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Nursing homes that use telemedicine during off hours send fewer patients to hospitals, compared with those using no telemedicine services. Six hospitals in the study were trained to use a new telemedicine system (five hospitals waited 11 months to adopt the telemedicine system and were used as controls). In the six intervention facilities, hospitalization rates fell 11.3% in the four that were “more engaged” in telemedicine use but only 5.3% in the two that were “less engaged.” Telemedicine services cost $30,000 yearly, which in turn saves Medicare $151,000 in hospitalization costs. Currently, though, nursing homes pay telemedicine costs, whereas Medicare receives the savings. Innovative programs, such as the accountable care organization model of the Affordable Care Act, are needed to overcome this disincentive. “Until adoption of these innovative payment and financing models increases, we do not believe that the business case for telemedicine services in nursing homes is a strong one,” write the authors in February's Health Affairs.