Medicare, the Internet, and the future of telemedicine.

OBJECTIVES: Beginning October 1, 2001, the Health Care Financing Administration (HCFA) will extend Medicare coverage to a wide range of telemedicine services and providers, allowing for medical visits, consultations, mental health services, and pharmacologic monitoring of patients living in rural areas. Payment to providers will be at a rate similar to that paid without the use of telemedicine. Furthermore, Medicare will pay a facility fee of $20 to the originating site per telemedicine session. This article discusses how advances in computer connectivity and communication infrastructure, coupled with Medicare reimbursement for telemedicine services, present medical providers with a unique opportunity to improve healthcare delivery to their patients, in particular those living in rural counties in the United States. DATA SOURCES: Peer-reviewed articles published in the literature and industry-specific surveys published on the Internet.
CONCLUSIONS: There is little doubt that recent changes in HCFA reimbursement for telemedicine will have a dramatic impact on the delivery of medical care to rural America. By correcting the mistakes of the 1997 Balanced Budget Act provisions, Congress has acknowledged telemedicine as a viable, potentially life-saving technology. The most likely scenario for the expansion of telemedicine services to rural counties will be through networks using Internet technology. The expansion of the Internet and broadband infrastructure should allow for the establishment of geographically wide and technically robust telemedicine networks, with a minimum of expense.