News Blog

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill
Thursday, March 29, 2018

The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth providers, hospitals, and entrepreneurs need to cut through the hype and understand what the provisions will really do for telehealth. This article summarizes the key takeaways and insights on how the recent legislation will benefit the telehealth industry.

Significant Changes for Medicare and Telehealth Services

The bill introduces some of “the most significant changes ever made to Medicare law to use telehealth,” according to Senator Brian Schatz, a longtime sponsor and proponent of federal telehealth legislation. Key elements of the bill include: (1) expanding stroke telemedicine coverage; (2) improving access to telehealth-enabled home dialysis oversight; (3) enabling patients to be provided with free at-home telehealth dialysis technology without the provider violating the Civil Monetary Penalties Law; (4) allowing Medicare Advantage (MA) plans to include delivery of telehealth services in a plan’s basic benefits; and (5) giving Accountable Care Organizations (ACOs) the ability to expand the use of telehealth services.

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Telemedicine Credentialing by Proxy: What Hospitals and Telehealth Companies Need to Know
Thursday, March 29, 2018

Hospital-based telemedicine services continue to rapidly expand across the country, allowing providers to deliver care to rural areas and better allocate the staffing and availability of specialist physicians such as neurologists and emergency medicine. However, despite the uptick in telemedicine services at hospitals, many medical staff offices still use the traditional “primary source verification” process to credential physicians. For example, in the Foley & Lardner 2017 Telemedicine & Digital Health Survey Report, only 33% of respondent hospitals or provider groups use telemedicine credentialing by proxy. The traditional credentialing process is far more time-consuming and costly than credentialing by proxy, and hospitals (particularly originating site hospitals that receive/purchase telemedicine services) should consider how to take advantage of the streamlined credentialing by proxy process offered by both CMS and the Joint Commission. At the same time, non-hospital telemedicine companies and provider groups (i.e., the distant site providers delivering/selling telemedicine services), should consider structuring their operations and processes to allow the use of credentialing by proxy with their clients. It can reduce the onboarding and go-live time from several months to several days, thus allowing telemedicine providers to start delivering services much more quickly.

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Five Worrisome Trends in Healthcare
Thursday, March 29, 2018

4. The undermining of the private healthcare market. "Just recently, we have gotten rid of the individual mandate, and the [cost-sharing reduction] subsidies that were [expected to be] in the omnibus bill ... were taken out of the bill," he said. And state governments are now developing alternatives to the ACA such as short-term duration insurance policies -- originally designed to last only 3 months but now being pushed up to a year, with the possibility of renewal -- that don't have to adhere to ACA coverage requirements, said Burrell.

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Paper health records have privacy risks, study finds
Tuesday, March 27, 2018

  • Despite strict laws requiring healthcare providers to secure patients’ personal information, some organizations risk privacy breaches by disposing of paper-based records in garbage and recycling bins, according to a research letter published this week in JAMA.
  • The authors conducted a recycling audit of five Toronto, Ontario, teaching hospitals from November 2014 to May 2016 and found personally identifiable information (PII) and personal health information (PHI) in recycling at each of them.
  • PII totaled 2,687 documents and included patient identifiers, prescriptions, test results and billing forms, among other information. Of those, 1,042 were deemed “high sensitivity," meaning they had PII and a description of their medical condition. Another 843 included the patient’s diagnosis.


Millennials more likely to use walk-in clinics, telemedicine, survey shows
Tuesday, March 27, 2018

  • Younger consumers are opting for nontraditional ways of engaging with healthcare and applying their shopping behaviors to the decisionmaking process, a new EBRI Research survey finds.
  • Millennials — those born between 1980 and 2000 — are also more than twice as likely as baby boomers to use a walk-in clinic (30% versus 14%) and more than twice as likely to consider telemedicine (40% versus 19%).
  • They are also more likely to research their care options online. For example, 51% of millennials report checking a doctor’s or hospital’s rating and 28% use cost tracking, too. Those figures drop to 31% and 10% for baby boomers.


JAMA analysis supports EHR use safety
Tuesday, March 27, 2018

  • Concerns that EHRs may contribute to patient harm are real but, according to one research letter published in JAMA on Tuesday, the actual number of incidents appears to be extremely low.
  • Of 1.7 million safety reports, just 1,956 (0.11%) named an EHR vendor or product and potential patient harm and 557 (0.03%) specifically suggested EHR usability factored into the problem.
  • The analysis includes reports from 2013 through 2016 on 571 Pennsylvania-based healthcare facilities and a large academic healthcare system outside the state. Only reports that mentioned one of the top five EHR vendors or products and noted possible harm were included.


The truth about medical bankruptcies
Tuesday, March 27, 2018

Pop quiz: What percentage of bankruptcies in the United States are caused by medical bills?
If you lived through the debate over passing Obamacare, you probably answered something like “half.” That was the figure in common currency among advocates of health-care reform; then-Sens. Chris Dodd (D-Conn.) and Hillary Clinton (D-N.Y.) were just two of the prominent advocates who used it. Other variants were also popular; Barack Obama, for example, was fond of saying that “the cost of health care now causes a bankruptcy in America every 30 seconds.”
It’s a memorable number. But it’s almost certainly many times the true count.

