PHOENIX - A new state-ordered mandate on insurance companies could soon mean more accessible - and definitely more affordable - health care in rural areas of Arizona.
The measure, signed into law earlier this month, prohibits health insurers from denying payment for medical services solely because they are provided through telemedicine.
Approval came after insurance industry lobbyists, who normally oppose any new mandate, agreed to back the change.
Charles Bassett, who represents Blue Cross Blue Shield, said his company remains concerned it will end up paying twice for every hospital visit: Once for the doctor on-site and again for the doctor who is brought in electronically to consult.
But Bassett said there are some possibilities for cost savings, particularly when a patient does not have to be transported by ambulance, or even more costly, by helicopter, to an urban hospital.
Sen. Gail Griffin, R-Hereford, who sponsored the measure, said this is a small first step. The law will cover only certain rural areas.
Insurers would be required to pay for telemedicine treatment only for specific conditions. And implementation was delayed until the end of 2014 to satisfy insurance industry concerns.
But Griffin said she is convinced there will be no increase in costs, which she said could open the door for even wider use of telemedicine.
Daniel Roe, director of the emergency department at Bisbee's Copper Queen Community Hospital, said it's a matter of getting the expertise where it's needed.
"Because we are in such a remote environment, we have trouble recruiting physicians to find specialists that would be willing to locate in Bisbee," he said.
The result, he said, is the hospital has a surgeon "a couple of days a week," a urologist on Wednesday and just recently hired a pediatrician.
"But we don't have a cardiologist, a pulmonologist, a neurologist," he said.
What that has meant in the past is that patients who show up with chest pains or a stroke had to be sent to Tucson, he said. Now technology allows his hospital to keep many of those patients in Bisbee, which means lower costs.
But the fact that insurance companies only pay about half the time for telemedical services limits his ability to recruit, he said.
Starting in 2015, all new and renewed insurance policies must include coverage for services provided through telemedicine "if the health-care service would be covered were it provided through in-person consultation."
Roe described a scenario where a pediatric patient comes to the hospital. Rather than send the child to Tucson, a specialist who might be at Tucson Medical Center comes on the screen, talks to the patient and family and looks at pictures transmitted through a high-definition monitor. He said the remote doctor can listen to the patient's heart and look in his ears and throat using through a digital instruments. X-rays are sent digitally to the computer at TMC, and the doctor can review lab results.
Roe figured the cost of one ambulance transfer to Tucson pays for 70 to 80 telemedicine consultations.
There are restrictions. The only services that have to be covered through telemedicine are trauma, burns, cardiology, infectious diseases, dermatology, mental health disorders and neurologic diseases, including strokes.
And the coverage applies only in the 13 rural counties and the more remote areas of Pima and Maricopa counties, like Ajo and Gila Bend.