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Telemedicine could improve Pennsylvania health care. So why the hold-up over insurance?

Pennsylvania hospitals and other providers want to expand their telehealth services. But that means investing in technology, equipment, and new ways of providing medical care. That's difficult for hospitals to do without knowing if insurance companies will pay for these services.

Cardiac surgeon Mauricio Garrido, left, and other members of a surgery team at Abington hospital, use telehealth to communicate more quickly with family members eager to know what's happening in the O.R. MICHAEL BRYANT / Staff Photographer
Cardiac surgeon Mauricio Garrido, left, and other members of a surgery team at Abington hospital, use telehealth to communicate more quickly with family members eager to know what's happening in the O.R. MICHAEL BRYANT / Staff PhotographerRead moreMICHAEL BRYANT / Staff Photographer
    by Andy Carter
    Published 

Thirty-eight states and the District of Columbia have laws that call upon insurers to cover care delivered by telehealth services (for example, services delivered securely via smartphones, laptops, and other electronic devices).

Unfortunately, Pennsylvania does not yet have such a law. That's holding back the use of telehealth—and hindering expanded access to convenient, high-quality care for Pennsylvanians.

What's at stake?

Telehealth, also called telemedicine, has already contributed to big improvements in stroke care, burn care, pediatric oncology, neurology, and many other areas. Using telehealth technology, doctors whose patients have serious health problems can quickly consult with specialists, regardless of where they are located.

>>READ MORE: How Abington Hospital-Jefferson Health is using telehealth to help worried family members.

Hospitals and health systems want to do even more. Some have already started offering telehealth to consumers as an option for health care services such as:

  1. Treatment of minor ailments

  2. Post-op checkups

  3. Behavioral health counseling

  4. Chronic disease management

What's the problem?

The complexity and diversity of insurers' contracts with hospitals and other providers is impeding greater use of telehealth. These insurance arrangements are all over the map. Every contract is different, with insurers willing to pay for some telehealth services but not others.

Pennsylvania hospitals and other providers want to expand their telehealth services. But that means investing in technology, equipment, and new ways of providing medical care.

It's difficult for hospitals to make those investments without knowing if insurance companies will pay for these services.

What's the solution?

 About a month ago, the Pennsylvania Senate unanimously passed legislation (Senate Bill 780) to establish some ground rules. The legislation:

  1. Defines the key components of telemedicine

  2. Sets licensing requirements, to make sure that telehealth patients are cared for by the appropriate professionals

  3. Requires health insurers to pay for care delivered via telemedicine if they pay for that same care when provided in person

Senate Bill 780 gives consumers added consistency and protection when making use of telehealth services. Health care providers are assured payment.

Now it's up to the Pennsylvania House to pass Senate Bill 780.

Pennsylvania hospitals, health systems, and physicians, as well as the AARP, are all for this legislative solution.

What about you?