Telemedicine At Home: New Vt. Law Expands Health Insurance For 21st-Century Treatment

Jun 7, 2017

Health insurance in Vermont will soon be required to cover medical care delivered via telemedicine, even if the patient receiving the treatment isn't at a doctor's office.

The University of Vermont Medical Center already works with Rutland Regional Medical Center to give Rutland patients access to UVM's health specialists without hours of driving, and officials say the program is a success.

According to numbers from the UVM Medical Center, its specialists have given more than 550 neurology consults to patients in Rutland using telemedicine since the beginning of 2015, and just 15 of those patients required in-person follow-up care at UVM Medical Center. The rest completed their treatment in Rutland.

“So, amazingly good for specialty beds here, great for Rutland Regional keeping patients close to home, and especially great for the patients who can stay close to their loved ones where they were admitted,” said Dr. Steven Leffler, the chief medical officer at the UVM Medical Center.

One obstacle to expanding telemedicine is that insurers haven't been required to cover the cost of that care if the patient isn't at a doctor's office. On Wednesday, Rep. Bill Lippert, D-Hinesburg, explained how the new law will change that.

“Under current law, which we authorized several years ago … telemedicine has to take place between two health care facilities,” Lippert said. “It has to be from one health care facility to another health care facility. The key provision of this law expands telemedicine access to other locations, where the patient could be at a distant site like their home or their workplace.”

"The key provision of this law expands telemedicine access to other locations, where the patient could be at a distant site like their home or their workplace." — Rep. Bill Lippert, D-Hinesburg

UVM's Leffler says the change has major implications for health care in Vermont.

“It helps us get ready to be able to provide it in someone's house on their laptop,” Leffler said. “But there's some work to do to make sure that connection's secure, HIPPA protected and so on. This now is pushing us towards being ready for that.”

Mark McGee, a psychiatrist and the chief medical officer at Brattleboro Retreat, said the change could also help hospital emergency rooms connect with psychiatry services to help patients going through mental health crises.

“Telemedicine offers the promise that psychiatric patients in emergency departments may receive real-time care that may allow them to discharge to their home or their communities, potentially eliminating the need for a psychiatric hospitalization,” McGee said. “It also means that high-quality psychiatric care can be provided sooner, decreasing the distress and suffering while someone awaits a placement at a psychiatric facility.”

McGee, like Gov. Scott and Dr. Leffler, said this change sets the stage for a major shift in the way the health care system works in Vermont.

“Telemedicine is an important resource that has the potential to transform not just a particular specialty, but to transform our overall approach to health care,” McGee said.

The bill goes into effect Oct. 1, 2017, though officials say there are still technological and privacy issues to be resolved before Vermonters start receiving care outside of traditional health care settings.