Many health care providers are rolling out telehealth programs, but they’re having trouble getting reimbursed for those services by insurance companies, says a new survey of 100 senior healthcare systems executives by Foley & Lardner LP, a Chicago law and market analysis firm.

68% of survey respondents say they are “well beyond” implementing telemedicine, compared with 53% of healthcare organizations that were in a growth or expansion phase.

However, 59% called reimbursement for telehealth their biggest problem with these programs, ahead of state licensing requirements at 44%.

More than 80% of respondents noted telemedicine was their top digital initiative, ahead of mobile apps, remote patient monitoring and electronic health records. Providers and patients are largely satisfied with the telemedicine platforms they are using, with over half of the organizations that track return on investment reporting savings of 10% or more.

Patients also seem to be satisfied with the quality of telehealth services they are getting from providers, with 32% of healthcare organizations reporting that patients say they are “extremely satisfied with their digital visit compared with 41% that are satisfied and 3% that were dissatisfied.

“The pendulum has swung to really embrace telemedicine, which wasn’t close to being adopted and implemented on this scale when the respondents were first surveyed in 2014,” says Nathaniel Lacktman, a partner and healthcare lawyer with Foley & Lardner and chair of the firm’s telemedicine industry initiative. “Healthcare providers, entrepreneurs, and patients have realized the potential to improve the quality of care in a more convenient, cost-effective manner.”

Other survey findings indicate that healthcare providers are exploring using telehealth as a channel for international expansion. “Despite legal and regulatory uncertainties, 54% of respondents said they offer or are interested in offering telemedicine services on an international scale,” the survey says.

But there are obstacles to expanding telehealth. More than half of healthcare system executives cited reimbursement from carriers and others as the greatest challenge to implementation. While 75% of executives reported that all or some of their telemedicine services were reimbursed, one-third of respondents also noted that payment rates were lower than in-person services in a clinic or the emergency room.

Physician buy-in, which was ranked as a major concern by 39% of respondents in a 2014  Foley & Lardner telehealth survey, fell to 32% this year, “as organizations appear to be making progress in winning over traditionally skeptical providers,” the law firm says.

Among other challenges, 25% of executives say they were having trouble obtaining institutional leadership, support and funding for telemedicine programs. “Healthcare organizations must look beyond short-term uncertainty in areas like reimbursement and regulation to form a long-term view of how this technology can augment their delivery system,” says Foley & Lardner.

Consumer telehealth is not yet a mainstream healthcare delivery channel, but the potential for much greater use of digital doctor visits by patients is likey, Lacktman says. “It (telehealth) isn’t as ubiquitous as using the ATM, but there is a real uptick in usage.”

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