American Well CEO: CBO, “Tower of Babel” are holding back pro-telehealth legislation

By Jonah Comstock
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According to American Well CEO Roy Schoenberg, telemedicine regulation is something of a paradox: Everyone in government agrees it’s a good thing, yet it’s challenging to actually get laws passed.

“I think there is growing critical mass in Washington that understands that telehealth is one of those rare rare things that even for politicians end up being a tremendous asset,” Schoenberg told Babyforyou.net.ua. “If you’re an elected representative and on your flag you put telehealth, it really ends up as no-brainer credit points for you. Because we all understand that using technology to modernize what we do is kind of a good thing. It really helps most of everything that we do. It creates efficiencies, it creates transparency, it is an instrument of democratization of healthcare.”

Schoenberg will lead in Las Vegas called “Telehealth on the Hill: How Policy is Ushering in Change”.

He says there are two main reasons telehealth legislation has trouble getting passed. One is what he’s dubbed a “Tower of Babel” problem.

“If you think about it, the biggest hurdle right now is people speak in different languages around telehealth,” Schoenberg said. “People have completely different ideas about where they want telehealth to go, whatever that means to them. If we could first of all set a unified vocabulary such that everyone speaks the same language, the moment we have more unified understanding I think it would probably be the most important intervention in allowing everybody to move forward.”

The other issue is the Congressional Budget Office, which has to give a score to any proposed legislation on its projected costs and savings to the federal budget.

“The problem is that the CBO is having a hard time coming up with a number that says what’s going to happen when we allow technology to help healthcare delivery,” Schoenberg said. “That’s a very loaded question, and as you can imagine, there is no simple formula to answer it. Would it mean that more elderly patients at home are going to get more frequent care? What is that going to do to their outcomes? Is it going to be a waste of money or does it mean we can intervene early in their deterioration and maybe save millions in care for delayed medical conditions?”

Existing data on private populations can help, but it’s not necessarily extensible to the population over which the government has the most control: Medicare patients. Schoenberg says some of the most important legislation that isn’t being passed is about Medicare reimbursement for telehealth.

“If you are an American citizen and you are anywhere from a young age all the way up to 65, you’re going to see a lot of telehealth coming to you as a covered part of your healthcare,” Schoenberg said. “When you get to 65, which sadly also marks the point where a lot of people have a significant hike in their healthcare needs … boom, zero, nothing. You’re not eligible for anything because medicare is still sitting on the fence about what telehealth is.”

Schoenberg’s session will take place at the Sands Showroom at the Venetian on Thursday, March 8th at 2:30 pm. for the HIMSS 18 Annual Conference.

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