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    New Mexico Telehealth Alliance TELEHEALTH RESOURCES | COMMUNITY | PROGRAM SUPPORT Connecting New Mexican's to Better Health. The New Mexico Telehealth Alliance (NMTHA) is a tax-exempt 501(c)(3) non-profit corporation dedicated to promoting telehealth solutions that deliver quality healthcare throughout the state. The NMTHA is a network of members representing a broad spectrum of public and private healthcare organizations. The NMTHA provides program support enabling members to effectively share resources. Board members and officers are all volunteers. ​ Vision: Through the efforts of the NMTHA’s work on policy, quality, and equitable access to telehealth services, New Mexicans will be able to get the care they need when they need it. Mission: To advance effective use, equitable access, and sustainability of delivering telehealth services in New Mexico. Why is an Alliance needed? Click here to learn more. Special Announcement: AUDIO-ONLY Billing in New Mexico. View the NMTHA communication with the Office of the Superintendent of Insurance. See Details Be part of the solution! Join the New Mexico Telehealth Alliance Telehealth and telemedicine are no longer an innovative approach to healthcare - they are a necessary part of it. More than ever, access to quality healthcare, especially in New Mexico, is fundamental to the wellbeing of many communities, especially in rural and territorial areas. Supporting the New Mexico Telehealth Alliance through membership helps ensure access to meaningful information and supports the viability of telehealth services in New Mexico. Membership Matters Benefits of Membership Stay Connected! Stay connected with the NMTHA community. Sign up to receive updates and notifications on industry trends, latest Telehealth news, events, and more. Thanks for submitting! Submit


    Events Webinars & Featured Videos FEATURED WEBINAR NMTHA Town Hall Event: The Future of Telehealth As our world changed due to the COVID-19 pandemic, so did the world of Telehealth. But what happens next? Featuring nationally recognized speaker and Telehealth pioneer Dr. Weinstein, plus Russel Toal from New Mexico's OSI. Access Video FEATURED SERIES Experts in Telehealth: An Interview Series NMTHA brings "Experts in Telehealth" a video series interviewing experts from various areas within the Telehealth arena. Access Video Past Webinar Series 10-week Educational Series Access Videos Still available from our 2021 10-week educational series are webinars focused on data, broadband in New Mexico, client engagement, and more! These webinars were hosted by the New Mexico Telehealth Alliance and made possible through funding by Health Resources and Services Administration Office for the Advancement of Telehealth and the Southwest Telehealth Resource Center. ​ Fall 2021 Webinar Series Topics include the future of telehealth, billing, using telehealth for clinical specialties, and more. Access Videos

  • Telehealth Requires Efforts to Improve Access to Reach Full Potential

    Telehealth Requires Efforts to Improve Access to Reach Full Potential Mark Melchionna November 29, 2022 New research found that telehealth expansion lacks benefits when efforts to improve access are not present, which may often lead to health disparities. Regions with limited healthcare resources may not benefit from telehealth expansion, prompting the need for efforts to improve access, a new JAMA Network Open study finds. Throughout the recent expansion of telehealth, researchers continuously gained insight into new methods for reaching areas with limited amounts of healthcare resources, highlighting many areas and populations facing limited healthcare resources. The fact and theories about the relationship between telehealth and health disparities led researchers to conduct a cross-sectional study containing 2015 to 2019 American Community Survey data which was linked to national, state, and county-level metrics of healthcare access. Prior to the study, the authors hypothesized that internet access was poor in areas that lacked sufficient access to traditional healthcare resources. Known as healthcare deserts, communities with limited healthcare services such as pharmacies, hospitals, PCPs, and low-cost health centers were reviewed for the study. The data sources included dataQ and GoodRx databases for 60,249 pharmacies, federal information on primary care health professional shortage areas, and geospatial information. Researchers calculated the proportion of populations with internet access and the expected number of healthcare deserts, which represented the population-weighted mean number of deserts in a given region. They also noted statistics for metropolitan status for each state. Among 3,140 counties reviewed in the study, researchers determined that healthcare access and internet service availability corresponded with one another. They found that the states with the largest percentage of households without internet service were Mississippi, Arkansas, Louisiana, New Mexico, West Virginia, and Alabama. The states with the lowest number of households without internet service and the lowest fitted number of healthcare deserts were Washington, New Hampshire, Colorado, Utah, California, and Maryland. Rural areas were more