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IOM Geographic Variations Committee Holds Final Webinar on Telehealth

October 26, 2012—The Institute of Medicine (IOM) Committee on Geographic Adjustment Factors in Medicare Payment Oct. 24 held its third and final webinar on the recommendations outlined in the recent report titled Geographic Adjustment in Medicare Payment Phase II: Implications for Access, Quality, and Efficiency [see Washington Highlights, July 20]. The webinar focused on improving access to primary and specialty care for beneficiaries in medically underserved rural and urban areas, particularly through telehealth.

Karen Edison, M.D., chair, Department of Dermatology, medical director, Missouri Telehealth Network, and director, Center for Health Policy, University of Missouri, spoke about the challenges in telehealth adoption with traditional payment and regulations. She identified reimbursement as the key hurdle for health care professionals, particularly the lack of uniformity among different payers from state to state. She stressed that the key to incentivizing providers to participate in telehealth would be to tie reimbursement to the location of the service provider instead of where the services are received. 

Dr. Edison also said that the major barrier to the widespread use of telehealth is the lack of incentives such as long wait times in most practices, higher reimbursements for procedural codes than for cognitive services (i.e., evaluation and management (E/M) codes), and lack of training or mentoring in telehealth. She added, “We need to use this opportunity to train the next generation of health providers” in telehealth.

The committee’s recommendations for encouraging adoption of telehealth are:

  • Provider payment reform;
  • Paying for cognitive services;
  • Use of integrated patient care delivery, such as accountable care organizations (ACOs);
  • Meaningful use of electronic health records with telehealth integration; and
  • Mature electronic health information.


Len Marquez
Director, Government Relations
Telephone: 202-862-6281


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Jason Kleinman
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Telephone: 202-903-0806