The report, 2019 Telemedicine and Locum Tenens Opportunities Study, by the professional medical network Doximity, states the global telemedicine market will exceed $130.5 billion by 2025 and health care stakeholders will want to make sure there are enough physicians to feed the growth. The study found physicians also have an increasing interest in temporary, part-time employment.
Interest in telemedicine continues to rise “without much support from policy makers,” and physicians seem to be “gravitating to telemedicine on their own,” the study reports.
Medicare and Medicaid cover telehealth under limited circumstancessays Ben Knotts, a grassroots director for Americans for Prosperity in Virginia who has worked on telemedicine policy reform.
“This discourages providers from using the technology further, since they’re not even confident they’ll be paid for the service,” Knotts said.
Additionally, state Medicaid programs have their own unique payment policies on telehealth. Rural states are more open to reform, says Philip Eskew, a physician, attorney, founder of DPC Frontier, and advisor to The Heartland Institute, which publishes Health Care News.
“In Wyoming, the state Medicaid department took many steps to encourage telemedicine, including offering physicians equal fee-for-service payment for telehealth visits [as compared to in-office visits] and providing Wyoming physicians with a telehealth platform at no cost to the physician,” Eskew said. “I don’t think most states have been so encouraging.”
Licensure Laws in the Way
State licensure laws are another barrier to telehealth, says Christine Calouro, a policy associate at the Center for Connected Health Policy.
“A telehealth service is considered to take place at the physical location of the patient, so a physician must be licensed in the physical location of the patient, which can be costly, time-consuming, and an administrative burden,” Calouro said.
The Interstate Medical Licensure Compact expedites the licensure process, but not all states participate.
Another way around these obstacles is through direct primary care (DPC), flat-fee health care which does not participate in insurance or government programs, says Eskew.
“Initial DPC patient visits are almost always in-person and involve a comprehensive physical [exam] and history,” Eskew said. “Follow-up visits for routine chronic conditions that are well-managed can often be done through telemedicine, phone, or email—whichever platform makes the most sense.”
Ashley Bateman ([email protected]) writes from Alexandria, Virginia.
“2019 Telemedicine and Locum Tenens Opportunities Study,” Doximity, July 2019: