Tele-medicine question response service: Analysis of benefits and costs

Abstract

Medicare and other healthcare payers are increasing reimbursement for tele-monitoring with in-home devices, but have not expanded reimbursement to include tele-medicine question response services. We model the costs and benefits of providing these services in a multi-period setting for healthcare payers and providers compared to a central planner baseline model. We also consider how patients’ risk level and potentially shorter skilled nursing facility stays can increase the benefit of these services. While many payers worry that reimbursing for question response services will cause excessive payouts, we find that payers would benefit from providing a per-call subsidy to providers to incentivize optimal question response service staffing levels. We also find that payers could provide a per-patient subsidy for patients discharged early from skilled nursing facilities that would more than cover the costs of providing the question response service for all patients. These models are grounded in data and multiple discussions with regional home health providers that provide these question response services.