Telemedicine empowers patients, but challenges physicians

WHAT USED TO be local marketplaces, in which physicians treated patients in their immediate geographic areas, has the potential to develop into a national marketplace characterized by a small number of providers dominating the healthcare landscape To date, 29 states and the District of Columbia have enacted legislation requiring some form of reimbursement by private insurers for telemedicine services, many times at levels equivalent to inperson services. A bipartisan working group of the Senate Finance Committee has outlined several potential telemedicine policy options with regards to chronic care management for Medicare recipients, including: ? (i) expanding access to home dialysis and using telemedicine to satisfy the monthly clinical visit requirement; ? (ii) amending Medicare Advantage plans to allow further reimbursement by Medicare; ? (iii) allowing accountable care organizations to use telemedicine, thus waiving the geographic restrictions; and ? (iv) permitting telestroke technology, which enables stroke specialists to perform stroke-specific neurological exams via telemedicine.