Time is Brain: The Impacts of Telestroke Legislation on the Greater American Population

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Joseph M. DeVivo, InTouch Health CEOBy Joseph M. DeVivo, InTouch Health CEO

You probably know it quite well. In the United States alone, it is the fifth leading cause of death for men and the fourth leading cause of death for women. It impacts 800,000 individuals annually. And kills 180,000 Americans each year.

It’s a stroke.

Stroke impacts hundreds of thousands of families across the United States – from rural communities to major metropolitan areas. When it comes to treatment, speed is critical because the difference between life and death can be mere hours making access to specialists critically imperative regardless of the patient’s geographic location. The more quickly a stroke victim is treated, specifically within 3-4 hours of symptom onset, the better his/her chance of an improved outcome and survival rate. The main problem: there is currently a drastic shortage of stroke specialists available to meet the demand.

Bridging barriers to care with telestroke technology.

Telestroke brings specialized neurological care to where it is needed most, enabling the remote evaluation, treatment and monitoring of patients through electronic communications devices regardless of location.  Telestroke is ideal for overcoming multiple barriers to care – from rural isolation and long-distance travel times, to a shortage of neurologists at a hospital – which cuts down treatment time and ensures patients are receiving proper care within the window of treatment.

When time is brain, minutes are precious.



Science tells us that a person’s chronological age is a primary risk factor for stroke. Because of this, recognizing that the U.S. elderly population is growing should be a major cause for concern in America. According to the CDC, stroke as a disease costs the country approximately $34 billion each year. This number will only continue to rise as boomers age and demand increases for dedicated stroke care.

In fact, 66 percent of hospitalizations for stroke occur in adults 65 years and older who are Medicare eligible or are Medicare beneficiaries, placing a significant responsibility and hardship on the U.S. healthcare system.

Current legislation is limiting.

Unfortunately, current legislation limits Medicare coverage and reimbursement of acute stroke telehealth services – only covering telestroke treatment for those located in rural areas which creates new barriers to care.

Here are a few of the facts:

  • Medicare’s annual budget is $600 billion+ and covers approximately 58 million beneficiaries.
  • 94 percent of strokes occur in nonrural locations.
  • But access to telestroke and other telehealth services under Medicare are limited due to geographic restrictions, meaning that, 77% of Medicare’s beneficiaries who live in nonrural locations are not covered for these services.

According to a report by the U.S. Government Accountability Office, Medicare used telehealth to treat less than 1 % of their beneficiaries between 2014 through 2016.

This is an unacceptable number.

While there have been concerns by the Centers for Medicare and Medicaid Services about the overutilization of telemedicine for patient doctor visits, this is not applicable for stroke victims. Stroke is an emergent medical condition. Telemedicine will not increase the number of stroke victims, but telemedicine will instead increase patient access to high quality care. A MedPac report to Congress from June 2016 shows that, “telehealth services (the use of two-way video to connect stroke patients in the hospital ED with neurologists in distant locations for evaluation and monitoring) may be the best example of positive results [for telehealth].” (P. 231)

As boomers continue to register for Medicare, the rate of enrollment will skyrocket through 2030. Congress must recognize a shift in the way care is delivered to ensure this population receives the best care possible, when time matters the most.

There is no time to wait. We need change now.

By enacting telestroke legislation, we can enable hospitals to transfer both specialized medical expertise and needed treatment across physical and geographic barriers to ensure our fathers, mothers, sisters, brothers, partners and friends have a better chance for positive health outcomes regardless of where they live.

Seconds count when a stroke occurs. By supporting the following legislation, we hope to increase access to care, allowing ALL Medicare beneficiaries to have equal access to the same high-quality, life-saving care, as quickly as possible.

  • S.431 & HR.1148: Furthering Access to Stroke Telemedicine (FAST) Act
  • S.870: CHRONIC Care Act of 2017
  • S.1016 & HR.2556: CONNECT for Care Act of 2017
  • HR.2550: Medicare Parity Act of 2017
  • HR.3360: Telehealth Enhancement Act

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