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Report: Telehealth Market Estimated to Reach $19.5B by 2025

April 2, 2018
by Heather Landi
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The global telehealth market is forecasted to reach $19.5 billion by 2025, according to a report from market intelligence company Transparency Market Research.

The global telehealth market was valued at $6 billion in 2016 and is projected to expand at a compound annual growth rate (CAGR) of 13 percent from 2017 to 2025, according to the report. An increase in the geriatric population, a rise in the prevalence of chronic diseases such as diabetes, cardiovascular diseases, and others, and a surge in demand for self-care devices and solutions is predicted to drive the market through 2025, the report states. What’s more, technological advancement in medical imaging and mobile solutions for healthcare will also drive the market.

However, the report also notes that cyber threats and the rise in data security breaches will likely limit the market’s growth.

In the U.S., the telehealth market is predicted to grow 14.8 percent during this time period to reach $2.8 billion. North America and Europe are projected to dominate the global telehealth market during this time period, driven by government initiatives to increase adoption of telehealth solutions, technological advancements, and efforts of key players to expand their market presence in North America, the report notes.

The market in Asia Pacific is anticipated to grow by 15 percent through 2025. And, the report states that an aging population, a large patient pool suffering from chronic diseases, a surge in demand to cut down healthcare costs, and improving health care infrastructure in countries such as India, China, and Australia are estimated to propel the telehealth market through 2025.

The report also examines the global telehealth market by application and projects that radiology will account for a high share of the market, projected to expand at a CAGR of 13 percent from 2017 to 2025. “Telehealth technology and services enable knowledge and resource sharing between rural and urban areas in minimum time duration. Moreover, consistent evolution in information and communication technologies, effective image transfer, consultation and reporting, and scarcity of radiologists across the globe are the factors expected to drive the segment through 2015,” the report states.

Cardiology is another key application of telehealth and is anticipated to account for 19 percent market share by 2025. Increase in prevalence of cardiovascular diseases such as heart diseases and stroke are the factors likely to drive the segment during this time, the report states.

In terms of end-users, the report segments the global telehealth market into payers, providers, patients, and others. The providers segment accounted for major share, about half, in terms of revenue in 2016, due to an increase in adoption of telehealth products in healthcare settings and a rise in partnerships between companies and hospitals for telehealth systems. The payers segment is anticipated to grow at a higher CAGR through 2025, due to an increase in adoption of telehealth and connected medical devices by insurance companies for insurance claim management.

On a global level, the telehealth market is fragmented in terms of number of players providing hardware, software, and services, the report states. Key players contributing to the growth of the global telehealth market include Teladoc, Inc., American Well, BioTelemetry, Inc., Medtronic, Aerotel Medical Systems Ltd., InTouch Technologies, Inc., Koninklijke Philips N.V., Honeywell International, Inc., GE Healthcare, and AMD Global Telemedicine, Inc. According to the report, these key players have focused on inorganic growth strategies through various partnerships, collaboration, and expansions as a key strategy.

For instance, in March 2017, GE Healthcare acquired Monica Healthcare, a monitoring technology company dedicated toward improving the birthing experience and enhancing obstetric care through wearable wireless fetal monitoring devices, the report notes. Moreover, in January 2018, Royal Philips and American Well entered into strategic partnership. Through this partnership, the two companies will work together to embed American Well's mobile telehealth services into an array of Philips solutions for both healthy consumers and patients with a medical need, spanning personal health and wellness, population health management, and clinical programs.

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Medi-Cal Telehealth Proposal Called ‘Remarkable Step Forward’

October 30, 2018
by David Raths, Contributing Editor
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Covers payment for dental services as well as treating homebound, seasonal and homeless patients

The California Department of Health Care Services (DHCS) is proposing significant changes to its telehealth policy in the state’s Medicaid program known as Medi-Cal. The nonprofit Center for Connected Health Policy (CCHP) calls the proposal “a remarkable step forward.”

Since the passage of and enactment of AB 415, the Telehealth Development Act, CCHP has noted that DHCS had the ability in law to create a more expansive telehealth policy. Now it has proposed one.

A CCHP report notes that DHCS is soliciting feedback from stakeholders on a proposal that would clarify when services provided outside of the “four walls” of a federally qualified health center (FQHC) or rural health center (RHC) are eligible for the prospective payment system (PPS). The department is proposing that all such services be paid the PPS when rendered to homebound, migratory, seasonal workers and homeless patients, patients in the hospital, dental services rendered to established patients by a contracted dental provider, and telehealth services provided to its established patients when certain requirements are met.  

Providers would still have to document services with the same specificity as would be required when services are provided within the four walls; the FQHC or RHC must provide written policies that describe all of the services that will be provided outside of the four walls, along with circumstances for which the services will be provided; and all HRSA policies and procedures for approved scope of projects apply.

The proposal also lays out specific rules for billing as well as for store-and-forward services provided for ophthalmology, dermatology, and dentistry for its established patients. 

DHCS also is proposing to update and clarify its telehealth policy manuals within the Medi-Cal program. Among the most intriguing proposals in the draft, according to CCHP, is allowing the distant site/treating provider to decide when it is appropriate for telehealth to be used and whether it should be via live video or store-and-forward. 

E-consult (provide-to-provider consultation), falling under the auspices of store-and-forward, would also be reimbursed through two CPT codes, making California and Connecticut the only state Medicaid programs in the country reimbursing for that particular service. Under Medi-Cal’s proposed draft policy, the services would still need to be a Medi-Cal-reimbursable service and the CPT or HCPCS code definition should allow for technology to be used, but CCHP said this proposed policy is far more advanced than most any other Medicaid policies in the country.