The figure was based on a series of papers released by a team including Sen. Elizabeth Warren (then a professor at Harvard Law School) and co-authors David Himmelstein and Stephanie Woolhandler of Physicians for a National Health Program. Theirs was hardly the only paper to attempt an estimate of medical bankruptcies, but no one else got eye-popping numbers like that — or nearly so much attention from the media.

Critics at the time, including me, pointed out that there were all sorts of problems with the data, but none of the critiques had the viral charms of the original study. But behind the scenes, the debate has continued. And last week, the New England Journal of Medicine published a new estimate done by a team of health and labor economists.
Their method is considerably more robust than the one adopted by Warren et al., who looked at the presence of medical bills in bankruptcy filings. The problem with doing that is that bankruptcy tends to be multi-causal. If you have a half-million-dollar house, three luxury cars, a boat — and also a heart attack — which of these things “caused” your bankruptcy?
More: 2018-03-27 Healthcare Dive [issue:14626]&utm_medium=email&utm_source=Sailthru&utm_term=.67a7910043ee   ...

Without Context Or Cushion, Do Online Medical Results Make Sense?
Tuesday, March 27, 2018

As she herded her two young sons into bed one evening late last December, Laura Devitt flipped through her phone to check on the routine blood tests that had been performed as part of her annual physical. She logged onto the patient portal link on her electronic medical record, scanned the results and felt her stomach clench with fear.
Devitt’s white blood cell count and several other tests were flagged as abnormal. Beyond the raw numbers, there was no explanation.
“I got really tense and concerned,” said Devitt, 39, a manager of data analysis who lives in New Orleans. She immediately began searching online and discovered that possible causes ranged from a trivial infection to cancer.
“I was able to calm myself down,” said Devitt, who waited anxiously for her doctor to call. Two days later, after hearing nothing, she called the office. Her doctor telephoned the next day. She reassured Devitt that the probable cause was her 5-year-old’s recent case of pinkeye and advised her to get tested again. She did, and the results were normal.
“I think getting [test results] online is great,” said Devitt, who says she wishes she had been spared days of needless worry waiting for her doctor’s explanation. “But if it’s concerning, there should be some sort of note from a doctor.”
Devitt’s experience illustrates both the promise and the perils of a largely unexamined transformation in the way growing numbers of Americans receive sensitive — sometimes life-changing — medical information. A decade ago, most patients were informed over the phone or in person by the doctor who had ordered testing and could explain the results.

More: 2018-03-27 Healthcare Dive [issue:14626]&utm_term=Healthcare Dive   ...

Telehealth Billing Compliance: Medicare Says Goodbye to the GT Modifier
Tuesday, March 27, 2018

For over a decade, Medicare has required providers to append special modifiers to their CPT and HCPCS codes when billing for telehealth services. The two primary modifiers for telehealth services were GT (indicating the service was delivered via an interactive audio and video telecommunications system) and GQ (indicating the service was delivered via an asynchronous telecommunications system). Effective January 1, 2018 that has changed because CMS has decided to largely eliminate the requirement to use the GT modifier on telehealth claims.
Instead of using the GT modifier, providers must mark their telehealth services claims with “Place of Service (POS) 02.” A POS code is required on professional claims for all services – telehealth or otherwise – and using POS 02 signals to Medicare that the service was provided via telehealth. Previously, providers were instructed to use the POS code for where the patient was located at the time of the service. Effective January 1, 2018, POS 02 is to be used for all telehealth services under Medicare. The introduction of POS 02 rendered it unnecessary to also require the distant site practitioner report the GT modifier on the claim.

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Former telemedicine leader cofounds AI, robotics, automation group to support healthcare industry adoption
Friday, March 23, 2018

The former CEO of the American Telemedicine Association, Jonathan Linkous, has joined forces with medical textbook and journal publisher Mary Ann Liebertto launch a group to help healthcare organizations address the challenges of implementing advanced technology from artificial intelligence and automation to robotics.
The new group comes into being at a time when machine learning, a form of AI, is becoming more widely used or at least piloted by the healthcare sector, as health tech companies adopt different ways to use it to speed up analysis of large amounts of data. But adoption has been limited by the need to better understand how the algorithms behind machine learning tools arrive at their analysis.
The Partnership for Artificial Intelligence and Automation in Healthcare (PATH) is designed to bring together health systems, payers and regulators to find how these technologies can improve the delivery of medicine, reduce costs and expand access to healthcare services to millions of people across the globe, according to a news release from the new group.
The group plans to highlight emerging innovations so as to improve understanding of these new technologies and how they can be harnessed to advance patient care. PATH also plans to establish priorities for navigating barriers such as regulatory hurdles, provider and consumer acceptance, and payer policies, according to its website.
“AI and related innovations have already enabled industries such as banking, aviation, and entertainment to grow, provide higher quality products, and allow consumers greater choice,” Linkous, PATH CEO, said in the news release. “With spiraling costs, increasing need, decreasing resources, and rapidly advancing technologies, healthcare desperately needs to catch up.”

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