Effects of US Reimbursement Policies on Telemedicine Use in New Jersey

Reimbursement refers to the process by which healthcare commercial insurers pay for the services offered by the healthcare providers. In the United States, the government reimbursement bodies include Medicaid and Medicare. Medicaid is a coverage program for low-income citizens who cannot afford their medical expenses. In contrast, Medicare is a coverage program for aged people, the disabled, and patients with end-stage renal disease who are 65 years and above. Some policies govern the reimbursement process in different fields. One of the fields where these policies apply is telemedicine use.

As a nurse student, I know that telemedicine is an essential tool in clinical practice. Telemedicine refers to the use of technology and health care delivery. In New Jersey, Medicaid pays for online patient monitoring and a live video. However, Store and forward are not included in the reimbursement policies (Center for Connected Health Policy, 2021). On the other hand, Medicare care plans for individuals may have different policies for telemedicine. For instance, the government reimburses telephone consultations and recorded in-person visits. According to the Pew Research Center (2019), only 15% of Americans lack smartphones. Therefore, the policy emphasizes reimbursement for telephone consultations.

Before the onset of COVID-19, the adoption of telemedicine was still low, especially in rural states. With the emergence of COVID-19, in-person visits were highly discouraged in order to help curb the spread of the Coronavirus. Therefore, the healthcare system had no other option but to enact changes that support telemedicine services (Bagchi, 2019). According to the American Medical Association (2019), telemedicine ensures and supports the recommended social distancing and ensures safety for healthcare providers. As a result, specific changes were put forward by the federal and state governments to ensure ease of telemedicine use. The changes included expanding the services eligible for reimbursement to include Emergency department visits, home visits, inpatient care, inpatient nursing visits, and physical or occupational services. For instance, in New Jersey, the policies were adjusted to include specific Store and forward service circumstances. This, therefore, increased the adoption of telemedicine use. However, these changes are termed temporary changes to help in curbing COVID-19 spread.

References

American Medical Association (2020). Telehealth implementation playbook. Retrieved on 10^th Nov 2021. Available from: https://www.ama-assn.org/system/files/2020-04/ama-telehealth-playbook.pdf

Bagchi, A. D. (2019). Expansion of telehealth across the rural-urban continuum. State and Local Government Review, 51(4), 250-258. https://doi.org/10.1177%2F0160323X20929053

Center for Connected Health Policy (2020). New Jersey Current State Laws and Policy. Retrieved on 10^th Oct 2021. Available from: https://www.cchpca.org/new-jersey/?category=medicaid-medicare&topic=consent-requirements-medicaid-medicare

Pew Research Center. 2019. Mobile fact sheet. Retrieved on 10^th Nov 2021. Available from: https://www.pewresearch.org/internet/fact-sheet/mobile

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