Landscape of Business Models in Teledermatology
Effective business models for teledermatology must be implemented to make the practice a feasible option for dermatologists to deliver care. This study sought to detect and report types of teledermatology business models in practice. We interviewed 19 private and academic dermatologists who have been reimbursed for teledermatology services. Most respondents described teledermatology business models fitting 4 categories—standard fee-for-service reimbursement from insurance, capitated service contracts, per-case service contracts, and direct to consumer—which are described in this article. We also anticipate new teledermatology business models will be needed as technology and insurance reimbursements evolve.
Practice Points
- Teledermatology services may improve access to dermatology care but are limited by lack of reimbursement.
- Different business models have been successfully implemented for use of teledermatology in different care settings.
- As more legislation incentivizing telemedicine is enacted, the standard fee-for-service business model for teledermatology likely will expand.
Because most states require that providers hold a medical license in the jurisdiction where their patient is physically located, physicians providing teledermatology services across state lines could face additional licensure requirements. However, these requirements would not be a barrier for physicians providing teledermatology services within the context of an in-state referral network. Licensure requirements generally do not restrict physician-to-physician consultations.7
Conclusion
As reimbursement models across medicine evolve and telemedicine continues to enhance delivery of care, we anticipate that quality-based reimbursement ultimately will drive successful utilization of teledermatology services. Telemedicine has been noted to be a cost-effective tool for coordinating care, maintaining quality, and improving patient satisfaction.8 Although none of the teledermatology business models surveyed currently incorporate incentives for faster case turnaround or higher patient satisfaction, we expect models to adjust as quality measures become more prevalent in the reimbursement landscape. Effective business models must be implemented to make teledermatology a feasible option for dermatologists to deliver care and patients to access care.
