Medicare Should Compensate for Evidence-based Cardiovascular Disease Telehealth Services, Says American Heart Association

December 20, 2016 Categories: Advocacy News

Washington, D.C., December 20, 2016 – A new policy statement issued today by the American Heart Association advocates that evidence-based telehealth services for heart disease and stroke should be covered by Medicare. The statement highlights the effectiveness of using telehealth to treat the 85 million Americans suffering from cardiovascular diseases (CVD).

Telehealth is defined as the use of telecommunications and information technologies to share information and provide clinical care, education, public health and administrative services at a distance. The new statement, which builds on the association’s 2009 telestroke policy, points to several different telehealth benefits for the treatment of heart disease and stroke – diseases that place a significant burden on public health. CVD and stroke cost the U.S. health care system over $320 billion and $33 billion, respectively, each year. By 2030, the annual costs of CVD and stroke are projected to balloon to nearly $1 trillion. According to the paper, telehealth interventions, as long as they promote data accuracy and patient privacy, can reduce this burden, making care both more affordable and accessible.

“Telehealth is not only a proven tool for increasing access to high quality cardiovascular and stroke care for many patients, but it also meets all of the National Academy of Medicine’s domains of quality. It is recognized as safe, timely, effective, equitable, efficient and patient-centered care. With increasing physician shortages, rising costs and a burgeoning demand for treatment, telehealth can greatly improve value in health care and, most importantly, produce better health outcomes for all,” said Lee Schwamm, MD, FAHA and lead author.

Despite these benefits, telehealth is tragically underutilized to effectively treat patients with CVD and stroke, with too many legal and regulatory barriers standing between Americans and these services. Geography also plays a big role in whether access to this type of care is available. Currently, payment by Medicare for telehealth services for CVD patients is only available if you live in rural areas of the United States and where real time communications are available. Other obstacles include the lack of private insurance coverage for telehealth, the lack of interstate medical licensure, ensuring health care professionals can master the digital learning curve and the costs associated with obtaining telehealth technologies.

“With heart disease and stroke being leading causes of death in our nation, our health care system must continue to adapt to take full advantage of proven forms of treatment, like telehealth, that can effectively fight these deadly diseases and advance health care quality,” said American Heart Association CEO Nancy Brown. “Barriers must be removed so that more Americans suffering from CVD and stroke, regardless of where they live, can reap the benefits of this valuable type of care.”

To confront these challenges, the association makes a number of recommendations to effectively utilize telehealth in cardiovascular and stroke care. The key proposal is that Medicare should provide benefits coverage for all evidence-based telehealth services for cardiovascular and stroke care. The association recommends that coverage and payment parity exist across all states, ensuring that insurers and others offer and cover specific, proven evidence-based telehealth interventions. Other recommendations to overcome barriers to telehealth include:

  • Ensure that all properly trained providers are deemed eligible providers for telehealth interventions, without restricted networks that would limit reimbursement by provider;

  • Encourage the development of simpler, less expensive technology platforms that allow for inter-operability between systems and keep the patient burden and costs for health care systems as low as possible;

  • Ensure that large electronic health record systems incorporate telehealth and make it compatible with traditional health records to promote a single integrated health record for all patients;

  • Encourage the development of improved education for providers to simplify the process of delivering telehealth and increase adoption among providers;

  • Ensure that adoption of telehealth does not sacrifice quality in the name of cost-savings, such as by restricting patient access to limited networks of telehealth specialists rather than in-person specialty care, and promotes high quality care delivery;

  • Invest in additional research to determine the cost-effectiveness of new telehealth interventions.

This statement is part of the American Heart Association’s commitment to advancing evidenced-based public policy research and advocacy to promote the cardiovascular health of all Americans. The association has created the Center for Health Technology and Innovation to develop and promote evidence-based telehealth tools and technologies that emphasize the patient perspective.

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ContactAbbey Dively (202) 785-7905 abbey.dively@heart.org