Viewpoint: 3 ways to retool Medicare coverage, reimbursement for the digital revolution

Here are three concepts policy makers should consider if thinking about advancing legal or regulatory reforms to improve Medicare as part of the brand-new digital revolution, according to the co-authors.

Jackie Drees –
Monday, October 26th, 2020

As society pushes toward the very first phases of the “4th commercial revolution,” there is an increased opportunity for innovation to modernize the U.S. health care system, according to two national healthcare policy experts.

In an Oct. 23 perspective short article for Health Affairs, Robert Horne, president of Forest Hill Consulting, and Lucia Savage, chief privacy and regulative officer at Omada Health, explained the potential transformation opportunities for health care in the fourth industrial revolution, or the “combination of innovations that is blurring the lines between physical, biological and digital sphere.”.

To capitalize on these opportunities from digital velocity, “policy makers should modernize the regulative and statutory guidelines that govern how product or services are offered to Medicare beneficiaries,” Mr. Horne and Ms. Savage wrote.

1. Produce protection and compensation policies around private functions of digital technologies in addition to updates that better facilitate direct monetary relationships with digital health suppliers. This has the prospective to increase coverage options and customer choice for digital health services.

2. Embrace an integrated and practical method to digital technologies that permits programs to think about digital protection and compensation throughout different silos of care. This technique would assist much better determine how digital coverage might generate advantages throughout the whole program in addition to improve data combination at the point of care to enhance care management for clients, companies and caretakers.

3. Rebuild CMS coverage and payment capabilities to produce financial relationships directly with producers and shift digital protection down into different payment systems. This brand-new coverage department would preferably be able to team up with Medicare private strategies to improve the programs testing capabilities.

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Produce protection and reimbursement policies around specific functions of digital innovations along with updates that much better help with direct monetary relationships with digital health suppliers. Embrace an integrated and functional method to digital technologies that permits for programs to consider digital coverage and compensation across different silos of care. This strategy would assist better determine how digital protection may produce benefits across the whole program as well as enhance data combination at the point of care to strengthen care management for service providers, patients and caretakers.

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Reconstruct CMS coverage and payment capabilities to create monetary relationships straight with manufacturers and transition digital protection down into various payment systems.