Home health companies in Vermont want the Agency of Human Services to pay for telemonitoring services for Medicaid beneficiaries.
Medicare and private insurers already pay for the service, which yields significant savings by reducing hospital admissions, said Peter Cobb, director of the Vermont Assembly of Home Health and Hospice agencies.
Telemonitoring in a home health context means placing devices in the patient’s home to take vital signs and relay the information back to the home health agency. When readings are outside parameters set by a physician, a nurse is sent to the patient’s home.
It is a distinct service from telehealth or telemedicine, which generally involves video conferencing with physicians in lieu of in-person appointments.
Sen. Kevin Mullin, R-Rutland, is sponsoring a bill, S.234, that would require the Agency of Human Services to cover telemonitoring for certain conditions and classes of Medicaid beneficiaries starting in July.
In the interest of disclosure, Mullin said he sits on the board of the Rutland Area Visiting Nurses Association, a provider of home health telemonitoring services.
“I do believe this would be a step forward, and consistent with our goals of delivering better care at a better price,” Mullin said, “It’s just amazing if you look at how much home health can save versus other settings.”
Mark Larson, commissioner of the Department of Vermont Health Access, said he recognizes the benefit of home telemonitoring, but he wants to make sure the state can get approval from the Centers for Medicare and Medicaid Services to cover telemonitoring through Medicaid.
“I know there’s frustration we’re not moving faster on this topic,” he said, adding that his department views home telemonitoring will an important part of the overall health care landscape.
Regardless of what happens with the bill, Vermont will move forward with telemonitoring, Larson said, adding that there is money in the State Innovation Model grant to pay for it.
He said his department needed time to examine the specifics of S.234, and that they would get back to the Senate Health and Welfare Committee with input the following week.
Larson wants to make sure that the conditions in the bill funnel the right patients into the system, and examine what the payment rates would be.
“Our goal isn’t to break the bank for Medicaid, but to produce a reasonable product that makes sense,” Cobb said.
But home health agencies are already providing these services to Medicaid beneficiaries without the reimbursements because of its success in preventing readmission for patients recovering from surgery or with chronic conditions, Cobb said.
“It’s part of our general service, we’re just not getting paid for it by Medicaid,” he said.
Cobb proposed a fee of $375 per patient per month, and estimated that at that rate, the cost to Medicaid would be between $135,000 to $270,000 each year.
The program would pay for itself quickly, he added, noting that each readmission that can be avoided saves an average of $11,000.