 

 

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CMS Proposes to Expand Telehealth Benefits Under Medicare Advantage Plans

October 29, 2018
by Rajiv Leventhal, Managing Editor
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The Centers for Medicare & Medicaid Services (CMS) is proposing to implement several sections of the Bipartisan Budget Act of 2018, including expanding telehealth benefits under Medicare Advantage plans.

In a recent proposed 362-page rule that updates Medicare Advantage (MA or Part C) and the Medicare prescription drug benefit program (Part D), CMS is suggesting to implement a section of the Bipartisan Budget Act of 2018 that enables MA plans to offer “additional telehealth benefits” not otherwise available in original Medicare to enrollees starting in plan year 2020 as part of the government-funded “basic benefits.”

Under this specific proposal, MA plans will have broader flexibility than is currently available in how they pay for coverage of telehealth benefits to meet the needs of their enrollees, CMS stated. “In addition, we solicit comment on how to implement the statutory provision that if an MA plan covers a Part B service as an additional telehealth benefit, then the MA plan must also provide the enrollee access to such service through an in-person visit,” the proposal read.

The proposal went on to note that the original Medicare telehealth benefit “is narrowly defined and includes restrictions on where beneficiaries receiving care via telehealth can be located.” As such, CMS believes that the additional telehealth benefits in MA will increase access to patient-centered care by giving enrollees more control to determine when, where, and how they access benefits.

The proposed rule, according to CMS, would also give MA plans more flexibility to offer telehealth benefits to all their enrollees, whether they live in rural or urban areas. “It would also allow greater ability for Medicare Advantage enrollees to receive telehealth from places including their homes, rather than requiring them to go to a healthcare facility to receive telehealth services. Plans would also have greater flexibility to offer clinically-appropriate telehealth benefits that are not otherwise available to Medicare beneficiaries,” CMS stated.

As such, the federal agency stated that although MA plans have always been able to offer more telehealth services than are currently payable under original Medicare through supplemental benefits, this change in how such additional telehealth benefits are financed makes it more likely that MA plans will offer them and that more enrollees will be able to use the benefits.

The Bipartisan Budget Act of 2018 was signed into law earlier this year, and includes major telehealth advances. Now, CMS believes that this latest proposal will promote “flexibility and innovation so that MA and Part D sponsors are empowered with the tools to improve quality of care and provide more plan choices for MA and Part D enrollees.”

CMS Administrator Seema Verma said in a statement accompanying the proposed rule, “President Trump is committed to strengthening Medicare, and an increasing number of seniors are voting with their feet and choosing to receive their Medicare benefits through private plans in Medicare Advantage. Today’s proposed changes would give Medicare Advantage plans more flexibility to innovate in response to patients’ needs. She added, “I am especially excited about proposed changes to allow additional telehealth benefits, which will promote access to care in a more convenient and cost-effective manner for patients.”

The agency believes that if finalized, the proposed changes would result in an estimated $4.5 billion savings to the Medicare Trust Funds over 10 years, largely arising from recovery of overpayments to MA plans.

Related Insights For: Telehealth

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Study Shows Effectiveness of Tele-Rehabilitation Platform

October 23, 2018
by Rajiv Leventhal, Managing Editor
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The Duke Clinical Research Institute (DCRI) has teamed up with a virtual rehabilitation therapy company to test how its digital rehabilitation platform delivered physical therapy following total knee replacement (TKR) surgery.

The randomized controlled clinical trial, "Virtual Exercise Rehabilitation In-home Therapy: A Research Study (VERITAS),” was designed to evaluate the cost and clinical non-inferiority of using a virtual rehabilitation platform from Reflexion Health to deliver physical therapy following total knee replacement surgery.

In the study, VERA, Reflexion Health's virtual exercise rehabilitation assistant, with clinician oversight enabled a substantial reduction in post-acute costs and rehospitalizations while being as effective as traditional physical therapy, according to officials who touted the results this week.

Per the company’s website, VERA is a tele-rehabilitation platform that coaches patients through their prescribed physical therapy exercises, measures progress, and reports outcomes back to their physical therapist. VERA aims to guide and encourage patients to do their best on the path to recovery—all from their own home.

VERITAS was a multi-center, randomized controlled trial that enrolled 306 adult participants scheduled for TKR surgery at four U.S. sites. Of the consented participants, 287 completed the trial. The treatment group concluded with 143 adults who received Reflexion Health's VERA both pre- and post-surgery, compared with a control group of 144 adults who received traditional in-home or clinic-based physical therapy at participating sites. Clinical outcomes, health service use, and costs were examined for three months after surgery.

The study results demonstrated an average cost savings of $2,745 per patient for those who received virtual physical therapy using VERA technology with clinical oversight when compared to usual care with traditional physical therapy. Virtual physical therapy met its secondary effectiveness endpoints of non-inferiority for reducing disability and improving knee function. Compared with usual care, safety endpoints for patients with virtual physical therapy were similar, the results revealed.

"Physical therapy is a critical component of recovery for patients following total joint replacement surgery. As people live longer and these surgeries become more common, it is important to identify solutions that maintain or improve outcomes while decreasing the burden on patients and providers," Janet Prvu Bettger, Ph.D., associate professor with the Duke Department of Orthopedic Surgery and principal investigator of the study, said in a statement. "We are pleased with the results of the study which show that Reflexion Health's VERA coupled with remote clinician oversight, is a cost-effective paradigm for physical therapy—one that is more convenient for patients while providing clinicians greater insight into the recovery process."

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