Texas ranks worst in telehealth

by Jack McCarthy

Source: GovernmentHealthIT

Telemedicine is moving ahead nationally but a few states, most especially Texas, are slow to recognize its value, according to a new report.

Many signs point to the growing adoption of telemedicine, the National Center for Policy Analysis (NCPA) explained in its report. Since 2014, 25 states have revised their professional standards and licensure requirements to accommodate providers offering health services via telemedicine, and the Centers for Medicare and Medicaid Services changed its fee schedule in 2014 to encourage more telehealth practices. Additionally, the number of patients using telehealth services is expected to reach 7 million by 2018, up from 350,000 in 2013.

But despite this national trend, three states – Texas, Alabama, and Arkansas, receive "Fs" when it comes to telemedicine rankings, NCPA says, citing the American Telemedicine Association. All other states received "A" or "B" grades with the exception of Georgia, which received a "C."

Texas, in particular stands out as behind the curve in telemedicine implementation, NCPA said.

"The Texas Medical Board has strongly resisted efforts to expand telemedicine in the state's private health sector, with the possible exception of patients few doctors want to treat -- prisoners," the report said. "The state prison system's decades-long use of telemedicine has been a great success."

Texas, Alabama and Georgia are the only states that require an in-office follow-up visit after a telemedicine encounter. "This is striking considering Texas ranks 51 out of 51 (including Washington, D.C.) for access to medical care in the United States," the report says.

Titled "The Doctor Wil See You Now?" was written by Jennifer Vermeulen, a research associate with NCPS, which is headquartered in Dallas.

The state's prison telemedicine program has been a smashing success. In 1994, the state contracted with the University of Texas Medical Branch (UTMB) to offer telemedicine visits to state prisoners. Over the past 20 years, UTMB has performed 250,000 telemedicine visits and improved health outcomes among inmates, while saving taxpayers $780 million.

But in January 2015 the Texas Medical Board prohibited doctors from writing prescriptions for telemedicine patients who did not have a previous relationship, including an in-person visit. The regulations also require the patient to have an in-office follow-up.

The restrictions came as nearly 13 percent of the state's population has been designated as medically underserved, meaning that an individual's circumstances make it difficult to either access or afford health care services, the report said.

The report says the holdup of telemedicine implementation is undermining healthcare accessibility goals of Texas.

"The protectionist policies of the Texas Medical Board (TMB) threaten to undermine the effort Texas has made to increase access to medical care through telemedicine," Vermeulen wrote. "With the population of Texas projected to double by 2050, attempting to limit telemedicine patients and providers is a dangerous bet against the future of health care in Texas."