Telemedicine has developed as an innovative way to remotely view and treat patients without necessitating for patients to physically come into a physicians’ office or healthcare facility. This study aims to provide insights into the effectiveness of integrating telemedicine in medical facilities, where patients have high hierarchical condition category (HCC) risk scores.
This study utilized two raw datasets: (1) a Centers for Medicare & Medicaid Services (CMS) dataset created from the 2017 Medicare Physician and Other Supplier National Provider Identity Aggregate Report and (2) a National Center for Education Statistics (NCES) dataset created from the NCES table on the number and percentage of households in each state with computer and internet access. A regression analysis was carried out on the CMS dataset to determine the correlation between HCC risk scores and the reimbursement lost by healthcare facilities, where over 50% of their patients are diagnosed with chronic obstructive pulmonary disease (COPD). A second analysis was conducted with the NCES dataset to show which states had a high proportion of both households with internet access and COPD patients. A final regression analysis was run and translated into an interactive map in order to determine which regions of the United States could most benefit from telemedicine adoption.
This study discovered a number of physicians and healthcare facilities in the eastern region of the United States that could benefit significantly from telemedicine applications. These findings were supported by the locations and data abstracted from facilities with high numbers of COPD patients, which were found to have poor HCC risk scores and thus high reimbursement losses.
This study confirmed the association between HCC risk scores and reimbursement losses. In order to alleviate those losses, this study identified states across the United States that should choose to incorporate telemedicine into how they diagnose and treat patients based on the needs of healthcare facilities and the internet capabilities of households in those states, because telemedicine integration presents the potential to improve patient HCC risk scores and reimbursement amounts by lowering readmission rates while also promoting higher patient and physician satisfaction. Future efforts should develop specific strategies to assist with telemedicine implementation and should track the observed effects of its adoption on reimbursements and quality of care.