Telemedicine adoption is fragmented in Maryland, according to the December 2013 “Maryland Telemedicine Task Force—Interim Report” prepared by the Maryland Health Care Commission (MHCC). Diffusion of technology in acute care hospitals is about 46 percent as opposed to roughly 10 percent among physicians.
Existing law requires state-regulated payers to reimburse for telemedicine services when certain conditions are met. In general, providers have been slow to take advantage of the law. Senate bill 776 “Telemedicine Task Force-MHCC” signed into law requires the MHCC in conjunction with the Maryland Health Quality and Cost Council to reconvene the Telemedicine Task Force.
The aim of the task force is to identify opportunities for expanding telemedicine and requires MHCC to update the Governor, Senate Finance Committee, and the House Health Government Operations Committee with an interim report on the work of the task force. The task force’s interim report was received December 2013 with the final report due December 2014.
In 2014, the reconvened task force intends to finalize recommendations pertaining to the technology required to support a telemedicine registry, develop use cases to implement in a phased approach beginning in underserved and rural areas, and develop care delivery models leading to the adoption of telemedicine.
The development of a telemedicine provider registry will have information on telemedicine providers, technology used, a third party payer network, and provide immediate consultative support. This information would all be available through a state-designated HIE query portal.
Two value-based reimbursement models emerging in the state are planning to use telemedicine as a way to improve care delivery and control costs. The reimbursement models were funded under federal grants and allow for upfront investments in technology and training that otherwise would have been absorbed by individual practices.
In one of the models, the state Medical Society referred to as MedChi, plans to use telemedicine in three accountable care organizations. MedChi is going to implement a telemetric call center where nurses and community health workers will monitor data feeds from the homes of their most at-risk patients. The patients will be provided blood pressure cuffs and other monitoring devices and contacted proactively if there are problems.
Evergreen Health Cooperative, a health insurance cooperative in Baltimore City, is undertaking the second model and intends to use telemedicine to foster collaboration and communication among members of their patient-centered care teams. Specialists will be accessible via live video conferencing from the primary care office at all times.
To extend telemedicine to Medicaid, Maryland Medicaid recently began implementing two telemedicine pilot programs. The “Rural Access Telemedicine Pilot Program” and the “Cardiovascular Disease and Stroke Telemedicine Pilot Program” to work to improve participant access to consulting Medicaid providers when an appropriate specialist is not available for a consultation.
For both programs, distant site providers may be located anywhere in Maryland, the District of Columbia, or any contiguous state but must be licensed to practice medicine in the State of Maryland.
Go to the web site for the full interim report at http://mhcc.dhmh.maryland.gov/hit/telemedicine/Documents/telemedtaskforce_interimreport.pdf or call 410-764-3460 for more information.