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Telehealth Rapidly Increasing in Workers’ Compensation

Published on May 30, 2018
by EBONI MORRIS, manager, government relations and public affairs 

Interest and implementation of telehealth has increased rapidly in workers' compensation programs across the country. Within the current health care system, the use and definition of telehealth has evolved and spread rapidly. Telehealth in workers' compensation typically refers to the evaluation of an injured worker via video chat, phone calls, or email utilizing electronic tools such as tablets, laptops or smartphones. This evaluation would be done by a medical provider: physician, a nurse, pharmacist, etc.

According to the National Conference of State Legislatures, almost all states (49) and the District of Columbia have some coverage for telehealth services within their Medicaid program. Thirty-two states and the District of Columbia have telehealth private payer laws. For workers compensation, the implications for adopting telehealth options for injured workers can have various positive impacts for the variety of health needs and case management efficiency. There is potential to asses less complex claims and triage the severity of injury to the worker. In addition, there is also an opportunity to evaluate if other providers should be involved in the case. Telehealth can also be beneficial to patients who have limited access to providers, whether it is a geographical barrier or challenges with their physical condition.

However, injured workers and medical providers may not be aware that telehealth is an option. Further, many workers compensation program rules and state laws are not clear on the use of telehealth. There may also be regulatory barriers to its implementation. For example, medical appointments needing to be in person, provider licensing and credentialing issues, potential reimbursement disparities and protecting the safety and security of patients. All of these issues make telehealth implementation an uphill battle.

Even with the uncertainties, many state workers compensation programs have already or are looking into adopting telehealth. For example, Texas recently released proposed rule which would expand access to telehealth services in the Texas workers’ compensation system by allowing health care providers to bill and be reimbursed for telehealth services regardless of where the injured employee is located at the time the services are delivered. Harbor Health Systems, a One Call company, is one of the first companies to receive approval from the California Department of Workers' Compensation to offer telehealth through its medical provider networks (MPNs).

Telehealth provides an additional strategy for payors to use in order to improve health outcomes for injured workers and potentially lower costs. Providing for the immediate triaging of injuries, faster claims closings and return to work rates are all potential benefits of its use.

Eboni Morris is Manager Government Relations & Public Affairs at One Call.  In this role, she is responsible for assisting with the development and execution of the government relations strategy. Ms. Morris has over 13 years of experience in state and federal government affairs and health policy.  She’s worked for numerous nonprofits and associations in Washington, D.C. including American Academy of Orthopedic Surgeons (AAOS), National Urban League, and National Conference of State Legislatures (NCSL). Ms. Morris has a Master’s degree in Public Policy from UMBC (University of Maryland Baltimore County) and Bachelor’s degree in Political Science from Siena College.

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