Cleveland Clinic was one of the first large health systems to offer telemedicine visits with its Express Care Online. This was a significant initiative because the Clinic is both an innovative organization and a trendsetter. I believe that other hospital CEOs will soon be put in the position of explaining why they are not following suit. Intermountain Healthcare launched a telemedicine program early this year called Connect Care so I thought that it would useful to look at some of the features of its program.
For one thing, it's powered by American Well which is the same telehealth support company used by the Cleveland Clinic (see: American Well, CVS Health and Cleveland Clinic Partner to Deliver On-Demand Care to Healthcare Consumers). Intermountain also opted for a soft launch for Connect Care, undoubtedly to work out some of the early kinks. Below is a quote about this from its medical director, Dr. William Daines (see: Intermountain Healthcare Launches $49 Telemedicine Visits):
We started a launch with Intermountain employees only. That was February 8, . It was a great chance for us to solve a few technology problems, to gauge was general interest would be, and also to make sure that our medical protocols and safety mechanisms were working the way we wanted them to. Sometime in the middle of March we went live with SelectHealth members, our allied insurance partner. In April we started with our public marketing campaign, which included lots of different advertising channels; print, outdoor, television, radio, digital. There was also a soft digital campaign that launched at the end of March that was on a few patient-facing websites.
Both the Cleveland Clinic and Connect Care charge $49 for a visit. The Cleveland Clinic web site explains that this fee covers a ten-minute consultation and that some insurance companies cover telehealth sessions like a regular office visit (see: Cleveland Clinic Express Care Online). For smart phone and tablet users, there is an app that can be downloaded to manage the visit. For laptop and desktop users, a visit can be launched directly using a link on the web site.
Clearly, telemedicine visits will never expand as a cost-effective way to deliver ambulatory care visits unless and until such visits are covered by Medicare. Intermountain points out on its web site that such visits are not now reimbursed (see: Connect Care Coverage):
Medicare does not currently cover visits in which you are treated at home by a provider via electronic services (telephone or video). Medicare members may choose to see a Connect Care provider but will be responsible for all charges.
On the other side of this question, Chiron Health says that Medicare's telemedicine's reimbursement policy is "nuanced" (see: Medicare reimbursement for telemedicine). If you are interested, you might want to review some of the details of how CMS has navigated telemedicine reimbursement thus far. I suspect that at some point in the near future its payment policy will be less nuanced.