Mr. Hwang first points to telemedicine, saying while the commercial market has largely adopted telemedicine as a service to cover, CMS has more stringent parameters for when e-visits can be reimbursed, such as requiring the patient to already be present in a healthcare setting, in rural areas and by live, two-way video.
The effects of these reimbursement barriers go beyond adoption of technology, according to Mr. Hwang. “These policies also shape how entrepreneurs and investors size up market opportunities and form views on product strategy. By erecting barriers to adoption of technology, CMS could inadvertently subvert its very development.”
Essentially, if certain technological products and services won’t be reimbursed, there’s little incentive to further develop them.
Mr. Hwang writes this is slowly starting to change. For example, in CMS’ rule for bundled payments for hip and knee replacements, providers are afforded flexibility in using technology to improve patient care. The new rule, released in November and effective in April, lifts some of Medicare’s restrictions on telemedicine delivery and reimbursement and permits telemedicine consults when the patient is at home. Additionally, providers can offer telemedicine services for patients in urban areas.
It is these types of programs and rules that will boost demand for new, innovative technology, Mr. Hwang writes.
“These tech-friendly provisions are limited to the joint replacement program. CMS can and should apply this flexibility to its other value-linked payment programs,” Mr. Hwang writes.
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