Telehealth advocates were recently successful in getting a new rule published by The Centers for Medicare and Medicaid Services (CMS) to ease restrictions in the process for credentialing and privileging of telehealth practitioners in small and critical access hospitals. This is particularly helpful so that practitioners in rural areas can provide care without extensive credentialing and privileging requirements that oftentimes have proven to be prohibitive. Now they can take advantage of “privileging by proxy.”
With this new rule, smaller hospitals and clinics in rural areas are able to grant privileges to local providers based on the urban hospital providing telehealth services to the remote hospital or clinic. For short audio explaining this process, have a look at the ihealthbeat.org page. The complete transcript of the original report is also available on the same ihealthbeat.org webpage. (See the bottom of the page for link to the PDF file.)
Each of these battles represents a hard-fought victory that has taken years of diligent and concerted effort by many stakeholders. Each establishes significant progress in that the barriers to expanding telehealth are steadily being removed, and there is no going back. Once people in rural areas have access to improved healthcare through broadband connectivity, as well as the increased access to specialty healthcare, they will not settle for the well-intentioned, yet nonetheless inadequate access to health care. those who fear these advances are short-lived, can take comfort in knowing that there is no going back because the data are clear: increase access to specialty care reduces healthcare costs. With the US government focused on reducing healthcare costs, and clearly organizing to reduce those costs through technology, it is clear that what we are witnessing is a development of an information technology infrastructure that is parallel to the roadway development we saw in the last century with intrastate then interstate freeway systems connecting the country.
The next big hurdles that telehealth providers are battling are those of Medicare’s payment rules (reimbursement) and interstate licensing laws (cross boundary licensing, or licensure portability). Many big players are steadily working on these issues. (For more information about licensing and what current practitioners are legally obligated to consider, see this webinar being offered on July 11 by Dr. Maheu.)
Keep tuned to this blog for developments in these areas.