JustCare

Tag: Telemedicine

  • Medicare telemedicine scams around medical equipment on the rise

    Medicare telemedicine scams around medical equipment on the rise

    Victoria Knight reports for Kaiser Health News that family caregivers of institutionalized older adults are getting calls from scammers about the health care needs of their relatives. Medicare telemedicine scams around medical equipment are on the rise.

    If you get a call from anyone claiming to be with Medicare about a health care product or service you or someone you love needs, hang up. Or, if you want to know more, ask for the person’s name and callback number. Then, before you do anything else, call Medicare at 1-800-633-4221.

    Sometimes, the scammer on the phone pretends to be providing a telemedicine consultation. The scammer may ask about pain. Sometimes you simply receive medical equipment you don’t need.

    Whether there’s a call or not, scammers enlist doctors to make orders from medical equipment companies and then bill Medicare for the equipment. The doctors never consult with the Medicare patients, let alone examine them.

    If you receive equipment that you did not discuss with your treating physician, report the fraud to Medicare or call your local State Health Insurance Assistance Program (SHIP).

    Keep in mind that there are many types of fraud committed, particularly targeting older adults. Never give your personal information to anyone who calls or emails you, including your Medicare number or Social Security number. Do not believe the person if he or she claims to be from Medicare or Social Security or any other agency. Government agencies will never ask you for this information.

    You can read more on Just Care about financial scams here, Social Security scams here, and health insurance scams here.

    Here’s more from Just Care:

  • Telehealth services do not save money

    Telehealth services do not save money

    Over the last several years, there has been significant investment in telehealth services–which allow you to get care from a doctor via telephone or computer–as a low-cost convenient way to provide care for simple conditions. However, a recent study by RAND, a non-profit research organization, finds that telehealth services do not save money. Rather, RAND finds that telehealth services can lead to additional medical treatments, increasing costs.

    For the study, RAND looked at 300,000 people receiving telehealth coverage through CalPERS. Researchers found that in almost nine out of ten cases, telehealth services led to additional medical services. Only 12 percent of the time did people’s use of telehealth keep them from visiting the doctor or emergency room.

    “Like some other new patient care models that promise to cut costs and reduce the hassle of receiving medical care, it appears that in some cases, direct-to-consumer telehealth may increase spending rather than trim costs,” said J. Scott Ashwood, who was the lead author of the study. Ashwood and his colleagues found the cost of telehealth services for acute respiratory infections to be half the cost of a doctor’s visit and one-twentieth of the cost of a trip to the emergency room. But, they also found that most people getting the telehealth treatment ended up getting additional care, leading to higher overall costs for their treatment.

    Telehealth services have grown significantly. In 2015, 1.2 million people used these services. And, this year, the overwhelming majority of employers are offering telehealth services to their workers. The employers benefit to the extent the telehealth services allow workers to get care without leaving their office, increasing productivity. Workers can easily spend two hours traveling to and from the doctor’s office and waiting to be seen by the doctor.

    Of note, these same RAND researchers found last year that local health clinics also do not end up saving money on care. They found that more than half of all visits to these retail clinics for simple health needs were additional services, not replacements for doctors’ visits.

    Medicare covers some telemedicine services, both real-time audio and video, for some conditions in certain situations. If you don’t have Medicare, check with your commercial insurer about the coverage available through your plan.

    While Medicare only covers limited home care services, it is now in the midst of a demonstration project that pays for doctors and nurse practitioners to make house calls. That could be a better option than telemedicine.

    Here’s more from Just Care:

  • Telehealth on the rise

    Telehealth on the rise

    Telehealth or telemedicine–the provision of care through telephone or digitally, including video visits and online care–originally was designed to meet the needs of patients otherwise unable to access care, such as people living in rural areas. But, telehealth is on the rise, increasingly meeting the needs of people who want to avoid leaving work to travel to the doctor and keep their costs down.

