RENEE MONTAGNE, HOST:
Let's turn now to health care. Next week, a major new medical center will open in St. Louis. It will actually treat thousands of patients from five states, none of whom will be in the building. Mercy Hospital is being described as a telemedicine mother ship and a model for how rural health care can be delivered. But as Alex Smith from KCUR in Kansas City reports, a lot of insurers are reluctant to pay for it.
ALEX SMITH, BYLINE: Say you're a rural Midwestern farmer in bed recovering from surgery or a major illness. It's time for the nurse's check-in, but there's no knock at the door. At Mercy Hospital in St. Louis, just over the foot of the bed in a training room, a camera whirls around and a monitor lights up to show a smiling face with a headset on.
JEFF: Good afternoon, this is Jeff with SafeWatch. Just doing my afternoon rounds.
SMITH: It's a little hard to shake the "Jetsons" vibe, but this kind of health care is already alive and growing. And the new virtual facility will provide even more patients in remote parts of the Midwest and South with health monitoring that's comparable to what you could get in a big hospital.
TOM HALE: You can monitor their heart, their blood pressure, their respiratory rate, their temperature on a 24/7 basis. But even more interesting is you can monitor their position. So you can tell if they've been out of bed. You can tell if they've turned in bed.
SMITH: Tom Hale heads Mercy Virtual. He says telemedicine can be high quality and cheaper than in-person care. A lot of what Hale and his team now provides is care for patients in rural areas. But its use may soon explode with a different group of patients - baby boomers who want to age at home instead of in a nursing facility. Industry analyst Sarah Turk of IBISWorld says that could propel telehealth to a $3.5 billion industry by 2020.
SARAH TURK: What we may see in the future, which will likely occur, is that coverage will be expanded to include more physicians and more specialties and also a range of communication. So instead of it being only interactive video consultation, it could be text messaging as well.
SMITH: But she says the telehealth boom still faces some big challenges. Many insurance companies have been slow to pay for telemedicine, especially Medicare, the health care coverage for Americans over 65. Right now, Medicare only pays for telemedicine in rural or medically underserved areas and only when video conferencing is used. But telemedicine has broadened. Its technology has developed. And now it could, say, use a smartphone app to monitor falls in the home. So insurance companies and Medicare have to rethink their payment criteria. But Harvard researcher Ashish Jha says they have good reason to be skeptical.
ASHISH JHA: Look, if telemedicine really saved money, payers would be falling over themselves paying for this stuff, right, because it would actually benefit their bottom line.
SMITH: He says telemedicine does seem to provide good access to high-quality medical care. But even though it could save money, that's not what's happening.
JHA: What actually tends to happen is that it tends to be an addition, meaning you do the telemedicine; it leads to more tests. It leads to more follow-up visits. And over time, when you look at the data, it turns out that telemedicine, overall, is not necessarily a big cost saver.
UNIDENTIFIED WOMAN: A MAP (ph) is 55.
SMITH: Back in St. Louis, a room full of Mercy nurses gaze into arrays of computer screens and watch patients who are, in some cases, hundreds of miles away. With its new facility, the hospital says it could monitor nearly 7,500 acute-care beds in five states, and they plan to expand even more. For NPR News, I'm Alex Smith in Kansas City.
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