likely to have more health deserts and less internet service availability —78 percent compared to 26 percent of urban counties. Based on these findings, researchers concluded that telehealth expansion may not produce benefits within counties where telehealth is highly needed. Key factors that contribute to rural-urban health disparities in the US may include telehealth expansion without improving internet access as well as clinician shortages. Despite this conclusion, researchers noted limitations, which mainly related to the lack of digital literacy data that may have increased urban-rural disparities, along with the co-occurrence of poor internet and healthcare access across six domains. Previously, however, efforts have been made to support rural communities in obtaining telehealth resources. In September, Equum Medical worked with the National Rural Health Association to provide underserved rural communities with virtual resources. The goal of the collaboration was to assist rural hospitals as they aim to fill gaps in specialty care through tools such as of patient transfer assistance, remote patient monitoring, and help with telehealth implementation. See original article: < Previous News Next News >

  • News

    Telehealth Requires Efforts to Improve Access to Reach Full Potential New research found that telehealth expansion lacks benefits when efforts to improve access are not present, which may often lead to health disparities. November 29, 2022 Read More Can virtual nursing help ease clinician burnout? The turnover rate for nurses stands at 27%. Can telemedicine save the day? November 14, 2022 Read More Patients prefer telehealth for common illnesses, study shows But more than half are concerned about the quality of care they're receiving, according to the Software Advice survey. One of the firm's analysts dives into the results. November 23, 2022 Read More New Coding Modifier Offers Opportunity To Investigate Audio-Only Telehealth Prior to the pandemic, Medicaid program coverage of audio-only telehealth services was limited. During the early stages of the pandemic, Medicaid beneficiaries were significantly less likely to complete telehealth visits compared to commercially insured patients. This was likely due to a series of obstacles, including: lack of access to high-quality broadband, a device with video capability, requisite digital skills, and private space to conduct the visit. November 18, 2022 Read More Suicide Prevention and Stigma Reduction with Dr. Alison Arnold Danielle speaks with Dr. Alison Arnold, the Director Interdisciplinary Center for Community Health & Wellness at Central Michigan University (CMU). November 18, 2022 Read More Industry News

  • Can virtual nursing help ease clinician burnout?

    Can virtual nursing help ease clinician burnout? Bill Siwicki November 14, 2022 The turnover rate for nurses stands at 27%. Can telemedicine save the day? No hospital or health system is immune from the challenges of the nationwide nursing shortage. As organizations look for ways to reduce the administrative burden on nurses and improve engagement and satisfaction, virtual nursing is one consideration. Many tasks performed by nurses in the inpatient setting are repetitive – a virtual nursing unit allows nurses to manage these tasks remotely. Bedside nurses and staff then are freed up to focus on patient-facing care, while those in the virtual unit can monitor patients, enter data in the medical record and more. To better understand the ins and outs of virtual nursing, we interviewed Dr. Shayan Vyas, senior vice president and medical director for hospitals and health systems at Teladoc Health. Q. What is the national nursing shortage like today? How does it play out in hospitals and health systems? A. Every health system I've spoken with, that we work with, says workforce challenges are among the top three issues keeping them up at night. This is particularly true for nursing staff. In 2021, nurses were leaving the profession at an alarming rate. According to NSI Nursing Solutions, the turnover rate for nurses increased by 8.4% in 2021 and currently stands at 27%. An increase in patient volume and occupancy rates, among other factors, have led to severe emotional and physical exhaustion and, ultimately, job dissatisfaction and burnout. A 2021 McKinsey survey found that 32% of nurses were likely to leave their current position due to insufficient staffing levels, a lack of support and the emotional toll of the job. President Obama once said that "nurses are the heartbeat of the United States healthcare system," and I really believe that to be true. They put their lives on the line to serve and care for others every single day, and we need to give them the tools to more effectively, efficiently and safely care for others and save lives. Virtual care offers new strategies to address these challenges; virtual nursing is an important component that health systems can include in their transformation and care delivery redesign initiatives. Q. What is virtual nursing, and how does it work? A. Virtual nursing, simply put, is the delivery of nursing care and services from a remote location. Virtual nurses are responsible for monitoring multiple patients while collaborating with the nurses, physicians, therapists and other staff who