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The Affordable Care Act And Digital Health Applications

11/01/16 | Sarah Cassatly, Michael Cassatly

Telehealth, the delivery of health-related services and information via digital communication technologies, is a rapidly emerging, innovative, cost effective and efficient way to deliver health care. There are three main types of telehealth: store and forward, remote monitoring and real-time interactive services. Smart phone applications, or apps, that connect a provider with a patient, known as “connective health apps,” fall under this umbrella of telehealth and can function in all three of the categories. As the Affordable Care Act legislates to improve quality, lower costs and expand coverage, connective health apps, are an important aspect of the Act. This article will address to what extent the Affordable Care Act and private insurers cover and promote connective health apps.

What are Connective Health Apps and Their Benefits?

Connective health apps have recently gained popularity because of their low cost to both consumers and providers and the many benefits associated with them. Developing evidence suggests that health care is more efficient and effective when patients are actively engaged in their own treatment. Connective health apps provide varying services including chronic disease management, virtual access for patients to both doctors and insurance companies and access to test results. These apps can be connected with a medical device, such as a wearable thermometer, glucose monitor, or cardiac pacemaker allowing clinical provider to monitor a patient remotely and be alerted to healthcare problems or emergencies.

Additionally, these apps can help providers promote care to patients in rural areas or even allow a patient to consult a doctor or their insurance provider without leaving their home. Widespread usage of these apps would lead to a decrease in travel time to doctors’ appointments, lost work productivity, school absenteeism for children and energy usage and traffic. The benefits to society on an individual and macro level are endless, while the costs and downsides are few. Patients will still need to go to the doctor for annual check ups, but for daily monitoring of chronically ill patients, acute ailments such as a person seeking help with a winter cold, or a patient inquiring about a test result, these apps have unlimited potential.
The Affordable Care Act and Connective Health Apps
The Affordable Care Act does not directly address connective care apps, but does discuss telehealth as a mechanism to support greater access for patients. This willingness to address innovation to provide access for hard to reach patients, or patients with multiple comorbidities, within the Act itself signals openness towards connective care apps. These apps align with the Act’s triple aims: improving quality, reducing costs and expanding coverage.
With the passage of the Affordable Care Act in 2012, Congress created a new Center for Medicare and Medicaid Innovation, which is likely where connective health apps within the Act will first be studied. The Innovation Center’s purpose is to “test innovative payment and service delivery models to reduce program expenditures… while preserving or enhancing the quality of care furnished to individuals.” Connective health apps fall squarely within these goals, but the Innovation Center has not yet directly studied or commented on them.
The Innovation Center has seven categories of innovation models. The sixth, titled “Initiatives to Accelerate the Development and Testing of New Payment and Delivery Models,” is most likely where the Center would create a model to study the benefits and limitations of connective health apps. Currently, there is one model that is studying the effects of telemedicine in rural locations and a few models that fund “competitive grants compelling new ideas that deliver health care at lower costs to people enrolled in Medicare, Medicaid, and CHIP.” Although these models do not directly relate to connective health apps, they further signal a willingness on the part of the Innovation Center, as established in the Affordable Care Act, to address the many benefits and concerns of these apps. Although the Affordable Care Act has not directly opined on connective care apps, there is clearly a means to provide low cost access to patients in the future through connective health apps.

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