When bank robber Willie Sutton was asked why he robbed banks, he famously said, “that’s where the money is.” In health care, the money is in reimbursement. SAMHSA reported that in 2003, Americans received $121 billion in mental health and substance abuse care. Public payers – Medicare, Medicaid, and state and federal sources – covered 61% ($74 billion) of these costs. Private payers covered 26% ($31 billion). Only 13% ($16 billion) of costs were paid out-of-pocket.
The unfortunate reality in American health care is that new services are driven primarily by reimbursement. In telemedicine, previously major barriers – expensive technology, licensing regulations, provider and payer skepticism – are falling. Now the number one issue to resolve is
reimbursement.
The good news is that reimbursement is growing significantly. The first CPT code for online therapy was issued in 2004, but now CMS has dozens of codes to reimburse telemental health. The American Psychological Association recently published an excellent update on reimbursement. Key findings include:
… read the complete story ~ http://issuu.com/onlinetherapyinstitute/docs/tilt_issue5_final?mode=window&pageNumber=57
This article first appeared in the January 2012 issue of TILT Magazine ~ Therapeutic Innovations in Light of Technology.
Mark Goldenson is CEO of Breakthrough.com, a free virtual office for online therapy.
