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What does the future of telemedicine look like?

Update: Since writing this answer, I’ve given more thought into health entrepreneurship, and written a book about it (Free on iBooks. More details at beforedisrupting.com). A better version of this answer appears in the book.Bright.After years of obscurity followed by a decade of hype, Telehealth is finally emerging as a viable mainstream trend. Here are three trends that prove that this paradigm shift is here to stay:Government thinks it’s legit. In January 2015, the CMS issued a new provider reimbursement code (CPT 99490) for non–face-to-face health care services for patients who have chronic medical conditions. It allows an approximately $40 payment for 20 minutes of non-face-to-face chronic care management (CCM) services per patient every month. That non-face-to-face part is what legitimizes Telehealth as something the government thinks is worth paying for. The amount may sound trivial, but do the math like this: average PCP has around 1500-2000 patients under care annually. Even if only 500 of those are eligible for CCM, there is an annual payment of $20,000 per physician on the table for remotely monitoring and interacting with patients. There are footnotes to the deal, of course. Like patients have to explicitly agree to be in the CCM program and shell out a monthly $8 co-pay. But this is the start of a torrent of federal money that will germinate the long-sown seeds of Telehealth, just like what HITECH Act did for EHR industry.Big vendors and deals are emerging. The top four players (Teladaoc, MDLive, Amwell, DoctorOnDemand) have continued double-digit growth and multi-million dollar fundings. Teladoc blazed the path and even went public in early 2015. The official bonds these companies have formed with health insurers is what really underscores future viability. Multiple deals have been struck with big names like United Healthcare, WellPoint, Aetna, and Cigna, and CVS Health to offer Telehealth as either optional-and-charged or as included-and-free service. When traditional insurers start offering Telehealth, it’s time to pay attention.Regulatory forces are moving fast. In April 2014, the Federation of State Medical Boards (FSMB) adopted a model policy[1] to guide the state licensure boards in evaluating the appropriateness of using Telehealth technologies in care delivery. 2015 saw more than 200 telehealth-related bills were introduced in 42 states[2]. Medicaid program in almost all states (49 actually) and the District of Columbia already have some coverage for Telehealth. In June 2015, Texas Medical Board stated their disapproval of virtual visits with physicians who have not previously seen patients in-person and ruled that provider-patient relationship can’t be established remotely. Dallas-based Teladoc, in turn, sued the Texas Medical Board for being anti-competitive. The analysis of all this legal wrangling shouldn’t be to predict winners or losers. A more important takeaway is that there is continuous movement. The legal landscape is shifting, and evolving faster than ever before.[1] https://www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/FSMB_Telemedicine_Policy.pdf[2] http://www.ncsl.org/documents/health/telehealth2015.pdf

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