A Robert Wood Johnson Foundation report notes many states are tightening their network adequacy standards, and telemedicine might help insurance companies meet those standards, especially in rural and undeserved areas, as reported by Medscape.
Here are five observations:
1. Although most respondents to the report predict that telemedicine providers have the potential to support an adequate local network, particularly for specialty services, uncertainty about how regulators would perceive this effort, the lack of infrastructure in most practices and the concerns of organized medicine about telemedicine have inhibited insurers from using this technology to fill gaps in their networks.
2. The researchers defined telemedicine as including audiovisual consultations between patients and physicians, "store and forward" transmission of radiographs, scans and photos from one provider to another and remote patient monitoring.
3. The six states the researchers examined — Arkansas, Colorado, Illinois, Maine, Texas and Washington — all have network adequacy standards at the state level which include time, distance and access measures. Colorado is the only one of these states that has passed a law permitting insurance companies to use the availability of telemedicine providers to help meet network adequacy requirements. Texas was the only state where regulators had seen insurers include telemedicine in network adequacy submissions.
4. The National Association of Insurance Commissioners recently revised its model law for network adequacy. The model law, which states may use as the basis for their own legislation, now includes the use of telemedicine to establish the adequacy of insurance networks.
5. The state regulators who were interviewed for the report said they were open to the idea of telemedicine, but viewed telemedicine as a supplement to, not as a replacement for, in-person visits to physicians.