Who Pays for Mobile Health?

November 10, 2010

Mobile health also means a wealth of data - everything from your patients’ real-time vitals to endless reference materials - and enhanced communication with your colleagues and patients. That means more time spent interpreting data or collaborating, which of course means money. And when it comes to mobile health - who pays?

The mobile health revolution is really taking off, evidenced by more than just the proliferation of health-related apps in the iTunes store. A vast majority of physicians use smartphones and a growing number are using apps to manage patient care, moving beyond reference tools and calculators.

But mobile health also means a wealth of data - everything from your patients’ real-time vitals to endless reference materials - and enhanced communication with your colleagues and patients. That means more time spent interpreting data or collaborating, which of course means money.

And when it comes to mobile health - who pays?

If the burgeoning industry is looking to providers to pick up the tab, “we will have to rethink that,” said Matt Wiggins, creator of mobile applications company Remedy Systems. Wiggins was on a panel of speakers this week at the mHealth Summit in Washington, D.C.

“The people who will pay are those with a vested interest in keeping people healthy,” he said, including insurance companies, CMS, interoperability companies.

Yet, the current fee-for-service reimbursement model doesn’t reward for the time spent coordinating care or collaborating. (Some payers are starting to reimburse for e-visits and other online interactions. And the time and money saved through efficiencies gained using mobile technology is also worth noting, although it can be a harder sell for some busy docs.) But all that could be changing.

“In the next five years, the world is starting to look very different in terms of us being paid more for quality and outcome,” Joseph Kvedar, a physician and founder of the Center for Connected Health, told me during my recent research for an article on mobile health. The health reform law includes projects and initiatives that seek to reward physicians for this quality improvement, which can be achieved and demonstrated using mobile technologies.

And the patient-centered medical home concept will also facilitate the shift in reimbursement priorities, as physicians use these tools to coordinate care. “Payment needs to be reflected outside of the face-to-face visit,” ClearPractice CEO Joel Andersen told me recently. “That’s the care coordination… and that requires mobility.”

Another word or two on efficiencies gained: Mobile health tools promise to help the physician by providing her patients with information and empowering them to be engaged in their care. Take for example an app called iTriage, which allows patients to comb through symptoms and information to help determine what kind of provider they should see. “There’s a lot to be gained from providing [information] through to a certain point, then accessing a physician at the right time,” said Peter Hudson, MD, CEO of Healthagen that developed the app, speaking on the mHealth Summit panel.

For a mobile health app to differentiate itself from the crowd, it must accomplish five things, according to Chris Wasden, managing director of strategy and innovation at PricewaterhouseCoopers who moderated the panel:
- The app must be an integrated and interoperable solution.
- It must be intelligent; Rather than just provide endless data, it must tell the user what to do with all that information.
- It must share information with other apps.
- It must have a social component, creating a community around the capabilities.
- It must demonstrate outcomes; the app must prove and document results.

Do you agree? What do you think about the burgeoning mobile health revolution?