posted by Chris Regal, Director, Clinical Innovations
on July 10, 2019
Americans have more chronic conditions than ever before, and preventive care can help people avoid these conditions, including diabetes, hypertension, and other lifestyle-related health issues.
Under the Affordable Care Act, over 20 preventive services are covered without any out-of-pocket costs for consumers. What’s more, many of these services can be delivered remotely. A doctor can screen for a variety of conditions via telehealth, such as depression, drug and alcohol use, and diet, and conduct Medicare annual wellness visits from a smartphone, tablet, or computer.
Insurance providers recognize the importance of virtual technology in preventing diseases from occurring or existing conditions from worsening. For example, the Diabetes Prevention Program (DPP) helps people at high risk for type 2 diabetes from developing the condition – through lifestyle changes such as healthy eating and physical activity. The year-long program also incorporates regular education sessions that teach participants how to improve heart health and avoid relapse.
Research shows people have successfully participated in the program virtually, attending classes online and using digital scales to record weigh-ins. While not currently covered by Medicare, virtual participation in the DPP under the program would significantly expand access. Given how many people are affected by and at risk for diabetes, and the evidence that the DPP works, the Centers for Medicare and Medicaid Services (CMS) should cover the Diabetes Prevention Program for Medicare beneficiaries using virtual technologies.
Health insurance providers are committed to making a difference in diabetes prevention, and many deliver the Diabetes Prevention Program both in-person and virtually – absorbing the costs for services that Medicare won’t reimburse. The Diabetes Prevention Programs offered by Anthem, Blue Cross Blue Shield of Michigan, Blue Shield of California, Highmark, Molina, Providence Health Plan, and Sutter Health show that virtual delivery is possible and can be successful.
Telehealth can also prevent tobacco use and its serious health consequences, including COPD, heart disease, stroke, and lung cancer. For example, Blue Cross Blue Shield of Massachusetts, Cigna, and EmblemHealth offer programs to quit smoking that combine medication with counseling elements via telehealth. Consumers report that these telehealth programs offer more convenience and flexibility without needing frequent travel to and from doctor’s appointments.
Moreover, digital preventive health care can benefit from people with a variety of health care needs. UPMC Health Plan offers telehealth as an option for maternal-fetal medicine. UPMC has found that early telehealth interventions can prevent complications during pregnancy and increase the likelihood that the mother will deliver her baby at the local hospital with her primary OB-GYN.
Telehealth can also be a valuable tool for education and counseling to help prevent or manage childhood obesity, prevent coronary heart disease among patients who cannot attend cardiac rehabilitation, and for suicide prevention through flexible and accessible behavioral health interventions.
Living a healthy life starts with prevention. As health care technology evolves and becomes more mainstream, telehealth will play an important role in ensuring long-term health and wellness for people and families across the country.