Health Care Reform Has Arrived with PPACA — Telehealth Is the Vehicle

PPACAIn a momentous week for U.S. healthcare, the Supreme Court’s decision to uphold the Patient Protection Affordable Care Act (PPACA) was the catalyst for the rapid deployment of many telehealth and other healthcare technology initiatives. In our summary, we will outline not only this week’s news, but also review the antecedents that make telehealth’s place in healthcare more predictable than many had imagined.

Telehealth Has Arrived!

What do our leading professional associations have to say about the PPACA healthcare law?

  1. In its press release after the passage of PPACA, the American Telemedicine Association concluded that PPACA “will have an impact on the development and adoption of telehealth. The ruling will further accelerate the deployment rate for telemedicine, mHealth and remote health care technologies.” The ATA also stated, “The announcement lifts the cloud of uncertainty that has caused many health providers to delay decisions to modernize and invest in such areas as telemedicine and related technologies.”
  2. The American Psychiatric Association was conservative in its response altogether, and simply asked readers to stay tuned for more information in the next few months.
  3. The American Psychological Association made many positive comments about opportunities for psychologists via PPACA, and highlighted technology as relevant to many of them, largely related to the new law. One of many benefits of PPAPA detailed by the APA stated, “A new Center for Medicare and Medicaid Innovation will test innovative payment and service delivery models to reduce program costs while preserving or enhancing quality of care furnished to individuals (section 3021, as modified by section 10306). Among the host of models that this new innovation center will test are: patient-centered medical homes; direct contracting with groups of providers to promote innovative delivery service models; geriatric plans to coordinate care for individuals with multiple chronic conditions, including cognitive impairment or dementia; community-based health teams to support small-practice medical homes to assist primary care practitioners in chronic care management; promoting access to outpatient services without physician referral where the provider (such as a psychologist) has authority to furnish such services under state law; and utilizing, particularly in entities located in underserved areas, telehealth services in treating behavioral health issues, for example, related to post-traumatic stress disorder and stroke.”
  4. The National Association of Social Workers emphasized the benefits of PPACA and its role in expanding primary care through Accountable Care Organizations.

Telehealth’s connection with Accountability Care Organization model (ACO) is foundational. With the recent change in our health standard, ACOs will need technology to function with integrated care models that tie profits to a practitioner’s ability to manage patient outcomes. Measuring and tracking outcomes over time will require technology to help providers increase their capability to follow up with patients. Effective health care delivery systems commensurate with the requirements of this law will require both sophisticated telehealth systems and well-trained telehealth practitioners.

Other signs that various types of technology will soon be required for healthcare include these developments:

  • Value Options has now partnered with American Well to develop a national network of telehealth-enabled providers to bring care to the patient home.
  • The Veteran’s Administration has been providing Telemental Health Services for at least five years. As we reported in our review of Dr. Godleski’s work on May 6, 2012, data from a study of 98,609 mental health patients showed that the use of telemental health services slashed the rate of psychiatric hospitalizations.
  • States, such as South Carolina, offer telepsychiatry consultation through their Department of Mental Health and to date, have received more than 6.3 million dollars in funding for more than 10,000 psychiatry consultations.
  • The House of Representatives approved a bill to allow licensed doctors anywhere to consult, diagnose and treat Massachusetts residents by internet video examination. The Senate and Governor will be asked to approve it next.

Since the use of technology in healthcare is expanding rapidly, and currently approved models for telehealth are dominating the media, practitioners may consider starting to develop skills related to telehealth. Practitioners are also needed to drive specialized technology development to assure that we have technology consistent with the requirements for our standards of care. It is important for mental health practitioners to be fully trained to understand technology adequately to help vendors shape “technological tools” for use in telemental health.

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