Abstract
SYNOPSIS
This executive update provides an update on the reimbursement policy trends
from the Center for Medicare and Medicaid (CMS) regarding digital health
applications and services. It analyzes the status of key Medicare
demonstration projects and their impact. The report also examines state-run
Medicaid program' s stance on emerging digital health technologies.
“The government reimbursement policy remains a sore spot for the growth
of the digital health industry,” said Harry Wang, Senior Analyst
with Parks Associates. “Technology vendors should learn from the
experience of the disease management industry with the Medicare Health Support
Pilot program and find a better way to engage government at both the federal
and state levels and eventually convince them of the value of technology to
the U.S. healthcare industry.”
Table of Contents
1.0 Executive Summary
2.0 Update on the Medicare Reimbursement Policy
- 2.1 Medicare Health Support (MHS) Pilot Program
- 2.2 Medicare Medical Home Demonstration (MMHD) Project
- 2.3 Other Medicare-sponsored Demonstration Projects
- 2.3.1 Care Management for High-Cost Beneficiaries Demonstration
- 2.3.2 Medicare Physician Group Practice Demonstration (PGP)
- 2.3.3 Medicare Senior Risk Reduction Demonstration
- 2.4 Most Recent Legislative Efforts and Policies
- 2.5 Medicare Policy Analysis
3.0 Reimbursement Policy from State Medicaid Programs
- 3.1 State Telemedicine Programs
- 3.2 State Medicaid Policy Trends
4.0 Implications and Recommendations
- 4.1 Medical Device Manufacturers
- 4.2 Health Service Providers
List of Figures
- DM Companies Participating in MHS Project
- Qualifications for Being Recognized as Medical Home Practice
- Reimbursement Rate Determinants for MMHD
- Participating Companies in CMHCBD Project
- State Telemedicine Networks that Cover Store-and-Forward Services
- List of State Medicaid Waiver Programs
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