services. She further noted that there are many myths to dispel regarding the use of telehealth, including those held by the public. Landgraf added that while Delaware Medicaid was able to achieve coverage of telehealth services through policy, she believes coverage needs to be codified as a state law, so that it does not depend on the support of the sitting administration.

Another participant asked Herrera if they planned to engage with providers to increase their interest in and use of telehealth. Herrera responded that two large academic centers (Johns Hopkins University and the University of Maryland) are already doing a significant amount of telehealth, and have their own telehealth departments. Herrera noted the centers are very involved in the advisory committee in providing subject matter expertise (e.g., equipment, standards of care). Herrera added that once Maryland Medicaid makes a decision, they will go forward with educational efforts for providers.

Specific Populations

One participant asked if any of the panelists had experience with using telehealth for the Department of Corrections. Rheuban responded that in Virginia, telehealth is a large element of service delivery, but that this population is managed by a different department than the Department of Medical Assistance Services. She added that there are correctional telehealth programs around the country that have been very successful.

Another participant asked about expectations for managing chronic disease through telehealth. Landgraf noted that in meeting with Medicaid managed care organizations, they have observed that traditional chronic care disease management is not producing the desired outcomes. She said they are working together to determine the high-cost drivers, choose methodologies, and conduct real-time evaluation to determine benefits. Jones added that like many states, the 30 percent who are in fee-for-service Medicaid are often the most costly. She said that when they talk about care coordination for this population, they might suggest the use of telehealth, but they cannot require its use.



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