The use of telemedicine constitutes a growing success in the United States, especially in underserved regions. Yearly summaries show a facilitated access to the services of medical specialists by rural populations. Tertiary care hospitals witness more frequent referrals of rural patients, in search for specific medical treatment. Yet, data from two reports issued by Feedback Research Services, indicate that for 1998, no big expenditures are likely to be made for telemedicine services by the government.
The first report has been published under the suggestive title: "California Telemedicine: A Reimbursement Dilemma" and deals with the consequences of economic, managed care, and political influences on claims submitted up till now. The second file has appeared under the name "Clinical Telemedicine Payment Models" and constitutes an attempt to assess the present service levels in the United States. The results somewhat differ from the reimbursement ratings, issued by the Health Care Financing Administration (HCFA) for the years 1999 up to 2002.
As far as California is concerned, telemedicine service providers so far didn't see any sufficient amount of money coming their way, notwithstanding the hope cherished by industrial managers and state legislators. At the national level, many responsible telemedical project demonstrators fail to meet the HCFA reimbursement criteria, which have been provided on beforehand. A growing number of comprehensive telemedical services are being organized by all sorts of health care institutions but the federal reimbursement mechanism won't be following this development through 1998.
In the next year, the Universal Service Programme might indirectly cause a rise in telemedicine initiatives. Since May 1998, this programme is funding regional investments in order to reach equal levels in telecommunications facilities throughout the country. Some rural telemedical service providers will take the opportunity to compensate their expensive monthly telephone costs. As the transfer rates are dropping, there is room available for further telemedicine project expansion.
In turn, the increased offer of telemedicine may bring about limited Medicare or other forms of reimbursement. Beneficiaries, who are situated in Health Professional Shortage Areas (HPSAs) are due to receive their payments from January 1st, 1999 on. A total amount of $19 million in telemedicine service reimbursements has been reserved for this type of population in 1999.