Speakers from several agencies, congressional offices, associations, and industry offered their thoughts on federal policy issues affecting the field of telehealth and telemedicine at the ATA Federal Telemedicine Policy Summit held June 27-28 in Washington D.C.
Jonathan Linkous ATA CEO opened the Summit by emphasizing growth ahead for telemedicine and telehealth. For example, since the health insurance exchanges will be coming on board, many more people will be eligible for Medicaid. More people on Medicaid will result in across the board growth for telemedicine services. It is anticipated that by next year, 50 million more people may be benefiting from telehealth and telemedicine.
As one of the headline speakers at the Summit, Mary Wakefield PhD, RN the Administrator for HRSA, highlighted successful HRSA programs and also specifically discussed programs utilizing telehealth and telemedicine particularly in rural areas.
So far HRSA has funded 1,100 Community Health Centers to provide services to 21 million patients seen at 9,000 sites, according to Dr. Wakefield. These Centers help medically underserved communities and vulnerable populations and today, many of the Community Health Centers are located in Beacon communities. Recent financial provisions provided by ACA included $11 billion and $2 billion provided by ARRA.
She also pointed out that one of the focal points for telehealth and telemedicine is within the Office for the Advancement of Telehealth (OAT). OAT directs several initiatives needed in the rural community. For example, several of the OAT grant programs involve Rural Health Network Planning, Delta State Rural Health Development, Small Hospital Improvements, and one of the grant programs is directed towards licensure portability. Grants for the Telehealth Network program w are due to be announced this summer.
Other HRSA programs such as the Ryan White HIV/AIDS grantee program provides HIV related services for about a half a million people without sufficient healthcare coverage or the financial resources to cope with HIV. The program fills the gaps in care not met by other payers for the HIV/AIDS community.
HRSA has also been concentrating on health issues involving mothers and children. The Maternal Health and Child Bureau’s state block grant programs help provide healthcare for this special population. In this capacity, telehealth programs have played a role with ongoing pilots in a number of states concentrating on the pediatric population and helping children with autism.
Dr. Wakefield is vastly concerned with the decline in the number of primary care providers serving rural areas but also in the country as a whole. To deal with recruiting more providers, the National Health Services Corporation is helping to attract providers to serve in underserved areas. Just recently the Corp announced that providers can use telehealth technologies to provide direct care to patients.
In addition, the Bureau of Health Professions within HRSA is also making grants available to colleges and universities to build up programs to help the development of primary care providers.
HRSA is reaching out to others at HHS such as the Office of the National Coordinator for help with information technology. HRSA is also looking to CMS and their Center for Medicare and Medicaid Innovation (CMMI) to fund new innovations. These innovations are addressing accountable care, bundled payments, primary care transformation, best practices, the Medicaid and CHIP population, but also capitalizing on telehealth technologies.
She mentioned one specific area that CMMI has successfully been working on called “State Innovative Models Initiatives”. This program is testing state-based models to enable multi-payer payment and delivery transformation. This program emphasizes telemedicine and home monitoring in many of the models.
To reach out, HRSA has been working with other agencies since 2011 through the White House Rural Council and has signed a Memorandum of Understanding (MOU) concentrating on telehealth. Since HRSA signed the MOU, the agency has been working with the Veterans Administration to focus on pilot projects to enhance the use of telehealth in veteran communities.
Dr. Wakefield mentioned that the Institute of Medicine held a workshop in 2012, to address the role of telehealth resulting in an IOM report titled “The Role of Telehealth in an Evolving Health Care Environment Workshop Summary”. To view the report, go to www.iom.edu/reports/2012/the-role-of-telehealth-in-an-evolving-health-care-environment.aspx
Go to www.americantelemed.org for more information on the ATA Federal Telemedicine Policy Summit.