    Now, according to a July 2016 article on the State of Telehealth in the New England Journal of Medicine, a large number of institutions offer virtual doctor’s visits at low cost 24 hours a day. For many, it’s a great alternative to waiting 20 days to get a doctor’s appointment and then spending 2 hours traveling and waiting for a 20 minute visit.

    People are now more interested in using telehealth to treat a variety of chronic conditions. Nearly half the U.S. population has one or more chronic conditions, 140 million people.  And, telehealth is moving from the hospital to the home, where it can meet the care needs of frail older adults and people with disabilities for whom leaving home is difficult. Combined with sensors on the patient and in the home, providers can learn a significant amount about a patient.

    Health systems with integrated care, such as Kaiser Permanente, the Veterans Administration and the Department of Defense, are finding that telehealth can promote health at less cost than in-person care. Kaiser predicts that it will provide more telehealth visits than in-person visits this year. In 2014, the VA provided more than 2 million telehealth visits. The Mayo Clinic says it will serve 200 million people remotely by 2020, including many who do not live in the United States.

    The biggest constraint on telehealth is that most insurers are not yet covering the cost of the services. But, telehealth coverage is on the rise. And, 29 states now require commercial insurers to cover telehealth services in the same ways they cover in-person care. Already, Medicaid covers some telehealth services today in 48 states.

    Medicare is behind on telehealth services, limiting coverage to areas where it is hard to see a doctor, as we reported here on Just Care. And, digital doctor visits present a bit of a challenge for older adults since only 58 percent of them are online. Moreover, state licensing restrictions limit the out-of-state care doctors can provide. But, there is a bill in Congress, the Tele-Med Act of 2015, which would give providers the right to treat Medicare patients in any state.

    According to Bloomberg BNA, the National Business Group on Health (NBGH) projects that, in 2017, 9 out of 10 large employers will offer employees telehealth services. NBGH further predicts that virtually all large employers, 97 percent, will offer telehealth services within four years.

    Large companies still don’t have a good sense of whether telehealth is bringing down their care costs. In fact, just four years ago, only 7 percent of these companies offered telehealth to their employees. But, they now believe it is a valuable benefit that promotes employee satisfaction. It can save people time and money. And, many insurers are now offering the service.

    Telehealth has its limitations. It puts less of a premium on the doctor-patient relationship–what the doctor can learn from looking a patient in the eye and conducting a physical examination as well as the trust that can be built–than in-person care. Continuity of care is easily lost, with fragmented care taking its place. And, lack of integration in the delivery of telehealth care could lead to conflicting treatments and poor outcomes. There are also privacy concerns.

    On the flip side, telehealth can lead to greater equity in the delivery of health care, reducing racial, gender and age disparities and well as disparities in treatment between people in rural areas and people in urban areas.

    Here’s more from Just Care:

  • New White House report recommends ways to help older people remain independent

    New White House report recommends ways to help older people remain independent

    A March 2016 report by the President’s Council of Advisors on Science and Technology, PCAST, recommends ways to help older adults remain independent, improving their ability to live in their homes and their communities longer. PCAST focuses on technologies and policies that foster independence, purpose, and engagement for older Americans. The report takes into account the need for social connectivity and physical and emotional well-being.

    The population is aging. In 2014, 46 million Americans were over 65, some 15 percent of the population. People are living longer. They are living with fewer functional limitations as they age. More than four in ten older adults report excellent or very good health status. And, one study found that almost nine in ten would like to remain in their homes as long as possible. While older adults are in better health than ever before, two out of three have multiple chronic conditions. Support services can be invaluable to them, yet many are unaffordable.

    PCAST looks at four changes many people experience as they age with the aim of recommending support services to make it easier for older adults to age in place: hearing loss, increasing social isolation, physical change and cognitive change. A report issued in March 2015 focuses on hearing loss. This report focuses on the other three changes and emphasizes their interrelationship. For example, if a person is unable to leave home, the person is more likely to be socially isolated, and the person’s social isolation can affect her mental health.