provide care at the patient's bedside. The virtual nursing unit can be centralized (for example, nurses work from a command center in a healthcare facility), distributed (nurses work from home or other remote locations) or hybrid. Adopting virtual nursing provides a way to mitigate potential staffing losses due to short-term injury or other conditions that require nurses to be off their feet. It is also a way to extend nurses' careers, for example, by offering nurses with developing or chronic physical limitations the option of working seated in a command center, instead of providing physically challenging care on a nursing unit. Virtual nursing programs also can help attract nurses by providing different options for shifts and work styles. This model supports organizations by enabling them to have virtual nurses work from anywhere – allowing them to provide much-needed care and services without requiring nurses to relocate so that they live close enough to a hospital to be able to go on-site for their shift. It also helps new nurses with clinical support, medication verifications and overall non-physical patient bedside care assistance. Health systems that have created virtual nursing programs to augment their bedside nurses have found virtual nursing can extend nurses' careers and improve job satisfaction for floor nurses by taking away responsibility for many tasks that do not require physical touch. This allows the bedside nurse to focus on hands-on patient care and contributes to higher patient satisfaction because of the responsiveness and additional attentiveness it enables. Virtual nursing can also allow advanced nurse practitioners like PAs and ARNPs the ability to connect virtually with a virtual intensivist, and the virtual nurse can help with many of the nonphysical contact needs of patient care. Q. How can virtual nursing reduce the administrative burden on nurses and improve engagement and satisfaction? A. While hands-on care will always be needed, many duties can be fulfilled virtually, including coordinating procedures, getting sign-offs from multiple care team members, reconciling medications, providing patient education, answering questions, initiating the discharge process and more. In many successful virtual nursing programs, administrative tasks like discharge paperwork, medication reconciliation, etc., have been shifted from bedside to virtual nurses. Virtual nursing systems enable virtual nurses to monitor patients and communicate with them, their families, and other visitors and care team members in real time, including responding to patient nurse calls. The goal is to provide a new level of support to patients, nurses and the bedside team. Several health systems with virtual nursing programs have reported high job satisfaction for their virtual nurses. Nurses say the virtual role enables them to spend more time with patients overall. The extra time, and the complementary nature of virtual and bedside nursing roles, contributes to improved job satisfaction for both bedside and virtual nurses, and positive experiences for patients. Q. Please talk a bit about one of your hospital clients using virtual nursing and the results they've achieved. A. Overall, the benefits of virtual nursing include staffing flexibility, potential retention and recruitment advantages, the ability to leverage staff resources, and favorable nurse and patient satisfaction. Another major benefit of virtual nursing is a reduced length of stay, resulting in improved throughput, as well as time saved in the discharge process. Some lesser-known benefits of virtual nursing are a differentiated and improved patient experience, with potential associated improvements to patient satisfaction and HCAHPS and NPS scores. Patients also are seeing a significant improvement in satisfaction as they no longer have to pull a bedside staff member to help answer questions or assist with administrative documentation. Our client, Saint Luke's Health System in Kansas City, Missouri, has helped address the nursing shortage by having virtual nurses support bedside nurses. The virtual nurses can assist with non-hands-on care, education, documentation, admission, discharge, answering questions, and reviewing the care plan or physician rounding with the patient and their loved ones, among other tasks. The unit has enhanced Saint Luke's bedside care response rates, increased patient and nurse satisfaction, reduced the burden on bedside nurses, and positively impacted quality and safety for a better work environment. Patients are discharged within two hours of the discharge order, some 20% faster than in other units, and they're also out of the hospital before noon at a 44% faster rate. This has, in turn, reduced the wait time for patients in the ED and reduces the time to treatment. What's more, these benefits have boosted nurse morale, improving workforce engagement, reducing fatigue, even improving Saint Luke's recruitment capabilities. We need to provide nurses, our frontline workers, with technology that improves their work, quality of life, and the level and effectiveness of bedside care. Twitter: @SiwickiHealthIT Email the writer: Healthcare IT News is a HIMSS Media publication. See original article: < Previous News Next News >

  • Patients prefer telehealth for common illnesses, study shows

