How to Pay for Telemedicine: A Comparison of Ten Health Systems

Raes, Sarah; Trybou, Jeroen; Annemans, Lieven

doi:10.1080/23288604.2022.2116088

Cited by 7 publications

(7 citation statements)

References 47 publications

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“…Limited insurance coverage and lack of payment models remain an important obstacle in this study, as noted in Table 2 . Compensation for telemedicine services is critical for optimal service uptake [ 41 ]. Governments, insurance companies, and other healthcare providers around the world are developing various compensation models to enhance the optimal uptake of telemedicine.…”

Section: Discussionmentioning

confidence: 99%

Experiences on the Utility and Barriers of Telemedicine in Healthcare Delivery in Kenya

Onsongo

Kamotho²,

Wit

et al. 2023

International Journal of Telemedicine and Applications

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Introduction. Telemedicine is the provision of health services over a distance using information communication technology devices. Telemedicine is emerging as a promising component of healthcare care delivery worldwide, accelerated by the COVID-19 pandemic. This study assessed the factors promoting uptake, barriers, and opportunities for telemedicine among doctors in Kenya. Methodology. A semiquantitative, cross-sectional online survey was conducted among doctors in Kenya. During a month, between February and March 2021, 1,200 doctors were approached by email and WhatsApp, of whom 13% responded. Findings. A total of 157 interviewees participated in the study. The general usage of telemedicine was 50%. Seventy-three percent of doctors reported using a mix of in-person care and telemedicine. Fifty percent reported using telemedicine to support physician-to-physician consultations. Telemedicine had limited utility as a standalone clinical service. The inadequate information communication technology infrastructure was the most reported barrier to telemedicine, followed by a cultural resistance to using technology to deliver healthcare services. Other notable barriers were the high cost of initial setup limited skills among patients, limited skills among doctors, inadequate funding to support telemedicine services, weak legislative/policy framework, and lack of dedicated time for telemedicine services. The COVID-19 pandemic increased the uptake of telemedicine in Kenya. Conclusion. The most extensive use of telemedicine in Kenya supports physician-to-physician consultations. There is limited single use of telemedicine in providing direct clinical services to patients. However, telemedicine is regularly used in combination with in-person clinical services, allowing for continuity of clinical services beyond the physical hospital infrastructure. With the widespread adoption of digital technologies in Kenya, especially mobile telephone technologies, the growth opportunities for telemedicine services are immense. Numerous mobile applications will improve access capabilities for both service providers and users and bridge the gaps in care.

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Section: Discussionmentioning

confidence: 99%

Experiences on the Utility and Barriers of Telemedicine in Healthcare Delivery in Kenya

Onsongo

Kamotho²,

Wit

et al. 2023

International Journal of Telemedicine and Applications

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“…Although telemedicine is already used in daily practice by physicians [ 11 ], it is unclear from literature in what context they use telemedicine applications [ 12 ]. Moreover, appropriate physician payment systems and reimbursement policies are still lacking in many countries [ 13 ]. In Belgium, telephone visits are only temporarily reimbursed, and the fee for a telephone visit is €20, which is slightly lower than the lowest in-person visit fee (€26.24 for an anesthetist visit), and much lower than the highest fee for an in-person visit (€62.12 for an oncologist visit) [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, appropriate physician payment systems and reimbursement policies are still lacking in many countries [ 13 ]. In Belgium, telephone visits are only temporarily reimbursed, and the fee for a telephone visit is €20, which is slightly lower than the lowest in-person visit fee (€26.24 for an anesthetist visit), and much lower than the highest fee for an in-person visit (€62.12 for an oncologist visit) [ 13 , 14 ]. The in-person visit fees are presented in Table 1 .…”

Section: Introductionmentioning

confidence: 99%

Physicians’ views on optimal use and payment system for telemedicine: a qualitative study

Raes

Annemans

Willems

et al. 2023

BMC Health Serv Res

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Background Telemedicine is already in use in daily practice, but appropriate reimbursement and physician payment is falling behind in many countries. One reason is the limited availability of research on the matter. This research therefore examined physicians’ views on the optimal use and payment modalities for telemedicine. Methods Sixty-one semi-structured interviews were conducted with physicians from 19 medical disciplines. Interviews were encoded using thematic analysis. Results Telephone and video televisits tend not to be used as a first patient contact, except for triage of patients in urgency situations. Several minimum required modalities for the payment system of televisits and telemonitoring were identified. For televisits these were: (i) remuneration of both telephone- and videovisits to increase healthcare equity, (ii) little or no differentiation between videovisit and in-person visit fee to make videovisits financially attractive and sustainable for physicians, (iii) differentiation of televisit fee per medical discipline, and (iv) quality requirements such as mandatory reporting in the patient’s medical file. The identified minimum required modalities for telemonitoring were: (i) an alternative payment scheme than fee-for-service, (ii) remunerating not only physicians but also other involved health professionals, (iii) designating and remunerating a coordinator, and (iv) distinguishing sporadic vs. continuously follow-up. Conclusions This research investigated the telemedicine usage behavior of physicians. Moreover, several minimum required modalities were identified for a physician-supported payment system of telemedicine, as these innovations necessitate challenging and innovation of the healthcare payment systems as well.

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“…Telemonitoring (and more widely, telemedicine) is already in use in daily practice but appropriate payment is falling behind in many countries. 7 Countries providing remuneration for telemedicine often compensates via a fee-for-service system which comes with several challenges such as (i) possible supplier-induced overconsumption, (ii) the need to specify each and every medical act apart which leads to situations where not all telemedicine services are covered, (iii) complex regulations about when and whether telemedicine is more appropriate than a physical encounter, and (iv) difficult discussions whether telemedicine should be remunerated equivalent to in-person consultations. Capitation-based or hybrid payment systems appear to struggle less with these issues.…”

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confidence: 99%

“…Capitation-based or hybrid payment systems appear to struggle less with these issues. 7 Indeed, recent research showed that physicians point to alternative payment schemes than fee-for-service as one of the minimum required modalities to successfully implement telemonitoring. 8 Moreover, they called for a fair remuneration of all healthcare professionals involved, 8 which is of particular interest when keeping the central role of nurses in the TELEPIED trial in mind.…”

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confidence: 99%

Health economic considerations to effectively implement telemonitoring of diabetic foot ulcer

Willems

2023

The Lancet Regional Health - Europe

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How to Pay for Telemedicine: A Comparison of Ten Health Systems

Cited by 7 publications

References 47 publications

Experiences on the Utility and Barriers of Telemedicine in Healthcare Delivery in Kenya

Experiences on the Utility and Barriers of Telemedicine in Healthcare Delivery in Kenya

Physicians’ views on optimal use and payment system for telemedicine: a qualitative study

Health economic considerations to effectively implement telemonitoring of diabetic foot ulcer

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