The momentum of telemedicine has been exponential over the past three years and has become the focus of many healthcare investment firms. As delivery and reimbursement in healthcare change, the focus of telehealth has been one of the biggest forces, both in the public, and private sectors to deliver a reduction in costs and increase patients’ access. There is a growing demand for convenience, innovation and personalized care from all parties involved, especially patients. In eye care, there has been the introduction of many technological disrupters which are misconstrued at “telehealth” options for patients. Eye care practitioners are now reluctant to embrace telemedicine because of how invasive these disrupters have been. To be clear, telemedicine should manage patient care through innovation, especially to those patients that have chronic conditions which require daily, and/or weekly monitoring, such as ocular surface disorders, post ophthalmic surgical care, and age-related macular degeneration. Trying to replace the refraction portion of a comprehensive eye exam in efforts to sell product can hardly be called telemedicine. In a study released by the Journal of American Medical Association called, “Supply and Perceived Demand for Teleophthalmology in Triage and Consultations in California Emergency Departments,“ concluded that telemedicine could play a role at mitigating coverage gaps in ophthalmic care in rural areas of California. Additionally, the Veterans Affairs utilizes telemedicine in diabetic care by imaging the fundus and then electronically sending the photos to an eye care specialist for evaluation of changes in the blood vessels. Telemedicine does not replace the comprehensive eye examination, rather it enhances the patient experience by convenience and personalize care through technology. Starting January 1, 2017, all eligible providers, including optometrists will receive their Medicare reimbursements being graded from 1 to 100 on how they deliver outcome-based care through the final MACRA Rule.
The Merit-Based Incentive Payment System (MIPS) encourages providers to use
• Monitoring health conditions of individuals to provide timely health care interventions.
• Timely communication of test results, timely exchange of clinical information to patients and
other providers, and use of telehealth.
• Care Coordination with telemedicine, etc.
By simply utilizing telehealth, eye care practitioners can maximize their Medicare reimbursements
with MIPS bonus points in the areas of:
• Quality (50% of your MIPS score)
• Advancing Care Information (25% of your MIPS score)
• Clinical Practice Improvement (15% of your MIPS score)
Additionally, there is a bipartisan effort in Congress to expand the Medicare Telehealth Parity Act of
2015 in three phases over a four year period. The goal of the legislation would be to expand
telehealth coverage to include:
• All federally qualified health centers and rural health clinics
• Expand qualifying geographic locations to include counties in Metropolitan Statistical Areas
with populations over 100,000.
• Expand coverage of telehealth services, to include services provided by certified diabetes
educators, respiratory therapists, audiologists, occupational therapists, speech language
therapists, and physical therapists.
Dr. Bryan M. Rogoff has a unique background in areas of eye care, business management and healthcare reform. His
experience spans both the corporate, and private sectors and continues his roles that specialize in clinical management
and operations, market trends, industry analysis, healthcare strategy, and high level negotiations. Currently, he serves as
a consultant for for the FDA and other industry partners, as well as serving as the President of the Maryland Optometric
Association and offers consulting services for private practice and industry relations at www.eye-exec.com.