Coverage for virtual care slipping

Private insurers and Medicaid are lagging on virtual care coverage, while Medicare is leading the way, Politico reported Sept. 19. 

Medicare and private Medicare Advantage plans, according to a report from the American Medical Association and consulting firm Manatt Health, are compensating physicians for the following virtual care:

  • Remote patient monitoring
  • Remote therapeutic monitoring
  • When patients contact providers via an online portal 
  • Interprofessional telephone, internet and electronic health record consultations

Meanwhile, Medicaid coverage varies by state, with only 34 states covering remote patient monitoring, and fewer states covering other virtual care initiatives. 

Some private insurers were found to cover a lot of virtual care initiatives, while some covered none, according to the report. 

Jesse Ehrenfeld, MD, president of the AMA, attributed this to the "digital divide," saying that insurers would have to start paying for digital health offerings if they want physicians to adopt the tools.

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