    Patients prefer telehealth for common illnesses, study shows Bill Siwicki November 23, 2022 But more than half are concerned about the quality of care they're receiving, according to the Software Advice survey. One of the firm's analysts dives into the results. Telemedicine has, at long last, become very popular. But lingering concerns remain on its effectiveness for certain diagnoses and treatments. Software Advice's 2022 State of Telemedicine Survey finds that while a majority of people prefer virtual appointments for common illnesses, more than half of patients still are concerned about the quality of care they're receiving. Software Advice, a Gartner company, polled more than 1,000 patients on telemedicine usage after the worst of the pandemic – regarding whether they intend to keep using it and improvements that can be made. We interviewed Lisa Hedges, associate principal analyst at Software Advice, to discuss the findings of the study and talk about the future of telemedicine. Q. What is the overarching message healthcare CIOs and other health IT leaders should take from your study? A. That failure to invest in telemedicine is downright foolish at this point. It's been around for a long time and fully took off during the pandemic. It isn't going anywhere now that so many patients have experienced the convenience it offers. This also means if you are one of the healthcare organizations that adopted telehealth during the pandemic and plan to eliminate those tools in the near future, you're making a mistake. The bottom line here is that telemedicine is a valuable tool for patients, and providers who offer remote care services for certain conditions and symptoms are going to have the edge over providers who don't. Q. About 86% of patients rate their telemedicine experience as positive; 91% are more likely to choose a provider that offers telemedicine. Why do you think this is, and what does it mean for healthcare provider organizations? A. Convenience and ease of use are top reasons patients like telemedicine, and that certainly makes sense when you consider the time it saves. Patients don't have to drive to a physical office, find parking, spend time in a waiting room (where they may be exposed to other contagions), and then drive back home once the appointment is over. All of that is hassle enough even without considering the fact that most people going to see doctors don't feel great, so their baseline before doing any of that is discomfort. What this means for providers is they're looking at a great opportunity. We're all well aware of the current shortage of qualified healthcare workers, and we know that the working conditions for healthcare staff have been particularly brutal during the pandemic. With so many employees quitting, it's left a lot of extra work behind for those who have stayed on, which leads to more burnout and even more turnover. If practices can find a way to alleviate that burden, though, they're going to make life better for their employees. Telemedicine can do this by shortening the average exam time, nearly eliminating patient wait times, reducing the average number of no-shows, and saving money by cutting down on operational costs. All of these things can directly or indirectly impact the quality of life for healthcare workers and for patients. Q. Only 49% prefer telemedicine visits for mental health treatment, despite it being one of the more remote-ready specialties. What does this finding say for the future of telepsychiatry? A. This is a great question that a lot of people are puzzling over. Mental healthcare does seem to be an ideal match for telemedicine, specifically the use of video conferencing to conduct therapy sessions. So, I was a little surprised that more patients in our survey didn't indicate a preference for telemedicine. But there are a couple of things to consider here. First, we didn't collect data on patient history, so not every participant in our survey has experience seeking mental health treatment. That could be a factor in this dataset. Second, 19% indicated no preference between telehealth and in-person appointments for mental health treatment when we asked this question, which means only 32% prefer in-person mental health appointments. So, it's still the majority of patients saying telehealth is their favorite option for mental healthcare. As far as what this means for the future of teletherapy, I don't think it's any huge concern. It could simply be that some patients are still warming up to the idea of having intimate conversations with a therapist through a computer screen. It could be an age thing. It could be something else. Regardless, I suspect that if we were to run this survey annually for the next few years, that 49% would increase every time. Q. One-third of patients worry that an in-person exam, lab work or other testing is critical to properly diagnose and treat patients. How can telemedicine jump this hurdle? A. I'm not convinced telemedicine needs to jump this hurdle to prove itself valuable. Sure, there are incredible advancements being made in remote patient monitoring tools and other wearable devices that can help diagnose patients from a distance, but I think it's equally worth noting that telemedicine is a tool to be used in the right