The American Medical Association (AMA) has highlighted a significant disconnect in the adoption of digital health among commercial insurers, Medicaid, and Medicare. This was based on research conducted by Manatt Health for the AMA. While Medicare and Medicare Advantage plans cover all 21 digital medicine services assessed, private health plans in the Medicare Advantage program do not offer the same coverage in the commercial market. Medicaid’s coverage is more limited, but it has been expanding over time.
- Inconsistent Adoption: There’s a notable disparity in the adoption of digital health services among commercial insurers, Medicaid, and Medicare.
- Coverage Differences: Medicare and Medicare Advantage plans cover all 21 digital medicine services assessed, but private health plans in the Medicare Advantage program don’t offer the same coverage in the commercial market. Medicaid’s coverage is more limited but has been expanding.
- Barriers to Digital Health: Despite the potential of digital health, its adoption among physicians is low. Barriers include the need for physicians to evaluate the technology supplied to patients for accuracy and reliability, and inconsistent coverage that makes physicians hesitant to invest in the necessary infrastructure.
- Commercial Market Challenges: Within the commercial market, there’s inconsistent adoption of digital healthcare. Some plans have added restrictions beyond what Medicare requires. Additionally, commercial plans vary in transparency, which can hinder informed decision-making by patients and physicians.
- Digital Health Partnerships: Health plans often collaborate with technology companies to provide digital health services in specific areas, like hypertension or behavioral health. However, these services often aren’t connected with a patient’s primary care physician.