Funding Resources: Availability and Some Conditions for Home Telehealth Uses

A good sampling to get us started…

• Medicare billing for home telehealth, under Prospective Payment. Limited, still, as noted in everything you will have read so far. In addition, in this transmission from the Centers for Medicare and Medicaid services (CMS): http://www.cms.hhs.gov/manuals/pm_trans/R1798B3.pdf take note that home telehealth is not included in this payment description. Take particular note, also, in your planning efforts that home care is excluded from the list of allowable sites to host or deliver telemedicine services in Health Provider Shortage Areas (HPSAs).

  Medicaid billing, as available. U.S. states that reimburse for telemedicine under Medicaid include: AR, CA, GA, IA, IL, KS, LA, MN, MT, NE, MC, ND, OK, SD, TX, UT, VA, WV. This information is provided at: http://www.cms.hhs.gov/states/telelist.asp. Some description of telehealth services that are reimbursed is provided on this page. Each state’s entry provides details on coding. Each entry also provides a state- specific contact name and phone number. Note, however, that only some states, such as Kansas, specify that home telehealth can be reimbursed.
  
  Here is additional and useful information about Medicaid:
  A recent report titled “Medicare, Medicaid, Telehealth and Telemedicine: The State of Medicaid Reimbursement in the U.S.,” generated by Nancy Brown, MLS, of the Telemedicine Resource Center, Portland, OR, provides details on contacting states and potential for telemedicine reimbursement under Medicaid in general. [See http://tie.telemed.org/legal/state_data.asp?type=medicaid ] However, Ms. Brown notes that she found no mention whatsoever in her surveys of telemedicine reimbursement under Medicaid of home healthcare organizations receiving monies. She reports about Medicaid reimbursement for telemedicine in general that:

  Most Medicaid offices are open to covering telehealth, but in most instances it took efforts from telehealth providers in each state to get the contracts with HMOs and insurance providers. If the Medicaid office is convinced that telehealth is effective, and if they have the funds, they’ll reimburse telehealth wherever. (Email correspondence with the author, June 9, 2005.)

• Other Federal Funding. An easy-to-use, one-stop site of federal funding sources for telemedicine, as listed in the Telemedicine Information Exchange’s web site, is available at: http://tie.telemed.org/funding

  However, as with all possibilities for funding, we have to examine details about those sources relevant (or not) to home telehealth. In this case, about one dozen federal funding sources are listed but some are not appropriate or actually exclude home telehealth. We have to read these descriptions carefully. For instance, several funding sources, such as loans from the USDA’s Rural Broadband Access Loan and Loan Guarantee Program specifically note that home health agencies are ineligible for grants. Restrictions noted in some other likely-seeming programs are requirements the potential grantees be located in a rural area or be focused on research and evaluation tasks.

• Foundation and Corporate Funding
  **The Health Funds Grants Resource Yearbook, 10 th ed. (of which Health Grants Funding Alert is an online counterpart, available at: http://www.healthresourcesonline.com ) provides extensive information on grant making in the foundation and corporate worlds. 15 chapters [link to Contents here, at: http://www.healthresourcesonline.com/health_grants/1ybk10.htm#contents] provide details on funding trends in the post 911 environment and many chapters focus on specific areas of need such as elderly health services, patient safety, and health profession training grants. See details on accessing both of these resources from Health Resources Publishing, at http://www.healthresourcesonline.com.
  
  Personal tips on grant searching and grant getting are provided by Robert K. Jenkins , the publisher of Health Resources Publishing, as follows. We should, first of all:
  • Zero in on the funding opportunities for health programs to support your organization’s mission.
    
    As Mr. Jenkins notes, however
    There is no magic, one-source, easy way to research funding opportunities. Veteran grantseekers know this.
    
    To be successful in obtaining grants for your organization, you not only need to do your homework, you must know the history—the federal agency or charitable foundation history of interest in and record of awarding grants similar to what your organization needs.
    
    Once you have identified your organization’s specific program and project needs, knowing who gave and for what is the starting point.
    
    Funding priorities are being revised. Grantmakers are changing their focus. This means you'll need to search harder to find the grant funding to meet your organization's funding goals.

    Reproduced ( in part) with permission from publisher Robert K. Jenkins, from the Publisher’s Introduction to The Health Funds Grants Resources Yearbook, 10 th edition

    ** The Foundation Directory provides information on 80,000 grantmakers and their criteria for approving grant applications. It is available online at: http://fdncenter.org, searchable for a monthly fee. Hard copies are available at most public and university libraries.

    Keep looking: As we continue to do our homework, we can make note of the foundation or corporate entity that has funded home telemedicine—for example, Blue Cross/Blue Shield of Michigan Foundation has undertaken such a project within the state of Michigan; and a wide range of foundations and corporations have done so as well—with clear restrictions in place regarding location and types of recipients of the monies or the healthcare services (e.g., services to be delivered only to employees of the corporate sponsor). Such grants or other funding are not unobtainable but time for researching them and making the right match with one’s own organization can be considerable.

• And the dreaded “Other” category….
  Private insurers and managed care entities may be funding sources. There is no clear cut identification of who reimburses for home telehealth and who does not or sometimes does. Funding possibilities may require considerable researching and negotiating efforts as a result. That much we can feel sure of.

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