circumstances – it's not a one-size-fits-all approach to medicine. Yes, for a lot of medical conditions, doctors actually have to see the patient to perform physical tests. Those situations aren't ideal for telemedicine, and we shouldn't be thinking of them as hurdles – or even failures. If, instead, we reframe our thinking so that we recognize the situations that are ideal for telemedicine appointments – those that don't require physical tests for diagnosis, such as mental healthcare or common ailments like upper respiratory infection – we can see that telemedicine is a deeply valuable tool as it stands. So, to answer your question, the real hurdle for telemedicine here is teaching patients when it is best used instead of needing to find ways to provide lab work or physical exams remotely. In essence: It's a messaging problem instead of a technology problem. The good news is patients seem to be recognizing this on their own. If you look at patient preferences for in-person appointments versus telemedicine appointments broken down by symptom in our report, you see that patients intuitively understand which symptoms are best treated remotely and which are more likely to need physical exams. Twitter: @SiwickiHealthIT Email the writer: Healthcare IT News is a HIMSS Media publication. See original article: < Previous News Next News >


    VIDEOS Clinical Issues in Telehealth (all videos here) Addressing Provider Burnout - Dec. 1, 2021 Rick Vinnay, LCSW, CEAP - The Solutions Group EAP and Wellness Programs, and Pierce Ferriegel, CEO - The Community Lighthouse Telemedicine Clinical Specialties - October 27, 2021 Dr. Randy Nederhoff, Neonatology, Dr. Rina Patel-Trujillo, Endocrinology, and Dr. David Phelps, Medical Director, PHS Urgent Care Clinics ​ Webinars & Featured Videos FEATURED WEBINAR NMTHA Town Hall Event: The Future of Telehealth As our world changed due to the COVID-19 pandemic, so did the world of Telehealth. But what happens next? Featuring nationally recognized speaker and Telehealth pioneer Dr. Weinstein, plus Russel Toal from New Mexico's OSI. Access Video FEATURED SERIES Experts in Telehealth: An Interview Series NMTHA brings "Experts in Telehealth" a video series interviewing experts from various areas within the Telehealth arena. Access Video Past Webinar Series 10-week Educational Series Access Videos Still available from our 2021 10-week educational series are webinars focused on data, broadband in New Mexico, client engagement, and more! These webinars were hosted by the New Mexico Telehealth Alliance and made possible through funding by Health Resources and Services Administration Office for the Advancement of Telehealth and the Southwest Telehealth Resource Center. ​ Fall 2021 Webinar Series Topics include the future of telehealth, billing, using telehealth for clinical specialties, and more. Access Videos

  • Toolkit | NMTHA

    Up Toolkit As part of a grant provided by the New Mexico Human Services Department, the resources below have been curated and organized to match themes that came out of interviews and surveys supported through the efforts of the NMTHA and Anchorum St. Vincent. In this Telehealth Toolkit you'll find... ​Other Toolkits Templates Best Practice Guidelines General Resources ​ ​ Eleven Telehealth topic areas including: Client Engagement Provider Engagement Provider Self-Care Technology Clinical Specialities Not finding what you're looking for? Click here for more resources. To navigate this toolkit click a question below! 1. How do we address broadband and other Telehealth challenges in rural New Mexico? 2. How do we get started with Telemedicine? 3. How do we improve client e ngagement? 4. How do we improve provider engagement? 5. How do we manage our Telehealth practice? 6. How can we reduce provider burnout? 7. How do we use/expand Telehealth in schools and youth programs? 8. What are the best ways to use Telehealth for clinical specialties? 9. What is the future of Telehealth? 10. What is the latest data on Telehealth? How do we collect data on Telehealth use? 11. What Telehealth platforms are best and other technology questions? HOW DO WE ADDRESS BROADBAND AND OTHER TELEHEALTH CHALLENGES IN RURAL NEW MEXICO? ​ Toolkits Rural Telehealth Toolkit This toolkit from the Rural Health Information Hub, compiles evidence-based and promising models and resources to support organizations in identifying and implementing telehealth programs to address common challenges experienced in rural communities across the United States. Audience: Facility leadership and providers in rural areas. General Resources Active Programs to Improve Telehealth Services in Remote Areas Office of the Advancement of Telehealth (OAT) provides funding to promote and improve telehealth services in rural areas. Audience: Executive leadership for clinics/facilities in rural areas. ​ Virtual Critical Care: A Lifeline for Rural Hospitals and Patients (CASE STUDY) Auburn University Health and Amwell identify methods participating rural hospitals reduced their transfers by more than 80%, enabling patients to receive care in their communities with minimal disruption to continuity of care. Comparing Televideo and Telephone Behavioral Health Services for People with Chronic Mental Illness Powerpoint presentation from the UNM Rural Psychiatry Program