VA ends co-payment for in-home telehealth care

Commercial healthcare providers follow the government's lead

In a move likely to spur the adoption of telehealth care, the Department of Veterans Affairs (VA) has removed a co-payment requirement that may have discouraged patients from using in-home video telehealth as a viable care option.

The move is far more than a cost-cutting measure: it validates telehealth care for commercial physicians and health insurance payers who may have been sitting on the fence.

"This is a very significant move in correcting the disincentive for telehealth care," said Roy Schoenberg, CEO of American Well, which provides the VA and commercial markets with telehealth technology services. "I think this is one of the exceptional examples of how the government has taken a step ahead of the commercial market."

In its new rule, the VA said it hopes to make the home a "preferred place of care, whenever medically appropriate and possible."

The VA's final rule is effective May 7.

Veterans must often travel great distances in order to obtain care at a VA hospital or medical center. To improve veterans' access to VA healthcare, the agency established outpatient clinics in local communities. In hand with that effort, the VA is also in the process of establishing telehealth services.

Telehealth uses real-time interactive video conferencing, sometimes with supportive peripheral devices such as a camera, to closely examine skin. This allows a specialist located in another facility to assess and treat a veteran by providing care remotely.

Like clinical video telehealth, in-home video telehealth is used to connect a veteran to a VA healthcare professional using real-time videoconferencing, and other equipment as necessary. That can replicate aspects of a face-to-face assessment and care that don't require physical contact.

Telehealth has been catching on in the commercial healthcare industry as well, with physicians using video conferencing, social networks, email and instant messaging to communicate with patients.

One of the barriers to the adoption of telemedicine is the lack of universal reimbursements from private payers, according to a University of Michigan study.

Schoenberg believes the new rules will send a message to the commercial market because the Centers for Medicare & Medicaid Services (CMS) closely coordinates with the VA.

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