the aca didn't change anything about the way telehealth services are paid for. it remains the way it has for the last couple years. medicare covers a small range of services, state medicaid programs cover more. there's actually a resource god out there that catalogues the 50 states in which medicaid programs cover. private insurers have not stepped up much outside of closed systems such as kaiser. the biggest innovation is what is going on in the va. and we talked about as you talk about aco and shared savings and focus more on the outcome and less on site of service delivery, telehealth may be a national fit with where health care is going and where it's been where the concern is on volume and the payment for that particular service. >> some of the healthcare systems and organizations may be our early adopters of telehealth because it works with management of patients and other. -- making care more accessible, one example being telehealth in an emergency room and you bring a board-certified physician into the virtual presence of the er that starts out with a nu

i think that the potential for telehealth is still i would say in its infancy.so we really can take this too many different levels. i think the point that you are making and the veterans have made providing care where the veterans live in that community, i think is the message we've taken to heart. and we have done a lot but we need to do a lot more. i think that the days of asking the veterans to drive 200 miles, 150 miles to come to the mothership and be able to receive care, i think has to be a passÉ. we need to move on to the point where we're able to provide more services either in our committee based outpatient clinics or potentially in their homes. so yes, that a certain area that we're looking at very actively and we will continue to expand that. >> thank you. and again thank the panelists for being here today, and i yield back. >> i'm just going to ask a couple more closing questions. dr. guice, looking at the gao report from january this year, it's as we found that military health care providers do not have a consistent understanding of their responsib

i think the potential for telehealth is still, i would say, in the infancy. we really can take this to many different levels. i think the point that you made and veterans made providing care where the veterans live in that community, i think, is a message that we have taken to heart, and we've done a lot, but we need to do a lot more. i think that the days of asking the veterans to drive 2 # 00 miles or 150 miles to come to the mother ship and be able to receive care i think has to be a passe, and we have to move on from the point where we're able to provide more services, either in our community-based out patient clinics or, potentially, in their homes. yes, that's app area we are looking at actively and will continue to expand that p on the phone: thank you, and, again, i thank the panelists for being here today, and i yield back. >> i'm just going to ask a couple more closing questions. you know, looking at the goa report from january of this year as we found that military health care providers do not have a consistent understanding of the responsibilities