Telemedicine provides patients with distance medical services and interacts with clinical workers with the help of remote technologies. With the development of telemedicine, patients can save their time and power, as the session is running online. For instance, it might be beneficial for older people who cannot come to the hospital. Additionally, it is a good way for people living in rural areas, as qualified doctors are usually in large cities. Telemedical technologies enable patients to communicate with doctors via various web platforms (Cleverley & Cleverley, 2017). It is essential to examine this issue from a business perspective and how financial and regulatory matters influence telemedical organizations.
Telemedical agencies can provide people with high-quality services and ease their life. Besides producing the image and sound, doctors and patients may exchange graphical data, such as x-ray images. Video conferences and mobile apps become mediators between clinical specialists and patients. Moreover, many people purchase fitness trackers to analyze their health data, and the doctor can receive this information in the online session. Doctors themselves may communicate with each other to consult and approach some medical information.
Telemedicine can improve the overall health background in the population of many countries. For instance, the doctor can track the heartbeat, blood pressure, and other indicators. In case of emergence, the doctor can quickly inform the patient about the dangerous level of these indicators. The person may connect with the doctor online to receive further action plans and recommendations. Constant monitoring and tracking of health data are not available in physical sessions, as the patient should wait for the next visit.
People often appeal to telehealth to consult on dermatological, mental, physical, allergic, and other healthcare issues. Due to the newly-appeared infection of COVID-19, the online sessions became more prevalent in patients over the globe. The doctor may establish the diagnosis after asking a patient profoundly, and there is a bunch of mobile apps that enable people to control their health without a doctor’s help. However, slightly half of the telemedicine participants in the global market do not refer to the scope of health care. These are primarily developers of medical equipment and IT technology creators. Therefore, almost half of mobile healthcare apps are supported by non-governmental agencies.
It is also vital to say that telemedicine saves a significant part of costs for medical organizations. For example, clinical agencies may reduce their costs on medical staff and equipment by utilizing online consultations. However, organizations established exclusively online may struggle because of the inability to provide physical visits. Moreover, Medicare requires telemedical services from both physical and remote places (Bajowala et al., 2020). Medicare also states that the physical entity should locate in places with insufficient medical workers and rural areas, where it is problematic to gather geographical data.
Medicare cannot involve specialists from other organizations to conduct medical services online. They claim that only their organization can provide telehealth services (Bajowala et al., 2020). In 2019, CMS started to develop distance clinical services utilizing its online patient portal and established coverage for online visits for patients (Bajovala et al., 2020). In contrast, Medicaid had less telemedicine coverage than Medicare, as Medicaid’s programs are not controlled federally. Moreover, Medicaid allows using schools and other administrative organizations as physical entities. However, these medical programs have a standardized recording of their charges for medical services designed in patients’ bills (Cleverley & Cleverley, 2017). If the patient requires a detailed account of the services provided, these organizations will list them. Accordingly, governmental medical organizations provide patients with fixed reimbursement for various clinical costs. Indeed, if patients decide to receive a clinical service, they may rely on the insurance provided by the third-party payers, but the price will differ.
Third-party payers are regulated by local laws and rules of medical health care payment. For instance, the price depends on the state where the patient decides to use telemedical services. In 2020, few states had established payment, including California, Delaware, and Minnesota (Bajowala et al., 2020). Insurance is the way patients can receive coverage for electronic visits. If neither Medicare nor Medicaid provides telemedical services for the patient, he has to possess the insurance and obey the state’s laws on clinical pricing (Cleverley & Cleverley, 2017). Therefore, there is a difference between providing telehealth care through Medicaid and CMS organizations and third-party payers, resulting in costs coverage differences.
The roles and responsibilities of financial and non-financial management in telemedicine are significant. For instance, in the financial part, various investors and lenders are currently interested in developing telehealth organizations because of the uprising technology era and coronavirus limitations. They often strive to catch new tendencies and invest in them. Therefore, financial managers collect and record the financial performance of the project. However, there is an issue that brings controversies to the scope of telehealth services. Developers and creators of telehealth apps often receive more money than doctors providing telemedical services (Makhni et al., 2020). Non-financial management staff decides the organization of telemedical services, making the appropriate equipment available. Thus, the decision-making process is conditioned by financial accounting executed from monetary operations, and non-financial managers provide the service with relevant facilities.
Currently, telemedical platforms lack proper governmental financial support because of the absence of a uniform financial model. Moreover, the usage of telehealth services remains an initial concern for the younger generation who is familiar with technologies and devices. Older people still struggle with utilizing web platforms, and it complicates the distribution of telehealth provision among the elderly generation. People do not treat telemedicine as conventional clinical services and face-to-face sessions (Makhni et al., 2020). Some rules, laws, and regulations limit the possibilities for telemedical services. For instance, few states established parity in reimbursement of telemedical services in comparison to this in real-life clinical sessions (Makhni et al., 2020). In many states, the logistics of a doctor’s practice complicates by patients’ written agreements to undergo telemedical appointments. The introduction of online clinical services is supported on the federal level only in several countries and states of the U.S. Although the implementation of telemedicine can significantly reduce clinical costs and lead to the more effective usage of health care resources, many states remain not ready to sustain it. Current state limitations and laws slow down the distribution of telehealth services.
Even though telemedicine is a perspective for supporting and improving the health background of people, there are many factors restricting telehealth services from promotion. For instance, conventional medical services have standard bills established on the governmental level, while telemedical pricing varies from state to state and depends on the type of organization. Medicare and Medicaid may provide telemedical services according to their rules of payment. These organizations may also provide partial coverage of costs on medical services, while governmental agencies have it fixed depending on the type of the clinic. Moreover, it is essential that currently, there is no fixed system of financing for the telemedical provision, and there are money disparities between financial and non-financial specialists. Limitations brought by rules and governmental laws become one more factor restraining the distribution of telemedicine and its financial management.
Bajowala, S. S., Milosch, J., & Bansal, C. (2020). Telemedicine pays: Billing and coding update. Current Allergy and Asthma Reports, 20(10). Web.
Cleverley, W. O., & Cleverley, J. O. (2017). Essentials of health care finance (8th ed.). Jones & Bartlett Learning.
Makhni, M. C., Riew, G. J., & Sumathipala, M. G. (2020). Telemedicine in orthopaedic surgery. Journal of Bone and Joint Surgery, 102(13), 1109–1115. Web.