Annual Spring Conference: Adapting Care for 2021 and Beyond. HOW DO WE GET STARTED WITH TELEMEDICINE? ​ Toolkits Setting Up Tele-behavioral Health Service This step-by-step guide provided by the Indian Health Services is meant to be comprehensive, touching upon everything that may need to be considered in setting up Telebehavioral health services at your site. Audience: Facility directors and providers serving tribal and Indigenous populations. ​ Telehealth Program Developer Kit ​From the California Telehealth Resource Center. “The CTRC Program Developer was designed to assist in developing and implementing telehealth services. This Guide provides overview information on the process and the activities and information you will collect during each of the development phases. Each of the steps is designed to allow an organization to consider critical aspects of development and to support decision making.” ​ Telehealth Implementation Playbook ​Learn more about identifying the need for telehealth, finding a vendor, designing the workflow, implementing and scaling from the American Medical Association. ​ A Toolkit for Building and Growing a Sustainable Telehealth Program in Your Practice ​ Telehealth services and payment, roles and responsibilities, licensing and legal requirements, technology, workflow, and family medicine scenarios. Toolkit from the American Academy of Family Physicians (AAFP). ​ Templates Telemedicine Multi-site Agreement ​Arizona Telemedicine offers a template for consideration of the mutual covenants and agreements for involved parties. ​ Best Practice Guidelines 15 Key Steps to Creating a Business Proposal to Implement Telemedicine Here you’ll find a concise overview of 15 steps to implement a successful telemedicine program at your facility offered by the Northwest Regional Telehealth Resource Center. Audience: Directors and Executive leadership. ​ ​ General Resources Telehealth Start-Up and Resource Guide ​Covering Telehealth vs. Telemedicine, ATA and AMA guidelines, startup to sustainability, telehealth module and outlook, reimbursement guide, Medicaid, Medicare billing, CNM code information and other resources. This start-up and resource guide was created in partnership between Telligen and gpTRAC, the GreatPlains Telehealth Resource and Assistance Center. It is intended to provide an overview and framework for implementing telehealth in critical access hospitals and rural areas. It is also intended to point the reader to reliable and informative resources for learning about telehealth and the organizations that support the use of telehealth in various ways. ​ General Provider Telehealth and Telemedicine Tool Kit ​This document contains electronic links to reliable sources of information regarding telehealth and telemedicine. Most of the information is directed towards providers who may want to establish a permanent telemedicine program. There are specific documents identified that will be useful in choosing telemedicine vendors, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. ​ The New Normal: Tips for Making Telemedicine Part of Your Permanent Practice September 2020, 1:02:46 In a video Alaska Native Medical Center and Shoshone Family Medical Center join together via Project ECHO to help participants understand tactics to develop a well-rounded telehealth program: move telemedicine into part of your standard operations, outline the elements of a telemedicine quality program, to understand considerations of health equity in your telemedicine program and proactively & reactively address patient barriers, to outline infrastructure components needed to support ongoing success of your telehealth program. Audience: Facility directors ready to establish a telemedicine program. ​ Telemedicine: Where Do I Start? July 2020, 1:03:41 Project ECHO long with Shepherd’s Clinic, UV Medicine and CommonSpirit Health offer an expert-guided video on how to start and navigate telemedicine. Audience: Facility directors ready to establish a telemedicine program. ​ HOW DO WE IMPROVE CLIENT ENGAGEMENT? ​ Templates Behavioral Telehealth Session Checklist Mental Health Technology Transfer Center Network provides this checklist which was put together by Operation PAR Inc. to provide basic guidance before the telehealth session, conducting the session, and ending the session. Audience: Behavioral health providers using telehealth and looking to improve their interactions with clients or behavioral health providers using telehealth for the first time. ​ Telehealth Instructions for Behavioral Health Patients Behavioral Health Partners offers telehealth instructions to behavioral health patients in preparation for the telehealth visit.​ ​ Patient Consent Form Telemedicine patient consent form provided by the Southwest Telehealth Resource Center. Audience: Facility directors.