Telemedicine in the Affordable Health Care Act Explained
Telemedicine is an important component of the robust and technology driven Affordable Care Act system (Obama care) and provides avenues for reducing costs in the new healthcare structure, because it offers options in how to access healthcare services.
The Affordable Care Act is the most comprehensive overhaul of the nation’s health care system in decades and it’s implementation and sign-ups will all be processed through marketplace exchanges.
What is the Meaning of Telemedicine?
Telemedicine is the use of telecommunication and information technology to provide clinical health care without a traditional face-to face consultation. It helps eliminate distance barriers and can improve access to supplementary medical services for people with:
- Basic or No Insurance
- High Deductible (HDHP) Insurance
- Traditional Insurance
Tele-health Vs Telemedicine
‘Tele-health’ is an older, broader term for services such as health education and is not limited to clinical services, while ‘Telemedicine’ narrowly focuses on the actual curative aspect between the patient and healthcare professional. Examples of Tele-health are health professionals discussing a case over the telephone or conducting robotic surgery between facilities at different ends of the world.
Tele-Health has a broader scope than telemedicine and is sometimes called e-health, e-medicine, or telemedicine. Health care professional use tools like e-mails, e-visits, e-prescribing, after-hours care, e-reminders, health assessments, self-management tools, health coaching etc.
The State of the Market
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The Affordable Care Act (Obama Care) Health Insurance Exchange (HIX) opens on Oct 1st, 2013. and goes into operation on Jan 1st, 2014. The Obama Care exchanges, are State, Federal or joint-run online marketplaces for health insurance. Americans can use their State’s “Affordable” Insurance Exchange marketplace to get coverage from competing private health care providers.
Steps to Sign up for Health Care Plans
- Participants enter personal information into a web portal
- Learn their eligibility for subsidies based on income, state-determined criteria or employer-based options.
- Use a price calculator to shop, compare and choose a best benefit health plan.
Several major health companies have programs like TelaDoc in Aetna, KP-OnCall in Kaiser etc, trying to set up footholds in a market that is widely expected to grow rapidly. All participants have to do is research for telemedicine benefits through their health insurance plans or sign up for independent programs.
How Health Care Professionals Administer Telemedicine
Doctors can treat most everyday health needs by phone or a scheduled video consultation. A study by the American Medical Association shows that 4 out of 5 visits to a primary care doctor could have been treated over the phone instead. After each consultation, patients will receive a clinical report which can be emailed to a primary care physician.
Registered Nurses manage triage calls and act as health coaches. For some specific symptoms, they give guidance for the most appropriate care, and over 32% of the time will offer self-care options so patients avoid a visit to the doctor, ER or Urgent Care facility entirely.
Common symptoms often treated through Telemedicine
Respiratory Infections, Cold/Flu Symptoms, Urinary Tract Infections, Sore Throats, Headaches/Migraines, Sinusitis, Allergies, Insect bites, Certain Rashes, Sprains/Strains, Arthritic Pain, Stomach Aches/Diarrhea, Gastroenteritis, Minor Burns and many non-emergency medical conditions
By 2014, the law mandates that all non-exempt Americans have health insurance or face a tax penalty. The Affordable Care Act has far-reaching advantages such as prohibiting insurance companies from dropping a clients’ coverage if they get sick or discrimination against anyone with a pre-existing condition and extending children’s eligibility on parent’s plans.
For entrepreneurs, who will most likely be responsible for their own health insurance, knowing how telemedicine can supplement their health insurance plans, means they can take full advantage of the options, savings and benefits.