How Telemedicine Promotes HCBS and Saves Money in the Process

| July 23, 2012

Telemedicine is gaining popularity as a way to modernize the health care system, improve the delivery of home and community-based services (HCBS) and save health care dollars.

Aging services organizations looking for a good technology investment may want to take a second look at telemedicine. According to a new report by Companies & Markets, this long-distance technology solution is expanding rapidly, with the global telemedicine market expected to reach $2.5 billion by 2018, up from $736 million in 2011.

The reason for the eye-popping growth is fairly simple. A growing number of policy makers and health professionals now view telemedicine as a vital tool that can help modernize the health care system, improve the delivery of home and community-based services (HCBS) and save health care dollars.

Facilitating Home and Community-Based Services

The role that telemedicine can play in HCBS delivery is illustrated clearly by a 12-year-old Department of Veterans Affairs (VA) program that combines HCBS services and telemedicine in order to give ailing veterans an alternative to nursing home placement.

The Medical Foster Home program is designed to help veterans who are unable to live safely and independently at home or lack a strong family caregiver. It places these veterans in private homes where paid caregivers drive them to appointments, serve meals tailored to their dietary needs and administer medications.

The VA trains its carefully vetted caregivers in a variety of areas, including cleaning wounds and managing incontinence. But, according to The New York Times, it has also begun equipping each Medical Foster Home with a telemedicine device so caregivers and participating veterans can communicate and send daily vital signs data to a VA nurse.

“The Veteran’s Administration has been innovative in providing veteran-centered programs for years,” notes Peter Notarstefano, director of home and community-based services at LeadingAge. “The VA Medical Foster Home Program demonstrates how combining housing with services and the use of technology can help seniors and persons with disabilities remain in the community for the same cost or less than it would cost in a nursing home or assisted living.” 

Saving Health Care Dollars

The VA pays about half as much to place a veteran in a Medical Foster Home as it does for a nursing home placement. These cost savings came as a surprise to Dr. Thomas Edes, the VA’s national director of geriatrics and extended care options. Edes told The New York Times that Medical Foster Homes were initially designed only to provide better care, not reduce costs.

In the wake of health care reform, however, cost savings are becoming an important selling point for telemedicine, according to Adam C. Powell, a technology consultant who works with health insurance companies and hospitals. 

Powell recently identified 5 ways in which telemedicine can save health care dollars:

  • Remote analysis services, like telepathology and teleradiology, allow small medical facilities to provide around-the-clock coverage without hiring a full-time pathologist or radiologist.

  • Remote monitoring technologies allow health providers to monitor patients on an outpatient, rather than an inpatient, basis.

  • mHealth monitoring technologies help patients with chronic disease avoid costly complications by giving health professionals the information they need to provide needed care before a health crisis occurs. 

  • Nurses and primary care physicians can provide at-home triage services through televisits that prevent unnecessary emergency room visits.

  • Providers can conduct remote patient visits at a cost that is lower than in-person appointments.