​ Telehealth Instructions for Behavioral Health Patients ​Behavioral Health Partners offers telehealth instructions to behavioral health patients in preparation for the telehealth visit. Audience: Behavioral health providers using telehealth and looking to improve their interactions with clients or behavioral health providers using telehealth for the first time. ​ Telehealth Visit Etiquette Checklist From the American Medical Association, “This checklist is intended for clinicians and care team members who will be hosting the telehealth visit to ensure that the professional standards of in-person care is maintained in a virtual environment.” Audience: Telemedicine and telebehavioral health providers. ​ Patient Information Sheet (English) Overview of telehealth visit for patients from the FQHC Telehealth Consortium. Patient Information Sheet (Spanish) Overview of telehealth visit for patients from the FQHC Telehealth Consortium. Best Practice Guidelines Telehealth Etiquette Video Series In this series of videos, we will learn the difference between a bad, good, and even better telehealth consult. While some of these demonstrations may seem humorous or “over the top”, all are based on actual patient scenarios. As you watch, notice the difference between the Good, the Bad, and the downright Ugly. Provided by the South Central Telehealth Resource Center and produced by Old Dominion University College of Health Sciences, School of Nursing. Audience: Telemedicine and telebehavioral health providers. ​ General Resources Telehealth Best Practices A short video from the Hawaii State Department of Health Genomics Section highlighting best practices for healthcare providers when using telehealth to provide services. April 2020, 4 minutes. Audience: All providers. ​ HOW DO WE IMPROVE PROVIDER ENGAGEMENT? ​ ​ General Resources Clinical Best Practices and the Art of the Tele-Physical Exam September 2020, 59:31 This video aims to help providers understand the process of conducting a telemedicine visit, select the equipment needed to conduct a physical assessment through telemedicine, collect physical data through a videoconferencing session without peripherals, and utilize creative strategies to obtain clinical data. Provided by the University of New Mexico’s Project ECHO is a joint effort with the Center for Telehealth Innovation, Education, & Research; Old Dominion University; and the Mid-Atlantic Telehealth Resource Center. Audience: Primary care providers. Physicians' Motivations and Requirements to Adopting Digital Clinical Tools Study by the American Medical Association on “Physicians’ motivations and requirements for adopting digital health and adoption and attitudinal shifts from 2016 to 2019.” Published February 2020. Audience: Executive leadership. ​ Telehealth Driver Diagram Develop a sustainable, patient-centered, and equitable telehealth model and achieve an advanced level of maturity with the FQHC Consortium diagram. Top Five Tips for Managing Expectations and Challenges of Transitioning to Telehealth May, 2020, 17:46 Discussion of the “Top 5” tips for Managing Expectations and Coping with the Challenges of Transitioning to Telehealth. Speakers: Nancy Roget, the Executive Director of the Center for the Application of Substance Abuse Technologies at the University of Nevada–Reno and Co-Director of the Mountain Plain ​​Addiction Technology Transfer Center (ATTC) Regional Center, and Paul Warren, a research project director at the New York State Psychiatric Institute, Division of Substance Use Disorders in association with Columbia University and Project Manager for the Northeast and Caribbean ATTC. Audience: Executive leadership and facility directors. ​ HOW DO WE MANAGE OUR TELEHEALTH PRACTICE? ​ ​ Toolkits Organizational Assessment Toolkit for Primary and Behavioral Health Care Integration Designed by a team of integration experts and offered by the National Council for Mental Wellbeing, the Organizational Assessment Toolkit for primary and behavioral health care Integration (OATI) provides a compendium of tools that lay out a path for organizations to assess their readiness for integration, as well as benchmarking opportunities for those organizations well down the line in integration efforts. Audience: Facility directors and providers looking to integrate primary care and behavioral health. Telehealth Playbook Federally Qualified Health Centers Telehealth Consortium provides a Telehealth Playbook as a how-to guide to support the adoption and sustainability of telehealth at health centers. Templates Job Description RN Coordinator - Telehealth Sample Sample from UW Health. (University of Wisconsin) Audience: clinic administrators and directors. Job Description: Telehealth Program Coordinator Sample Sample from the FQHC Telehealth Consortium. Audience: clinic administrators and directors. Job Description: The Telemedicine Navigator (TMN) Sample Sample from the FQHC Telehealth Consortium. Audience: clinic administrators and directors. Job Descriptions Multiple Telemedicine Positions Includes several sample telemedicine job descriptions. From the California Telehealth Resource Center. Audience: clinic administrators, directors and executive leadership. Appointment Types & Duration Guide From the FQHC Telehealth Consortium Audience: clinic administrators. ​ Best Practice Guidelines Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service Prepared by the Center for Connected Health Policy and The National Telehealth Policy Resource Center, this document provides guidance on billing for telehealth and virtual healthcare, and dives into fee-for-service Medicare as well as a Medicaid program. Audience: Facility directors and providers. General Resources 2021 Medicare Coverage and Payment for Audio Only Services (Telephone