Specialty Telemedicine Expands Value for Medicare Advantage Plans: Part 1

August 21st, 2020

Specialty Telehealth Expands the Value of Medicare Advantage


 Dr. Jonathan Wiesen, M.D., founder and chief medical officer, MediOrbis


Medicare Advantage (MA), also referred to as “Medicare Part C,”  a Medicare benefits plan  provided to Medicare registered patients through a private sector health insurer,  typically provides benefits beyond the standard Medicare benefits, including dental, health, specialty pharmacy, transportation and, in many instances, telemedicine. [1]

It is no surprise that enrollment in MA plans has doubled over the last decade and, to date, represents approximately 40% of all those enrolled in Medicare. [2]

The following series reviews the key societal, social and medical changes that have taken place since the onset of the COVID19 pandemic, thereby underscoring the importance of specialty telemedicine as a crucial benefit for ALL MA plans.


Post COVID19 Societal Changes for Medicare Advantage Beneficiaries


The societal changes and adaptations that we have witnessed in the last four months are nothing short of astounding.  Almost overnight, humanity transitioned to virtual interactions, reliant upon high definition video meeting software and ubiquitous broadband Internet for business, social “gatherings,” and family “visits.”


These adaptations were not limited to only the young, technology savvy populations.  More senior citizens than ever before have been using mobile platforms for everything from social interactions to mundane tasks such as paying bills and ordering food.  Healthcare for the elderly is similarly being transformed to a virtual, home based enterprise:  a recent Advisory Board Study survey demonstrated that 75% of individuals over 60 years of age used a telehealth – related monitoring device routinely, [3] and a recent study indicated that a majority of MA participants used telemedicine services during the COVID pandemic, with over 90% satisfaction with the experience. [4]


Global healthcare has also changed dramatically during this time.  Telemedicine has become routine both for primary and specialty care, from rural hospitals to tertiary care university hospitals.  Moreover, digital devices and monitoring modalities are more commonplace.  Not only are individuals utilizing cloud – based telehealth patient platforms, but they are also commonly being linked to clinical remote monitoring programs, now reimbursable by CMS.[5]


[1] https://www.medicare.gov/sign-up-change-plans/get-started-with-medicare

[2] https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans/how-do-medicare-advantage-plans-work

[3] https://www.timesrecordnews.com/story/news/local/2020/04/10/covid-19-moves-seniors-embrace-technology-coronavirus-survey/5122728002/

[4] https://www.fiercehealthcare.com/payer/poll-shows-ma-seniors-who-use-telehealth-are-excited-to-use-service-again

[5] https://www.bettermedicarealliance.org/sites/default/files/2018-02/BMA_OnePager_Telemedicine%20in%20Medicare%20Advantage_2018_01_26_v2a.pdf