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Virtual Health Commercial Parity Laws Inhibit Adoption

Despite significant progress in regards to virtual health reimbursement, substantial improvements remain necessary. According to a recent study by the Center for Connected Health Policy, current private parity laws give payers too much leeway to establish their own rules in regards to virtual health coverage and reimbursement. Frequently, the language used to write these laws omits necessary information that would incentivize providers to expand their virtual health capabilities.

Additionally, when studied, the laws were found to be opaque regarding what types of virtual health services were covered and often included burdensome restrictions, an absence of billing codes specifically for virtual health, and general obstacles to virtual health adoption. While 31 states now have commercial parity laws in place, the vast majority of these laws only include coverage parity, with only 3 states mandating payment parity. This lack of consistent equal reimbursement has led many organizations to find alternative ways of measuring both financial and non-financial benefits as legislation progresses.

Medicare Recipients Don’t Know If Their Health Plan Offers Virtual Health

In addition to the challenges to virtual health adoption presented by commercial insurers, Medicare patients are also experiencing challenges. A new survey shows that 57% of Medicare beneficiaries do not know whether their health plan offers virtual health, while an additional 31% say coverage is not available to them. Only 12% of those who answered the survey confirmed that they did receive the benefits.

As pressure to increase coverage of virtual health services for Medicare recipients continues, c-suite executives continue to prioritize virtual health adoption as a modality of care delivery.   A recent survey shows that 51% of health care executives consider virtual health a high priority, while another 36% ranked it as a medium priority.

Considering how best to launch your virtual health program? Refer to Sg2’s Virtual Health Resource Kit. Not an Sg2 member? Contact us to learn more.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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