Increased Telehealth Funding

On July 11 the FCC announced that they are seeking a new $100 million use of the Universal Service Fund to create a “Connected Care Pilot Program”. The announcement was made in a joint op-ed by FCC Commissioner Brandan Carr and Mississippi Senator Roger Wicker.

Commissioner Carr got interested in the concept when he visited Mississippi six months ago and looked at a telemedicine trial for diabetes patients in the Mississippi Delta. That trial was monitoring patients 24/7 and drastically reduced the cost of patient care by alerting doctors to problems at an early stage and avoiding costly hospital stays. That trial had saved $700,000 per year in savings due only to avoiding hospital readmissions. It’s hard to put a number of the avoidance of misery and early death that was avoided. It’s estimated if the same monitoring was done just for 20% of the diabetes patients in the state that the annual savings would be $189 million.

In the past the Telemedicine Fund has only been used support rural brick-and-mortar facilities – rural health clinics and rural hospitals. This new trial fund will be used to instead fund larger trials to monitor patients in their homes. It’s going to concentrate on programs that will benefit low-income patients including those on Medicaid and veterans receiving free health care. If approved the funding will support a handful of projects for a two or three-year period with the goal of measuring the savings.

We already have evidence that medical monitoring works. The Veterans Administration spends an average of $1,600 on patients in it’s remote monitoring program compared to $13,000 per year for similar patients who have home-based primary care. Another monitoring trial in the northeast showed a $3.30 net savings for every dollar spent on remote monitoring.

The FCC blog on the issue also points out that home monitoring improves the health outcome for patients.

  • A study of 20 remote patient monitoring trials found a 20% reduction in all-cause mortality and a 15% reduction in heart failure-related hospitalizations;
  • The VHA’s remote patient monitoring program resulted in a 25% reduction in days of inpatient care and a 19% reduction in hospital admission;
  • One remote patient monitoring initiative showed a 46% reduction in ER visits, a 53% reduction in hospital admissions, and a 25% shorter length of stay.

For the FCC to get involved in this means there will be connectivity costs to cover. I envision that a significant share of this program will go towards paying for some kind of broadband connectivity for patients in the program. In some places there will be decent broadband and in rural areas this is likely going to mean buying a fixed cellular connection for the monitoring.

Health care costs are out of control in this country and after more of these trials we’ll hopefully see insurance covering the needed connectivity costs for monitoring programs. If the savings are as large a promised then insurance companies and everybody will benefit from monitoring and early detection of problems compared to acute care costs when problems have gone too far.

This funding will be voted on at the August FCC meeting. The FCC in May already increased the annual funding for telehealth from $400 million to $571 million. I can’t tell by the press releases if this would be funded by that increase or if this is additive on top of it.

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