Saving Medicare

In the days before literally everything inside the Beltway is subsumed by the politics of the Presidential campaign, there might be one piece of legislation on which both sides of the aisle surely could agree: Medicare Telehealth Parity Act of 2015, that forms the path to revamp Medicare's outmoded approach to treatment and care that would improve our health, save money and herald in the future of healthcare globally.

By the way, it's innovations like telehealth and telemedicine that will also save Medicare.

And, while Congress usually does not pay much attention to global institutions, on this one, there is the seminal and truly groundbreaking Report on Ageing and Health. The WHO's Director General, Margaret Chan opens "At a moment of unpredictable challenges for trend is certain: the ageing of populations is rapidly accelerating world-wide ... the greatest costs to society are not expenditures made ... but the benefits ... missed if we fail to make the appropriate ... investments." One such investment surely must be the technology known as telehealth/telemedicine that could itself revolutionize doctors' visits, hospital stays, detection and treatment of health conditions.

Surely, we can agree across the aisle on a piece of legislation that will also help us fix the otherwise growing fiscal burden from our fastest growing demographic also at the greatest health risks.

With 77 million American Baby Boomers growing "old", Medicare must find innovative ways to improve care and reduce costs. Telehealth is one really good solution, pharmacy giant Walgreens has just demonstrated that it's on board.

The concept behind telehealth is simple: you can consult with your doctor via Skype or some other telepresence service about any number of things: a mysterious rash or lingering cough to a wellness question.

The value of telehealth is indisputable and America could lead the world in showing how it saves time and expense. In an era when the population is aging at breakneck pace - already a billion of us over 60, and two billion expected by mid-century - telehealth is an essential piece of any sustainable healthcare system across America or anywhere else on the planet.

While current American (and most other national or in the case of Europe, regional) law treats telehealth as a solution only for remote rural clinics, the proposed legislation on Capitol Hill would recognize the potential value of telehealth for a range of patients and services across society including in urban centers where more and more of us live, including our aging population that is itself expanding, especially the over 80s most at health risk. Critically, this update would come at a time when the nation's demographics demand a forward-looking policy approach. Telehealth ought to be an essential part of age-friendly cities, another part of Dr. Chan's WHO plan for Ageing and Health in our 21st century.

It is true that our current capabilities with telehealth are just the beginning. But, precisely because we are at a critical stage in development that the right public policies would be offer the incentives for the innovations that will yield nearly limitless benefit: improving care provided more rapidly, especially for those older citizens who might be less mobile, lower health expenses, drive economic growth. It's not hard to imagine how this works: Intel, for example, already has telehealth solutions based on the Internet of Things -- a system of "smart" devices that communicate wirelessly -- enabling doctors to easily review a patient's health through wearable devices and predictive analytics.

If we get the policy framework right -- which our legislators on Capitol Hill are now just debating -- the benefits of telehealth will snowball. Essentially, the right telehealth landscape could position the growing market of older adults to drive innovation, all the while reducing costs.

It may seem paradoxical - that anything new introduced into the healthcare space will actually reduce costs -- but it isn't. Consider telehealth's potential role in lowering hospital readmissions and ER visits, as two examples. Or the supplement it will provide to doctors, nurses and caregivers to our aging population. If telehealth were to reduce hospital readmissions, family and corporate balance sheets would benefit almost as much as the patients in need. Readmissions totaled $41 billion in spending in 2014. And ER visits, which cost approximately $1,200, exceed the average American's monthly rent.

These costs, of course, are particularly common among older adults with chronic conditions. Among one small sample of patients, a study by Banner Health and Philips found that telehealth reduced hospitalization by 45% and the cost of care by 27 percent. If the results are replicated on a larger scale, telehealth could save billions for patients and insurers. Common use of telehealth would of a moment, bring 20th century care into our 21st.

First, however, we need to get public policy right. Consider these two examples:

Medicare Part D cut billions in medical costs and improved older Americans' health by enabling access to the pharmaceutical breakthroughs. As a result, an increased number of older patients could effectively manage their conditions. Without costly ER visits and hospital stays, patients avoided unnecessary expenditures. With Part D Medicare reforms, seniors' hospital admissions dropped 8 percent overall, particularly in conditions that require strict medical adherence; those patients alone avoided 77,000 fewer annual admissions. In the first full year of the program, Part D realized $13.4 billion in overall savings.

Home care has achieved significant savings compared to hospital care, according to a variety of studies and projects. Research shows that home care could decrease long-term savings by easing access to high-cost institutional day-to-day care. For example, this summer Centers for Medicare and Medicaid Services found that participants in the first year of an in-home care demonstration study saved more than $25 million, an average of $3,070 per beneficiary. Similarly, a Columbia business professor estimates that in-home care might have saved as much as $25 billion in 2008 alone.

Why wouldn't we be able in a short time to claim the same for telehealth. Done right, telehealth not only improves treatment and care, but it saves money and drives economic growth by promoting innovation. As the population ages and the pundits boo-hoo the healthcare system for draining our resources, it's time to embrace telehealth.

Congress: the digital ball is in your court. And in the process you can lead the world on one solution for the health burdens of the aging of global populations while taking a step to bringing Medicare into the 21st century.

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