By Reps. Gregg Harper, Mike Thompson, Devin Nunes and Peter Welch
Feb. 24, 2014, 2:50 p.m.
Rural America and underserved communities struggle with inadequate access to health care. This is primarily due to provider shortages and a lack of resources in communities needing primary care and prevention education. Metropolitan areas face similar challenges in providing timely and adequate access to specialty and sub-specialty services — such as care for cancer patients and victims of acute strokes — due to urban isolation and cultural barriers.
That is why we have authored a bipartisan bill, the Telehealth Enhancement Act (HR 3306), to help connect these patients with health providers through telemedicine networks.
What is telemedicine? It is the use of technology-based communications to assist in the delivery of medical care. From emergency rooms in Mississippi to intensive-care units in California and rural health facilities in Vermont, telemedicine is already improving health care access and delivery, leading to timely diagnoses and better outcomes.
Technological advances have created new opportunities for enormous advances in health care delivery. However, this progress is stymied by an outdated statutory regime that restricts the use of telemedicine under Medicare. The unfortunate reality is that state Medicaid programs make better use of telemedicine than does Medicare, the nation’s largest health care payer. But the leadership shown by states on this issue has created a pathway to expand telemedicine on the national level.
After seeing telemedicine succeed in our home states and others, we engaged in a monthslong conversation with patients, providers and other industry stakeholders to determine whether Congress could strengthen Medicare and enhance Medicaid using this technology. The response was overwhelmingly clear: Until we can attract more physicians to underserved communities and tighten the access gap, the best and most cost-efficient alternative is to improve telehealth networks.
As Congress evaluates the use of alternative payment models and service delivery methods for Medicare, the time is ripe to grant providers flexibility to improve telemedicine. This is the time to explore how to use telehealth and other technologies to improve patient access and health outcomes. This is the time to find ways to efficiently meet the growing demands of our aging population. This is the time to find creative and innovative ways to bend the health care cost curve and save Medicare and Medicaid money. The Telehealth Enhancement Act does just that.
Our bill would expand telemedicine services into rural and underserved households for use in home dialysis, hospice and among homebound patients. It would also expand coverage of telehealth services offered in some metropolitan areas, such as for critical access and sole community hospitals. To improve the economic and clinical outcomes, our bill allows remote patient monitoring for some acute, chronic and other medical conditions — like a stroke — for all Medicare beneficiaries.
Additionally, our bill would give states the opportunity to enhance and expand Medicaid coverage to include telemedicine services for women with high-risk pregnancies and premature births. This model builds on the work of the Institute of Medicine and the operational experiences of the Arkansas ANGELS program.
The Telehealth Enhancement Act was also crafted with our current budget outlook in mind. As the cost and volume of health care increases with the growth of the Medicare population, we must find ways to ensure the long-term viability of the program. In fact, we believe that when the Congressional Budget Office officially scores our legislation, it will determine that our bill saves money for both the Medicare and Medicaid programs. We achieve these savings by building on existing payment innovations, providing incentives for fewer hospital readmissions, encouraging the use of accountable care organizations and enhancing acute hospital-service bundles.
Even though the changes proposed in the Telehealth Enhancement Act are small, they will have an enormous impact on health care prices and patient access, especially in rural and underserved communities. This is our attempt to devise a modern-day solution to an age-old problem.
Rep. Elijah Cummings, D-Md., right, hugs Harold Schaitberger, General President of the International Association of Fire Fighters, after the Congressman spoke at the IAFF's Legislative Conference General Session at the Hyatt Regency on Capitol Hill, March 9, 2015. The day featured addresses by members of Congress and Vice President Joe Biden.