WHA Telemedicine Work Group/DHS Discuss Future Medicaid Telemedicine Policy

Work Group: Remove payment barriers for chronic care management via telemedicine

August 04, 2017

The WHA Telemedicine Work Group was joined by staff from the Department of Health Service’s (DHS) Medicaid Telehealth Policy Team to discuss and provide input on potential future Medicaid telemedicine policy at its August 2 meeting.

In March, DHS invited WHA to provide comment on clarifications to various Medicaid telemedicine policies. DHS subsequently indicated it was beginning to consider broader changes to its telemedicine policies to further expand appropriate access, and DHS was interested in receiving WHA’s input. WHA and DHS arranged the August 2 work group meeting to help provide that input to DHS.

“The motivation of Medicaid is how can we get better access to quality care for members across the state,” said Sara Eskrich, DHS Medicaid telehealth policy team.

Chronic Care Management and Telemedicine to the Home

A significant portion of the discussion focused on care management opportunities via telemedicine. Work group members in particular recommended that Medicaid enable reimbursement for remote health monitoring and in-home follow-up care provided via telemedicine technologies for patients in need of chronic care management or follow up visits.

Transportation is often a barrier for Medicaid enrollees, especially for those with certain chronic conditions. Enabling payment for telemedicine to the home can increase the likelihood of care plan adherence and avoid more expensive emergency department visits and hospitalizations, explained members of the work group.

Behavioral Health and Telemedicine

The work group members and Eskrich agreed that telemedicine can be a key tool to expand access to mental health and AODA services in Wisconsin.

“We know we have access issues for behavioral health, and telemedicine could help resolve some of them,” said Eskrich. She also noted Medicaid data is showing that a significant number of Medicaid telemedicine claims are for behavioral health services.

WHA offered to have a subsequent future discussion focusing solely on further enabling telemedicine support for Medicaid enrollees with behavioral health needs.

Long Term Care and Telemedicine

Expanding telemedicine utilization into long term care settings was viewed as a potentially important way to reduce transfers from a long term care setting to the emergency department or inpatient setting. Use of telemedicine in the long term care setting appears to be low, and the work group speculated reasons for the low use of telemedicine in that setting.

The WHA Post-Acute Care Work Group will be further examining and discussing barriers and benefits to greater use of telemedicine in long term care settings at a future meeting.

Differences Between Medicaid and Medicare

Eskrich also discussed key differences in telemedicine policy payment between Medicaid and Medicare, specifically location restrictions that exist in Medicare but not in Medicaid. Unlike Medicare, Wisconsin’s Medicaid program does not limit telemedicine reimbursement to patients located in rural areas, explained Eskrich. Wisconsin Medicaid is agnostic as to whether the patient or provider is in a rural or urban setting.

Next Steps

The WHA Telemedicine Work Group discussed potential topics for its next meeting in November. It recommended having a follow up meeting with DHS regarding future Medicaid telemedicine changes in early 2018.

This story originally appeared in the August 04, 2017 edition of WHA Newsletter