One major barrier to creating new programs is lack of solid data that shows they can generate cost savings for government programs. That's one of the reasons CMS has been cautious about approving new plans. "CMS has been slow to create CPT codes for telemedicine services, which would facilitate providers being reimbursed, because a very clear connection between the service and it improving clinical outcomes is needed.
This can be tricky for telemedicine to improve, but CMS is still investing in pilots to determine just that. Once there is adoption by CMS, then adoption will occur with other payers."
Another problem at the federal level is the lack of a common language among different federal agencies on how telemedicine is defined. That has become more difficult as new areas of care such as remote patient monitoring enter the picture to create new categories of care.
A new federal study titled Federal Efforts to Define and Advance Telehealth – A Work in Progress, looked at how different agencies define telehealth. It found that the CMS and National Coordinator of Health IT defined telehealth as "the use of telecommunications and IT to provide access to diagnosis, health assessment, information, and patient care." The Health Resources and Services Administration defined it as "the use of electronic information and telecommunications technology to support long-distance health."