Groups urge feds to reimburse ACOs for telehealth

Saying they want to improve care coordination, several organizations are calling on the federal government to reimburse accountable care organizations for the use of telehealth and remote patient monitoring technologies.

In three letters sent today to incoming U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell, the groups which include the Alliance for Connected Care, the American Telemedicine Association, the Healthcare Information and Management Systems Society and the National Association of ACOs request that a forthcoming notice of proposed rule-making include coverage for ACOs.

Each of the letters outlines what the groups call “burdensome restrictions” on participants of the Medicare Shared Savings Program under section 1834(m) of the Social Security Act; the rule provides Medicare reimbursement for connected care on a limited basis, which they say disincentives its use.

“For ACOs, the existing statutory and regulatory frameworks hinder their ability to better manage care and treat their beneficiary population in less costly care settings,” the Alliance for Connected Care says in its letter. “These barriers are also counter to the Medicare Shared Savings Program’s goal of ACOs having the ability to coordinate care using telehealth, remote patient monitoring and other such enabling technologies.”

In the letter signed by the ATA, HIMSS and 10 other organizations, the groups maintain that policies should “reflect the dynamic and transformative nature” of health information and communications technology, as opposed to “stifling innovation.”

The ATA sent a similar letter in March to then-HHS secretary Kathleen Sebelius.

Likewise, the letter from the National Association of ACOs signed by executives from provider organizations, including Danville, Pennsylvania-based Geisinger, Phoenix-based Banner Health and the Marshfield (Wisconsin) Clinic slams the current legislation in place.

“Those of us working with providers who do not receive reimbursement for connected care services are faced with the difficult decision of assuming financial risk by providing the care for free,” the latter letter says. “For many physician-led and smaller ACOs without access to a lot of capital, it is not even an option.”

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