    PCAST offers 12 ways to promote independence and aging in place for older adults through technology. Here are five of the recommendations:

    1. Federal policy that promotes affordable internet access and training for older adults. Broadband access is key for social connectivity. It can help older adults be aware of local resources, volunteer opportunities and jobs. Broadband access also allows for telehealth and easy communication with caregivers.
    2. Sensors that monitor behaviors and activities of older adults also could add tremendous value, allowing caregivers to know whether an older person is safe at home. Of course, privacy and security issues need to be fully understood.
    3. The federal government should encourage banks and other financial institutions to improve ways to monitor and protect older adults from financial scams. PCAST states that “Financial exploitation of older adults is massively underreported.” The Consumer Financial Protection Bureau offers tips for people to protect themselves and the people they love.
    4. Federal agencies should promote the setting of minimum design standards for homes and products, which recognize people’s declining mobility as they age. Housing should have accommodations that make it easier for people to remain in their homes even if they have difficulty moving around. New technologies should be used to design and create lighter, more durable and more comfortable wheelchairs. And, packaging of foods and medical supplies should be designed so that older adults do not have to struggle to open them.
    5. Federal government needs to explore changes to its Medicare and Medicaid coverage policies that allow people to receive services at home, in particular telemedicine services.

    PCAST notes that there is no evidence that digital games of any sort promote memory or cognitive well-being. And, the federal government should be protecting older adults from spending money on these products.

    Here’s more from Just Care:

     

  • Cognitive behavorial therapy through telemedicine can reduce anxiety

    Cognitive behavorial therapy through telemedicine can reduce anxiety

    Older adults often suffer from anxiety disorder but lack access to treatment.  A recent study published in JAMA looked at cognitive behavioral therapy through telemedicine as a means of helping older adults to recognize anxiety symptoms and to cope.  At the end of four months, both the researchers and the participants saw a reduction in the severity of worry, generalized anxiety disorder and depressive symptoms among participants..

    The study involved 141 participants, 70 of whom received the cognitive behavioral therapy by phone and 71 of whom received unfocused supportive therapy by phone.

    Of note, Medicare now sometimes pays for telemedicine or telehealth services, but only for people in some rural areas and not from their home; it is also finding ways to pay for house calls.

    Here’s more information from Just Care about Medicare-covered services:

  • Benefits and risks of telemedicine

    Benefits and risks of telemedicine

    Telemedicine allows doctors to remotely assess the conditions of patients via telephone or video. Medicare covers some telemedicine services, both real-time audio and video, for some conditions in certain situations. If you don’t have Medicare, check with your commercial insurer about the coverage available through your plan.

    What are the benefits of telemedicine? There’s no denying that telemedicine is convenient, saves time and generally saves money. Through telemedicine, you can see a doctor and get a prescription with ease, even if you live in a rural community or a community with few doctors. Moreover, you don’t generally have to wait for an appointment. You also don’t have to leave your home or leave work to get a diagnosis.

    Does telemedicine improve health outcomes? According to Cochrane, based on the research to date, the jury’s still out on the benefits and risks of telemedicine. A series of studies show overall patient satisfaction. But, the evidence is still scant on the clinical benefits of telemedicine or the effects of telemedicine on health outcomes.

    One analysis of 80 reviews of telemedicine revealed that 21 reviews found telemedicine effective, 18 reviews found telemedicine “promising but incomplete,” and others still found that the evidence was still limited and not consistent.

    What are the risks of telemedicine? It can be difficult for doctors to evaluate patients remotely. Doctors get a better sense of patients’ conditions in person, through a physical evaluation. So, there is a real likelihood of misdiagnosis with telemedicine.

    While Medicare only covers limited home care services, it is now in the midst of a demonstration project that pays for doctors and nurse practitioners to make house calls. That could be a better option than telemedicine.