The Impact of US Government Reimbursement Policies for Healthcare Providers on the Use of Telemedicine in California

Telemedicine is an important aspect of healthcare service provision. As such, healthcare organizations have been supporting and promoting the adoption and application of telemedicine. As a result, reimbursement policies need to be implemented that allow for wide coverage of telemedicine services. Reimbursement policies that ensure adequate coverage for telemedicine may motivate healthcare providers to adopt the use of telemedicine in practice (Kruse et al., 2021). The United States reimbursement policies have a great impact on telemedicine adoption in various states. Notably, reimbursement policies vary across insurance companies. For instance, the Medicaid insurance company, which provides insurance coverage for low-income individuals and families, has reimbursement policies that also vary from state to state. In California, Medicaid expanded its coverage for telemedicine services and allowed reimbursement from broader services and modalities for service provision.

On the other side, Medicare, which provides insurance for older adults over 65 years, had limited coverage for telemedicine services. However, in recent years, through the Centers for Medicare and Medicaid Services, Medicare expounded the insurance coverage for specific services such as the COVID-19 response (Dominguez, 2021). The change of coverage policy by the Centers for Medicare and Medicaid Services has contributed greatly adoption and use of telemedicine in California. Further, other private insurance companies have been observed applying Medicaid reimbursement policies contributing to the wide use of telemedicine in healthcare provision. In addition to the above reimbursement policies, there are also state-specific reimbursement policies. For instance, in California, legislation termed the California Telehealth Advancement Act 2011 advocated for coverage of telehealth services for in-person visits. Accordingly, this policy aided in the establishment of a stable reimbursement in California.

References

Dominguez, J. (2021). California Medical Program: The need for progressive policies of Telehealth to meet COVID-19 pandemic and the future of healthcare (Doctoral dissertation, California State University, Northridge). http://hdl.handle.net/10211.3/221606

Kruse, C. S., Williams, K., Bohls, J., & Shamsi, W. (2021). Telemedicine and health policy: a systematic review. Health Policy and Technology, 10(1), 209-229. https://doi.org/10.1016/j.hlpt.2020.10.006