Wednesday, October 28 – Arlington, VA – Individuals living in rural and underserved settings encounter challenges that others may not regularly experience. Barriers to healthcare include factors such as mismatched clinician supply and demand, long distances between patient homes and sites of care, and isolation measures during Covid-19 that prevent ongoing in-person visits.
Traditional therapies in the United States may not be able to sufficiently address the increase in unmet medical needs that are emerging during this pandemic. DTA’s report “Digital Therapeutics: Reducing Rural Health Inequalities,” calls for Medicare and Medicaid to leverage evidence-based digital therapeutics (DTx) to address critical gaps in care for underserved populations, regardless of whether disparities are based on patient age, language, culture, income, disease state, or geography.
Value of DTx Products in Providing Care to Underserved Populations
Building on the ease of DTx product scalability and access through patient-owned devices, digital therapeutics create new treatment and self-management options for a broad range of chronic and mental health conditions. DTx products can easily reach high-risk, rural, and underserved populations who often lack access to healthcare services even during the best of times. This include digital therapeutics’ ability to:
- Easily scale and be accessible via a smartphone or tablet;
- Discretely deliver therapy to patients in their home environments;
- Offer therapy independent of a patient’s work or education schedule;
- Provide some therapies in languages such as Spanish, Arabic, German, and French;
- Lower stigma that may be associated with the delivery of certain traditional therapies;
- Directly impact life and disease state outcomes; and
- Provide meaningful results and insights on personalized goals and outcomes.
Unbalanced DTx Access Across Underserved Populations
While numerous patients who receive their insurance coverage through private payors and employers in the U.S. have access to DTx products, low income and aging populations covered by Medicare, Medicaid, and other publicly funded programs generally do not have access to these important therapies. Until Medicare and Medicaid begin providing patients with access to remotely delivered therapies and enable the formal reimbursement of DTx products, there will continue to be an unbalanced ecosystem.
Policy Solutions for Underserved Populations
Comprehensive, multi-faceted solutions are necessary to achieve healthcare parity for rural residents. It is crucially important that a key component of these plans include the expansion of digital therapeutic coverage and patient access. We encourage legislators to direct CMS to expand access to DTx products as follows:
- Formally recognize DTx products. Officially define and recognize DTx products in legislation so that Medicare and Medicaid patients have access to these critical – and quickly evolving – therapies.
- Codify DTx product coverage. Require CMS to assure that Medicare and Medicaid covers technologies that meet the definition of a digital therapeutic.
- Expand clinician coding and payment. Direct CMS to ensure adequate payment mechanisms exist to pay primary care providers and clinicians engaged in the authorization and clinical use of a DTx product.
Digital therapeutics offer a new ability to provide interventions to patients in rural and underserved settings. These opportunities — among others — can only be capitalized on if Medicare and other publicly funded programs create an adequate clinical payment mechanism and patient access pathway for high quality, clinically-validated DTx products.
The Digital Therapeutics Alliance (DTA) is a global non-profit trade association of industry leaders and stakeholders with the mission of broadening the understanding and adoption of digital therapeutics into healthcare. DTA works to enable expanded access to high quality, evidence-based digital therapeutics for patients, clinicians, and payors in order to improve clinical and health economic outcomes. To learn more please visit: www.dtxalliance.org.