Specifications include, but are not limited to: The NJ Department of Health (DOH) is looking to engage one (1) or more vendors {contractors} to conduct a statewide assessment concerning telemedicine and telehealth as stipulated in P.L. 2021, Chapter 310. The intent of the legislation is to determine whether or to what extent the provision of a telemedicine/telehealth system of health care services may improve the quality of care.; The SOW is provided to identify the work to be completed by the selected Vendors {Contractors}, on behalf of DOH, as stipulated in P.L. 2021, Chapter 310 to conduct a statewide assessment concerning telemedicine and telehealth. The intent of the legislation is to determine whether or to what extent the provision of a telemedicine/telehealth system of health care services may improve quality of care. The primary areas to be addressed, in the study, are listed below. However other areas may also be identified by NJDOH: 1. Clinical Efficacy 2. Standard, Quality, or Cost of Care 3. Utilization Management 4. Health Equity and Disparities, Provider Availability/ Network Adequacy in rural and other underserved populations At the conclusion of the study, the Vendor {Contractor} will provide a written report to NJDOH outlining its findings and recommendations that shall not be binding on any health benefits plan in NJ, State Medicaid and NJ Family Care, the State Health Benefits Plan, or the School Employee’s Health Benefits Plan. The study and scope of activities include the following: I. A statewide comparative study identifying if established provider rates for services delivered as inperson contact and consultation may be applicable and reimbursed when provided through telemedicine or telehealth services. II. Consideration for the adoption or impact of reimbursement requirements for telehealth and telemedicine in other jurisdictions as determined by NJDOH as necessary for inclusion in the study. 1) The effect of the availability and provision of health care services delivered through telemedicine or telehealth on utilization, access to care, patient outcomes, and patient satisfaction. a. Clinical Efficacy- surveying how the use of telehealth has reduced the number of nocalls/cancellations and greater patient adherence to attending follow-up appointments. Whether the delivery of services through telemedicine or telehealth effect the standard of care, quality, or cost of care. 2) Whether different or more stringent utilization management requirements recommendations should be adopted for coverage and payment for health services delivered through telehealth or telemedicine. a. Better Utilization Management- how the standard of care has not diminished with the use of telehealth in certain types of practice where an “in-person visit or exam” can be conducted in the same manner via telehealth with the right settings and proper audio/visual components. 3) How the incentivization of the provisions of telehealth and telemedicine services impacts underserved populations. 5 | P ag e a. Health Equity / Disparities- the ability to receive (CMS) reimbursement with the expansion of phone (audio) only for certain services, in addition to the traditional audio/visual requirement has allowed for better access, especially for those with poor internet connectivity or access to “smartphone” technology. b. Provider Network availability (address concerns about interstate compact practice) – review and research if the impact of telehealth/telemedicine services has improved access to care where there is a shortage of providers in those underserved areas.
