Opioid overdose was the No. 1 cause of injury deaths in the United States in 2017, claiming 47,600 lives, according to the Centers for Disease Control and Prevention. Those deaths are increasingly occurring in rural areas. In fact, the opioid death rate today is higher in rural America than in urban parts of the country.
While medication-assisted treatments exist, they often aren’t available to people struggling with Opioid Use Disorder who live in the nation’s more remote nooks and crannies. That’s because too few physicians trained and licensed to treat them practice in those settings, and too few people in need of care can get to the urban centers that can provide it.
Making remote care accessible
Telemedicine offers a lifeline. A study in West Virginia found that prescribing medication-assisted treatments remotely was just as effective as face-to-face care for people trying to overcome opioid addiction. But telemedicine has been slow to take hold in the United States, in part because of reimbursement issues. Half of the respondents in a study conducted by the College of Healthcare Information Management Executives and KLAS cited slow reimbursement for telehealth visits, and reimbursement at rates that are lower than face-to-face care, as limitations.
That may be changing, particularly with new programs that specifically serve people with Opioid Use Disorder. In 2018, the SUPPORT Act — short for Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment — was signed into law, with a provision to expand telehealth services for treating Opioid Use Disorder. The provision expands Medicare coverage of telehealth services to beneficiaries in their homes and reimburses services at the same rates as in-person visits. The law takes effect July 1.
The Centers for Medicare and Medicaid Services is the single largest payer for health care services in the United States and many private insurers follow Medicare’s lead for setting reimbursement rates. This bodes well for patients in rural areas who are seeking care and have telemedicine options.
Communication is key
In another promising move, the Federal Communications Commission increased funding for the Rural Health Care Program from where it had been stuck since the program was established in the 1990s. The FCC voted in 2018 to raise the funding cap to $571 million, up from $400 million, to improve rural providers’ access to modern communication services. Limited broadband services in rural areas have previously hampered use of telemedicine and been a barrier for both providers and patients.
The opioid crisis has created an immense amount of pain and suffering for victims and their families. Telemedicine is one of many tools that can help stem the tide, and it may prove especially helpful for rural Americans.
Leslie Krigstein, Vice President of Congressional Affairs, and Mari Savickis, Vice President of Federal Affairs, College of Healthcare Information Management Executives, [email protected]