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    Telemedicine: Reimbursement in fee-for-service, quality models

    Technology-based care growing in popularity, although reimbursement for phone calls may be challenge

    Ray Painter, MDRay Painter, MD Mark PainterMark Painter


    Younger generations of patients will demand immediate answers to their health-related questions via electronic information and telemedicine. We need to bring health care into the 21st century. But how?

    The provision of health care via technology and without direct eye-to-eye and skin-to-skin contact is an area of growing interest in the U.S. It is also an area of great concern. One of the key conundrums surrounding telemedicine is the when, how, and what to pay for the service.

    The current health care system is in a state of change from a fee-for-service model to a quality-based grouped payment model. Telemedicine is viewed differently within the two types of systems. As with other services, working in one system with an eye toward the future raises some interesting questions.

    Also by the Painters - Established patient return visits: How to avoid a denial

    There are several drivers that appear to be influencing the growing interest in telemedicine, including the change in technology, growing patient need/demand, geographic challenges (urban vs. rural), and a projected shortage of physicians in many market segments.

    Tempering the enthusiastic adoption of telemedicine are concerns for safety, abuse of the technology by those who are unqualified, legal implications, and clinical efficacy. These aspects of telemedicine are under study by many different groups.

    As the market continues to speculate the “how” of telemedicine, there is little question that it will be a part of the health care delivery and payment system. Therefore, we dedicate this article more to the current possibilities of payment and the motivations of the players that will likely influence telehealth’s adoption.

    Next: Payment in risk management model

    Ray Painter, MD
    Urologist Ray Painter, MD, is president of Physician Reimbursement Systems, Inc., in Denver, and is also publisher of Urology Coding and ...
    Mark Painter
    Mark Painter is CEO of PRS Urology SC in Denver.


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