GAO estimates that changes to Medicare Advantage plans to promote more telehealth and telemedicine use will save enrollees more than $500 million, though some costs will also result.
Pending changes in Medicare Advantage plans to include more telehealth and telemedicine coverage will save enrollees almost $560 million in 10 years, according to an analysis by the US Government Accountability Office.
Some of those savings, however, will be offset by added expenses. According to the GAO, the Centers for Medicare & Medicaid Services will see an additional $80 million in transferred costs from enrollees to the Medicare Trust Fund over that decade, due to the fact that telehealth will now be considered a basic benefit rather than a supplemental benefit.
In addition, the GAO reports, CMS will see roughly $700,000 in savings over the next 10 years through a more efficient grievance and appeals process, but it will have to pay out an extra $4.2 million to the Medicare Trust Fund to cover benefits while appeals are heard, and enrollees will see another $700,000 in cost-sharing for benefits during the appeal process.
Finally, CMS will see roughly $3.4 million in new costs to meet integration requirements for dual-eligible special needs plans; state Medicaid agencies will see about $500,000 in extra costs for that integration, half of which will be taken on by the federal government.
CMA finalized its changes to MA plans in April, saying the revisions will eliminate geographical restrictions on telehealth access and telemedicine services in MA plans by 2020, enabling those in urban areas to use connected health technology. The changes will also give MA members more locations to access care, including their own home.
“Today’s policies represent a historic step in bringing innovative technology to Medicare beneficiaries,” CMS Administrator Seema Verma said in a press release. “With these new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology and have greater access to telehealth. By providing greater flexibility to Medicare Advantage plans, beneficiaries can receive more benefits, at lower costs and better quality.”
The increase in connected care coverage will benefit an ever-increasing population of Americans, as well as the healthcare providers treating them. According to the Kaiser Family Foundation, some 20.4 million people, or 34 percent of the Medicare population, were enrolled in MA plans in 2018. And with an annual growth rate of about 8 percent, it is expected that the MA population will rise to about 42 percent in a decade.
The new rules come out of the Bipartisan Budget Act of 2018, which aims to boost telehealth and telemedicine use in MA plans by relaxing restrictions currently in places for traditional Medicaid plans. They were unveiled in October 2018, with public comment running through the end of the year.