SILVER SPRING, Md. – The U.S. Food and Drug Administration has approved Medtronic’s MiniMed 670G hybrid closed loop system, often referred to as an “artificial pancreas.” The device is intended to automatically monitor glucose and provide appropriate basal insulin doses for people with Type 1 diabetes ages 14 and older. “It’s the culmination of years of hard work,” said Alejandro Galindo, president of Intensive Insulin Management for the Diabetes Group at Medtronic. “The speed by which the FDA approved our PMA application submitted in June is truly unprecedented—just 104 days from submission to approval. That speaks volumes about the potential impact this innovative therapy can have on patients in the diabetes community.” Commercial release of the device will begin in the spring of 2017.
WASHINGTON, D.C. – The Department of Veterans Affairs is expanding its telehealth services to meet the growing needs of the 8.5 million veterans it serves.
The expansion will not only make services more accessible, but also increase capacity.
“People always ask us, if we have all of these telehealth services and all of this access to technology, why are there still issues with access to services for some veterans?” said Dr. Kevin Galpin, interim director of the National Telehealth Program. “We’ll be shifting the focus to increasing capacity. We want to get into the metropolitan areas and hire providers, then have them deliver their services to rural sites, increasing the capacity of the telehealth services we provide.”
Already, the VA performed more than 2 million telehealth services last year, reaching more than 677,000 veterans. Telehealth reduced hospital bed days of care by 58% and hospital admissions by 32%.
Going forward, Galpin said the idea is to create tele-primary care provider hubs and tele-mental health care hubs, and to increase the number of appointments at these types of sites.
“We can offer a tremendous amount of care this way,” he said.
The VA categorizes telehealth as clinical video telehealth, home telehealth, and store-and-forward telehealth. Galpin says these services are “mission critical,” especially for those in rural areas.
A pioneer in providing telehealth services, the VA hopes that other providers will follow suit.
“When home health or visiting nurse agencies see what we are doing, they may look at their similar patients and decide they want to do the same kind of thing,” Galpin said. “We are different from providers in the private sector, but we utilize the same goals: we want to take care of people and achieve the best outcomes so they can have the best quality of life.”
‘For 50 different states, there are going to be 50 different sets of rules’
By Kathy Dion, Managing Editor
YARMOUTH, Maine – Telemedicine parity laws are making news across the country, but the implementation of such directives can be a double-edged sword, say industry watchers.
Jim Reilly, vice president of telehealth for ConnectAmerica, believes that telemedicine parity laws are a good thing but there’s a weak link.
“For 50 different states, there are going to be 50 different sets of rules,” he said. “Everyone is not as motivated to comply as the next person, and when everyone is not motivated the same way, patients lose.”
Telemedicine parity laws like the ones recently adopted in the District of Columbia, Hawaii and Rhode Island (see below) provide payers with the opportunity to analyze the benefits of telemedicine. Rather than looking at the laws as an obstacle, they are realizing that telemedicine can save money and bring improved patient-member satisfaction.
Reilly believes that Medicare rules regarding telehealth have helped motivate other payers to see its benefits.
“The government is saying that they’re paying money for providers to take care of people,” said Reilly. “They are basically saying they don’t care how providers do that, but they want to see the outcomes.”
Reilly said that just visiting the employment section of any large private insurer, for example, shows that a rising number of jobs available have more to do with data analytics than clinical roles.
“CMS rules are trimming the herd and redesigning the model,” he said.
Nate Lacktman, a partner and healthcare lawyer at Foley & Lardner in Tampa, Fla., said telehealth policy offers widespread benefits: patients get increased access to care, providers have more opportunities to treat patients with insurance coverage, and health plans increase care management access to their members.
“As an ancillary benefit, telehealth coverage laws promote innovation in the private sector by catalyzing healthcare providers and plans to invest in and use the powerful health technologies available in the marketplace,” said Lacktman.
“I’ve got to tip my hat to the states for aligning themselves with the government,” said Reilly, “but there’s a lot more that needs to be done. We need to give the power back to the patient.”
Telemedicine updates in DC, Hawaii, Rhode Island
The District of Columbia recently released guidance on Medicaid fee-for-service coverage and reimbursement. The first official rules published by the Department of Health since its 2014 Telemedicine Policy, the guidance directs Medicaid to cover services including evaluation and management, behavioral healthcare services and speech therapy.
Hawaii has enacted another law to improve telemedicine there since its first parity law in 2014. The new law will remove telepresenter requirements, as well as geographic and site restrictions under Medicaid fee-for-service and managed care. The law extends coverage to include remote patient monitoring, store-and-forward, and mobile health.
Rhode Island, one of a handful of states to hold consistently low rankings in the country for telehealth coverage policy, recently enacted a telemedicine parity law to take effect in 2018. The new law places no restrictions on the patient or provider setting, and will permit coverage for real time audio/video and store-and-forward. The law does not require health plans to pay providers at the same or equivalent reimbursement rate for identical in-person or telemedicine-based services, and insurers will be able to execute telemedicine agreements as a condition of coverage and payment.
SILVER SPRING, MD – The Food and Drug Administration will not examine apps and devices that promote general wellness and pose a low risk to the safety of users. The agency’s Center for Devices and Radiological Health gave final guidance this week on the devices, which include wearables, apps, video games and software programs. There are two categories of general wellness products, said the FDA: those that aim to improve overall health but don’t make any references to specific diseases or conditions; and those that do reference specific conditions or diseases. Though they will not be examined, the FDA said disease-related general wellness claims “should only be based on references where it is well-understood that healthy lifestyle choices may reduce the risk of a chronic disease or medical condition.”
HARTFORD – CMS has approved payment by Medicaid to federally qualified health centers in Connecticut for electronic consultations with medical specialists, according to Safety Net Connect, a provider of web-based care coordination solutions.
Newport Beach, Calif.-based SNC’s eConsult platform is used by Community Health Center to provide increased access to expert care for the state’s medically underserved population.
“Garnering Medicaid reimbursement approval for healthcare initiatives is a complex process,” said Daren Anderson, MD, director of the Weitzman Institute, and vice president and chief quality officer of CHC of Connecticut. “Eligible programs must demonstrate solid proof of efficacy, cost savings, and ongoing value. We were able to meet these objectives through the positive outcomes of a year-long pilot that utilized SNC’s eConsult technology to enhance specialty care within our CHC health centers.”
CHC has used SNC’s eConsult technology to facilitate more than 1,000 eConsults between primary care physicians and specialists at FQHCs across Connecticut in fields like cardiology, demonstrating the ability to provide specialty advice for patients in less than one day, on average, with 89% of needs resolved within the medical home.
As of January 2016, CHC has begun contracting with state and federal agencies, as well as private insurers, to provide the SNC eConsult system to medical underserved patients across the US.