Bill Overview
Title: To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services.
Description: This bill permanently allows any site to serve as an originating site (i.e., the location of the beneficiary) for purposes of Medicare telehealth services, including a beneficiary's home.
Sponsors: Rep. Buchanan, Vern [R-FL-16]
Target Audience
Population: People who are Medicare beneficiaries
Estimated Size: 65000000
- The bill amends the Social Security Act concerning telehealth services.
- It focuses on Medicare, which primarily covers older adults and certain younger individuals with disabilities in the US.
- Currently, Medicare telehealth services have restrictions on originating sites.
- This legislation removes geographic restrictions, potentially impacting all who rely on Medicare for telehealth services.
- Telehealth services are expected to become more accessible, especially to those in rural or remote areas.
Reasoning
- The policy affects Medicare beneficiaries, a group consisting mostly of older adults and people with disabilities. These individuals may have varying levels of access to technology and healthcare.
- This expanded access to telehealth services will potentially improve the quality of life, especially for those in rural or underserved areas who have previously faced geographic restrictions.
- Not all beneficiaries will experience significant changes in wellbeing; factors like technology accessibility, personal health issues, and existing healthcare infrastructure will play roles.
- The policy budget seems adequate to cover a portion of the anticipated population in the short term, though long-term financial sustainability will depend on the actual uptake and continued service demand.
- Diverse simulations were chosen to cover a range of potential scenarios and commonness scores reflect distribution within the Medicare population.
Simulated Interviews
Retired (Rural Ohio)
Age: 73 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- This policy could really change my life, making check-ups simpler.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Retired teacher (Urban New York)
Age: 68 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- More flexibility is always good, but I didn't face constraints before.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired engineer (Florida)
Age: 85 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 4/20
Statement of Opinion:
- I'm comfortable going to the clinic.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Disabled (Remote Alaska)
Age: 62 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- If I get better internet, this could be life-changing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
Retired nurse (Suburban California)
Age: 77 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- It's good to have this option, though I'm cautious about privacy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Retired farmer (Rural Texas)
Age: 90 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I hope this will mean I don't have to leave the house as often for care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Part-time consultant (Minnesota)
Age: 70 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- It's a needed change for many but my situation isn't heavily impacted.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 8 | 8 |
Retired artist (Portland, Oregon)
Age: 76 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- Not sure how much I'll use this, but it's comforting for emergencies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired factory worker (Appalachian area)
Age: 65 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 9/20
Statement of Opinion:
- I hope this will really help me get more regular check-ups.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Retired accountant (Urban Chicago)
Age: 82 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- I'm happy for rural folks; my needs are met currently.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Cost Estimates
Year 1: $1500000000 (Low: $1200000000, High: $1800000000)
Year 2: $1600000000 (Low: $1200000000, High: $1900000000)
Year 3: $1650000000 (Low: $1300000000, High: $1950000000)
Year 5: $1800000000 (Low: $1400000000, High: $2100000000)
Year 10: $2400000000 (Low: $1900000000, High: $2900000000)
Year 100: $5000000000 (Low: $4000000000, High: $6000000000)
Key Considerations
- The policy significantly increases access to telehealth and thus could lead to increased healthcare utilization.
- The bill affects approximately 65 million Medicare beneficiaries, potentially increasing the baseline service demands significantly.
- Long-term cost impacts depend on integration with other healthcare models and how telehealth may influence broader service patterns.