Innovation

Major insurers jump on telemedicine bandwagon

jholleman@thestate.comAugust 25, 2013 

Dr. David McSwain of MUSC demonstrates the telemedicine stethoscope to the staff at Georgetown Memorial Hospital.

SARAH BATES PACK/MUSC — Sarah Bates Pack/MUSC

  • Telemedicine

    What is it?: The use of secure video, audio and text systems to allow long-distance medical examinations and consultations.

    How does it benefit patients?: People living in remote or rural areas without specialized medical services can be connected to specialists far away, saving travel time and expense.

After years of tentative but promising steps, telemedicine is primed to take off in South Carolina with the backing of two of the state’s major insurers.

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina announced this month that they will begin to pay claims for some telemedicine services.

“It’s a very big step, and it shows that they have a sense of commitment to telehealth,” said Dr. James T. McElligott, medical director of telehealth at MUSC.

Medicare and Medicaid stepped up their coverage of telemedicine claims two years ago, but Medicaid paid for telemedicine procedures for only 403 patients in 2011 and 2012.

Private insurers in the state have been more cautious in accepting the technology that allows doctors to treat patients long-distance via secure video and audio links. UnitedHealthcare and Carolina Care Plan cover some telemedicine procedures. But the insurance industry lobbied against a bill in the state legislature that would have required insurance companies to cover telemedicine. The bill, S.290, passed the Senate but stalled in the House.

The industry supports appropriate, market-driven use of telemedicine, according to Jim Ritchie, executive director of the S.C. Alliance of Health Plans. It doesn’t support government-mandated payment for all telemedicine.

BlueCross BlueShield and BlueChoice are taking a measured approach. Initially, the insurers will pay for telemedicine only in three specialties: high-risk pregnancies, stroke and psychiatry.

Telepsychiatry has a long history in the state. The S.C. Department of Mental Health began using long-distance links to help cut travel costs in 1995. Since 2009, a partnership involving the mental health department and the University of South Carolina School of Medicine, the S.C. Hospital Association and Medicaid has used $7.5 million in grants to build a telepsychiatry network in 18 emergency departments statewide. That program has treated 16,000 patients, proved to be cost-effective and earned national awards for its innovation.

Dr. Meera Narsimhan, vice dean of Innovative Healthcare Technologies at the USC School of Medicine, said BlueCross and BlueChoice have seen results from this project and are leading the way.

“We are very hopeful that other payers in the state will follow suit,” Narsimhan said. “Given the shortage of specialty providers and access in rural South Carolina, we need to be creative in the use of innovative technology tools to improve care for the citizens of South Carolina.”

In the other fields covered by the insurers – high-risk pregnancy and stroke treatment – the timely connection of people having problems in rural areas with experts at major hospitals is especially important. One MUSC program already connects stroke experts in Charleston with emergency physicians in 13 hospitals throughout the state, and another provides consultation for treating high-risk pregnancies in areas throughout the Lowcountry.

“Our intent is to improve access for our members in rural areas and small towns to specialty care and mental health providers, who tend to be in the state’s metropolitan areas,” said Dr. Laura Long, BlueCross’ chief medical officer and vice president. “We also expect this to increase cost efficiency, reduce transportation barriers, improve quality of care and communication among providers and our members, and in some cases to save lives.”

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