Calif. Community Health Centers’ Telehealth Programs Face Barriers

Community health centers in California face several financial challenges to offering telehealth services, a recent report by the Center for Connected Health Policy finds, according to a blog post on Healthcare Informatics.

Details of Report

For the report, the center and consulting firm Milliman examined five California CHCs and their telehealth-related finances.

The researchers sought to better understand the telehealth cost and reimbursement issues facing CHCs.

Findings

The report found that the CHC telehealth programs, particularly those with low participation, are not sustainable under traditional reimbursement models.

The report noted that several of the California CHCs used grants to subsidize parts of their programs. However, such a method likely would not lead to long-term self-sustainability, according to the report.

Among the challenges CHCs with telehealth programs face are:

• Complex billing and reimbursement rules; and
• Difficulty tracking telehealth visits (Raths, Healthcare Informatics, 9/20).

The report found that "[t]racking and data collection systems varied across the five CHCs studied," and with other demands placed on CHCs, "tracking telehealth encounters proved to be difficult and cumbersome" (CCHP report, 8/25).

For example, one CHC used two separate electronic health record systems, and some contracted providers did not use either system. As a result, the CHC needed to manually track each telehealth encounter to develop a complete picture of its program.

The report also noted that CHCs' billing and EHR systems typically are separate and have different user access points. Researchers concluded that such a "lack of interoperability between systems and user access points creates administrative burdens for billing staff and telehealth staff" when tracking:

• Payments to distant providers;
• Revenue; and
• Total charges.

Recommendations

The report suggested that CHCs create routine, standardized reports to track telehealth visits through their EHR and billing systems.

Meanwhile, the report also recommended that policymakers:

• Change existing federal laws that regulate Medicare reimbursement for telehealth services;
• Modify policies for Medicare and Medi-Cal, California's Medicaid program, for multiple visits in a single day; and
• Remove face-to-face from the definition of a CHC visit.

Center for Connected Health Policy Executive Director Mario Gutierrez said CHCs "need to be able to make changes to improve care," adding, "To do that, new models of care need to be developed" (Healthcare Informatics, 9/20).