April 18, 2016

Libby Baney: Emphasis on Network Adequacy Creates Opportunity for Telemedicine

Facing an influx of new and expensive enrollees through public exchanges, health insurers have resorted to narrowing provider networks to cut costs. That mechanism will become more difficult as states finalize and begin to enforce network adequacy standards. In an article in Inside Health Insurance Exchanges, Libby Baney, Faegre Baker Daniels counsel, touted telemedicine’s potential to help meet network adequacy standards and satisfy the demands of a growing market in a cost-effective manner.

“I’ve had a lot of conversations about the opportunities network adequacy presents for telemedicine, but I haven’t seen many companies focusing on it,” Baney said. “With narrow networks, there is a real opportunity for exchange plans to be more innovative through the use of telemedicine. They can use telemedicine to make their networks more robust and more competitive and drive more members to their plans.” 

While some states have modified laws to permit wider access to telemedicine, Baney said it remains to be seen how regulators will treat telehealth in assessing network adequacy.

“You could argue that it would be inconsistent for a state to have a parity law and, for example, robust permissions for the use of telemedicine, but not count [telehealth providers to satisfy] network adequacy requirements,” Baney said.

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