaid Expansion and Waivers
  • Medicaid Payment Reform
  • Medicaid-General
  • PPACA – ACA-Health Reforms
  • State-Run Programs
  • Telehealth Programs

However, the full-text of the legislation located is restricted to NCLS members.

Source: Health innovations state law database: tracking state laws for health care transformation, 2015-2016. National Conference of State Legislatures, accessed Jan. 27, 2017. http://www.ncsl.org/research/health/health-innovations-database.aspx

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

World’s 100 Largest Medical Technology Companies

Medical Design & Outsourcing magazine annually publishes its Big 100 list of the world’s leading medical technology companies, ranked by 2014 annual revenue. For each of the ranked companies, information is also included on annual R&D spending and the number of employees.

Topping the Big 100 list are:

  1. Medtronic
  2. Johnson & Johnson
  3. Philips Healthcare
  4. GE Healthcare
  5. Fresenius Medical Care
  6. Siemens Healthcare
  7. Cardinal Health
  8. Beckton, Dickinson and Co.
  9. Baxter International
  10. Stryker Corp.

See the article for further discussion and an explanation of the methodology used to create the list.

Source: Big 100 2016: A look at the world’s 100 largest medtech companies. Medical Design & Outsourcing, Sept. 2016.  http://www.medicaldesignandoutsourcing.com/2016-big-100/

Posted by AHA Resource Center (312) 422-2050 rc@aha.org