UnitedHealth: Use telehealth to ease rural crisis

By Eric Wicklund
10:46 AM

MINNETONKA, MN – A recent report from insurance giant UnitedHealth concludes that rural Americans face an increasing need for quality healthcare at a time when access is proving difficult – and it points to telehealth as a possible solution.

The report, from the UnitedHealth Center for Health Reform & Modernization, finds that people living in rural locations face greater difficulty accessing healthcare than their urban and suburban counterparts. In addition, the research indicates rural Americans experience more chronic conditions – such as diabetes and heart disease – and will be more likely to participate in Medicaid and other government-subsidized insurance programs by 2014.

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The solution? The health plan, which serves more than 75 million people worldwide, points to telemedicine and telehealth technologies.

“The next few years will be times of considerable stress on rural healthcare, but also times of great opportunity, since across the country there are already impressive examples of high-quality care, tailored to the distinctive needs of the local community,” said Simon Stevens, UnitedHealth Group’s executive vice president and chairman of the UnitedHealth Center for Health Reform & Modernization. “The challenge for all involved in rural America now is to build on that track record of innovation and self-reliance, so as to ensure that all Americans – wherever they live – can live their lives to the healthiest and fullest extent possible.”

The report, Modernizing Rural Health Care: Coverage, Quality and Innovation, features a survey, conducted by Harris Interactive, of 2,000 patients and 1,000 primary care physicians nationwide and an analysis from the Lewin Group. It projects an increase of about 8 million insured rural residents by 2019, thanks to Medicaid expansion and the state insurance exchanges that will be created under the Affordable Care Act.

The report calls for new incentives and reimbursement models for rural physicians, a bigger role for nurse practitioners and physician assistants, greater provider collaboration across rural locations and with urban providers, the use of mobile health clinics, rural adoption of electronic health records, market incentives for rural areas and more engagement by rural residents on wellness and preventive health measures.

To achieve these goals, the report recommends:

• Expanding rural broadband connectivity to enable telemedicine growth;

• Improving and aligning reimbursement across payers to encourage more telemedicine use;

• Improving the availability of telemedicine programs; and

• Reducing regulatory barriers

According to the study, there are 65 primary care physicians per 100,000 rural Americans, compared to 105 physicians per 100,000 urban and suburban Americans. Those numbers aren’t going to get better – nearly 80 percent of the rural physicians surveyed expect a primary care shortage in the near future, while 66 percent of the urban physicians foresee a shortage.

In a letter he sent last July, Jonathan Linkous, CEO at the American Telemedicine Association, takes the FCC to task for failing to spend enough on telemedicine.

"Despite the Commission's stated goal to provide up to $400 million annually in support of telecommunications to improve healthcare delivery, only about $80 million will be spent this year (outside of a onetime pilot program commitment),” Linkous wrote.

With more than $300 million in funds to spare, Linkous said that money should be allocated toward improving Americans' access to health services. "With the crisis America faces in healthcare, the Commission's failure to take action is disturbing," he wrote.

While the technology is ready to meet the demands, experts from IEEE, a professional technical association, say widespread use of telemedicine will require greater collaboration between technologists and clinicians.

"From faster wireless networks to mobile imaging applications to biosensors, the technologies for delivering telemedicine services are certainly there," said Yongmin Kim, IEEE Fellow and professor of bioengineering and electrical engineering at the University of Washington. "But advancing telemedicine through technology innovation alone is not enough. We now need to make it easier for the healthcare providers to embrace and apply these technologies in diverse medical environments."

To that end, the IEEE recommends that healthcare providers and technologists agree on standards for minimum system performance of telemedicine networks and platforms, along with the development of a common vocabulary to describe these technologies.

For more on telehealth: bit.ly/topic-telehealth

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