Telemedicine: Fostering Innovation Through Challenges, Trends, and Opportunities Latoya S. Thomas March 16, 2017
About ATA The American Telemedicine Association (ATA) is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and our members work to fully integrate telemedicine into transformed healthcare systems to improve quality, equity and affordability of healthcare throughout the world. Established in 1993 Over 8,000 members world-wide
About ATA Convener 13 Special Interest Groups (SIGs) 3 Regional Chapters 4 Corporate Councils 51 State Forums Telehealth Conferences Annual Meeting: Orlando – April 23-25 2017 Telehealth Capitol Connection (TCC) Congressional Briefing Series Accreditation Program Practice Guidelines 14 e.g. urgent care, mental, rehabilitation, diabetic retinopathy Public Policy Multi-state Federal
21st Century Landscape
Opportunities & Goals Knock down government barriers Coverage & Payment Clinical Practice & Licensure Portability Provider & Care Networks Knock down government barriers Promote “value” innovative payment and service models Address care delivery problems: Cost, access, outcomes, productivity
Delivery Delivery Models Hub & Spoke Integrated care Statewide and regional specialty networks Care coordination ECHO Medical Homes Health Homes LTPAC On-demand services Network adequacy Triage Emergency and Disaster response Linguistic and cultural competency VOLUME to VALUE
Policy Policy Reforms Service coverage and reimbursement State regulated health plans Federal programs Comparable clinical practice standards Licensure portability Pilots/demonstrations State taskforces and workgroups
Interstate Licensure Models National Reciprocity No bills pending Expedited Federation of State Medical Boards (FSMB) – 18 states joined Pending: Arkansas, Michigan, Nebraska, North Dakota, Rhode Island, Tennessee, Texas, and Washington Mutual Recognition National Council for State Boards of Nursing (Enhanced NLC) – 11 states joined Pending: Colorado, Georgia, Illinois, Iowa, Kentucky, Maryland, Mississippi, Montana, Nebraska, Nevada, New Jersey, North Dakota, South Carolina, Utah, and West Virginia Pending: Iowa, North Dakota, and West Virginia (APRN Compact) – 2 states joined Association for State and Provincial Psychology Boards (PSYPACT) – 1 state joined (Needs 7 states) Pending: Illinois, Missouri, Rhode Island, Texas and Utah Federation of State Boards of Physical Therapy – 5 states joined (Needs 10 states) Pending: Colorado, Florida, Kentucky, Mississippi, New Hampshire, New Jersey, North Carolina, North Dakota, Oklahoma, Texas, Utah, and Washington
Payment Payment Models Fee-for-service Capitation Episodic and Bundled payment Shared savings Patient and Provider Incentives VOLUME to VALUE Payment
Challenges Licensure portability Broadband Interoperable health information exchange Privacy and cybersecurity Educating stakeholders Policymakers Clinicians Health and Tech ecosystem ***Policies not unique to telehealth***
Moving Forward Delivery Innovation Policy Payment Innovation
ATA State Telemedicine Gaps Analyses
ATA State Policy Resources http://www.americantelemed.org/policy-page/state-policy-resource-center 2016 ATA Policy Priorities State Policy Toolkits State Gaps Analyses State Legislative Matrix (Members Only) State Legislative and Regulatory Trackers Monthly State Webinar State Policy Checklist ATA Wiki Telemedicine Practice Guidelines State Medicaid Best Practices Telemental and Behavioral Remote Patient Monitoring and Home Video Visits Store-and-forward School-based Managed Care Telestroke High-risk Pregnancies Telerehabilitation
Director, State Policy Resource Center AmericanTelemed.org ATAwiki.org Latoya S. Thomas Director, State Policy Resource Center LThomas@AmericanTelemed.org 202-223-3333