New bill would let health centers actually get paid for telehealth

Mountain Family Health physician Chris Tonozzi speaks with a patient using telemedicine from his office in Glenwood.
Chelsea Self / Post Independent

A new bill in the Colorado legislature could make telemedicine more accessible, and one local community health center is ready for it.

Right now, federally qualified health centers, also known as community health centers, don’t get paid for providing remote consultations to Medicaid patients.

 “We get an annual grant from the federal government to support care for uninsured people, and the other part of that is that we get reimbursement from Medicaid that covers what we spend on those visits,” said Dr. Chris Tonozzi of Mountain Family Health Center in Glenwood Springs.

“What’s been going on is that Colorado Medicaid hasn’t been willing to reimburse in their usual way for (telemedicine), based on what it costs us,” Tonozzi said.

“It’s a little bit of a niche bill for us, but we’re super happy. We feel like telemedicine, telehealth, is the wave of the future.” —Dr. Chris Tonozzi, Mountain Family Health Centers

In Colorado, Medicaid covers the costs of face-to-face visits, but telehealth consultations by community health centers don’t qualify.

That’s where a new bill proposed in the Colorado Legislature comes in.

The act would make a telemedicine service reimbursable at the same rate as an in-person, or so-called face-to-face visit.

“We would get reimbursed in our usual way, which would make (telemedicine) much more easy for us,” Tonozzi said.

Telemedicine consultations are required to have video and audio, so in a sense the services would still be face-to-face, just through a screen.

“Telemedicine visits can lead to cost savings for the Medicaid system by improving access to primary care and helping to avoid unnecessary trips to emergency departments,” according to the proposed bill’s declaration.

One place telemedicine consultations have been useful is in chronic disease management, Tonozzi said. 

For diabetes patients, for example, Tonozzi can schedule a follow-up with a patient and check in on many aspects of their diabetes control.

Particularly if they’re monitoring glucose levels on their own, “I can review those and then make a plan for changes and referrals,” Tonozzi said.

Patients who struggle with hypertension also have benefitted from telehealth.

“There’s a new movement to have patients do more blood pressure measurements at home, because they’re often unusually high when they come into the doctor’s office,” Tonozzi said.

“Those home blood pressures are really good to have, especially if they’re taking good blood pressures at home, being able to review those with patients at telehealth visits can be really useful.”

And during flu season, it would be nice to have the option of remote consultation, so patients aren’t exposed, or don’t expose others, to a virus.

The bill came about after Rep. Perry Will (R-New Castle) visited the Rifle Mountain Family Health Center.

Tonozzi wasn’t involved in that meeting, but said that others brought up the issue of telehealth billing.

Sen. Bob Rankin (R-Carbondale) joined the bill as a senate sponsor, and the bill also attracted two sponsors from the Democratic caucus: Sen. Kerry Donovan (D-Vail) and Rep. Yadira Caraveo (D-Thornton).

The bill is scheduled for a hearing in the House Committee on Public Health Care & Human Services Feb. 5.

Tonozzi noted that the telemedicine bill in Colorado isn’t a big change to healthcare, but it would be helpful to community health centers.

“It’s a little bit of a niche bill for us, but we’re super happy. We feel like telemedicine, telehealth, is the wave of the future, and can provide a lot of convenience for patients in particular, and help us get more care out to people in a more convenient way,” he said.

One of the larger problems for Mountain Family and other health providers is that Garfield County has one of the highest rates of uninsured in the state.

A total of 40 percent of Mountain Family’s patients are uninsured, while another 30 percent use Medicaid. The remaining are on a variety of insurance options, Tonozzi said.

Across the state, community health centers provide care for 40 percent of uninsured persons.

“We’ve been struggling to figure that out, and help more people get insured,” Tonozzi said.

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