Impact Unknown on Federal Spending by Expanding Medicare To Include Telemedicine, CBO Says
Whether expanding Medicare coverage to include telemedicine services would increase or decrease federal spending depends on the payment rates that would be established for those services and whether those services would substitute other Medicare-covered services or be used in addition…
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to currently covered services, wrote Congressional Budget Office's Health, Retirement and CBO's Long-Term Analysis Division Deputy Assistant Director Philip Ellis analysts Lori Housman and Zoe Williams in a blog post Wednesday. “CBO analyzes proposals to expand Medicare coverage of telemedicine on a case-by-case basis,” and would like to see more evidence from new and well-designed academic studies on how telemedicine coverage affects spending, the post said. Proposals to expand coverage for telemedicine or telehealth services in Medicare would need to define several factors, including: covered services and methods of delivery, types of providers and sites of care that would be paid to offer those services, and the types of patients who would be eligible for those services, the post said. Medicare’s total payments for telemedicine services are higher for equivalent services delivered conventionally because Medicare has to pay the doctor plus a facility fee, it said. “Although offering telemedicine to rural enrollees could improve the quality of care that such enrollees receive and could be more convenient for them, doing so might not reduce Medicare spending on their care,” the post said. But “providing telemedicine might well increase spending on services Medicare covers instead of substituting for services that would have been covered without telemedicine,” it said.