E/M) Resource from the Association of American Medical Colleges provides an overview of current Medicare coverage for audio-only services. Audience: Facility directors and providers. Billing and coding Medicare Fee-for-Service claims during the COVID-19 Pandemic More Medicare Fee-for-Service (FFS) services are billable as telehealth during the COVID-19 public health emergency. Read the latest guidance on billing and coding FFS telehealth claims. Audience: Facility directors and providers. ​ Coding Scenario: Coding for Telehealth Visits Guide for how to bill for a variety of telehealth visits from the American Academy of Family Physicians. Audience: Facility directors and providers. Coverage and Payment for Telemedicine The American Medical Association offers an overview of health plan coverage and payment for telemedicine services. Audience: Facility directors and providers. Interstate Medical Licensure Compact Pathway to expedite the licensing of physicians already licensed to practice in one state offered by the American Medical Association. Audience: Facility directors. NCTRC Webinar - Digital Marketing: Best Practices for Direct-to-Consumer Telehealth July 2020 - 59:09 This South Central Telehealth Resource Center presentation will help lay the foundation for you to build your digital strategy for your telemedicine practice. Participants will learn how to: Identify opportunities to reduce friction based on the consumer journey, discuss the highest value marketing channels based on consumer data, and define audience segments, and outline conversion goals. Audience: Executive leadership and facility directors. NCTRC Webinar - Leveraging Telehealth to Address Social Determinants November 2020 - 1:00:08 As the healthcare industry shifts from fee-for-service to value-based care, planning, implementing, and enhancing telehealth as a service delivery model will be a crucial part of the puzzle in ensuring that we are on the leading edge and not the bleeding edge of reimbursement strategies. Presented by the National Consortium of Telehealth Resources. Audience: Executive leadership and facility directors. Overview of Telehealth Billing and Reimbursement Policies August 2020, 1:03:35 Part of a 10-week series that was part of the National COVID Response offering peer-to-peer learning. Provided by the Center for Connected Health Policy via Project ECHO. Audience: Executive leadership and facility directors. Policy Telehealth Coding and Payment Quick Guide The American Medical Association’s Advocacy team has been summarizing the latest updates in Federal policy . Here are some additional key policy and payment considerations to keep in mind. Audience: Executive leadership and facility directors. Service Provider Directory Telemedicine and Telehealth The directory lists companies providing medical specialty services (such as radiology, rheumatology, neurology, psychiatry) and ancillary services (such as patient education and language interpretation) through telemedicine to healthcare providers such as hospitals, clinics, nursing homes, private practices and urgent care centers. Audience: Hospital and healthcare administrators and other decision-makers who want to expand or improve their healthcare services to their patients, employees, clients, etc. by connecting them with specialty care. Telehealth and Health Equity: Considerations for Addressing Health Disparities during the COVID-19 Pandemic September 2020, 1:04:50 Centers for Disease Control and Prevention presenters will discuss the intersection of telehealth and health equity and implications for health services during the COVID-19 pandemic. Presenters will identify long-standing systemic health and social inequities that contribute to COVID-19 health disparities while highlighting the opportunities and limitations of telehealth implementation as an actionable solution. Audience: Executive leadership, facility directors and providers. Telemedicine policy Guidelines for creating a telemedicine policy from the American Medical Association. Audience: Facility directors. Telemedicine Quick Reference Guide Created by Bluecross BlueSheild of New Mexico to help providers with questions regarding providing telemedicine services and billing for those services. Please note that this does not include federal or state exceptions for the Public Health Emergency for COVID. Audience: Directors and providers offering telemedicine in New Mexico. Workflows and Documentation August 2020, 1:02:00 The California Telehealth Resource Center along with Dartmouth-Hitchcock Medical Center and Mary’s Center offer an ECHO video presentation showing the basics of facilitating workflow conversations, creating workflow maps, and how to pull together and lead successful teams. Audience: Executive leadership, facility directors and providers. Podcasts Top Five Clinical Best Practices for Telehealth April 2020, 10:08 Mary Ellen Evers, LCSW, CAADC, a registered telebehavioral health clinician for mental health and addiction services and a telebehavioral health trainer for the Center for the Application of Substance Abuse Technologies shares her top five clinical best practices for providing services via telehealth platforms. Audience: Providers. Top Five Tips for Group Services Via Telehealth April 2020, 9:03 Sandes Boulanger, LCSW, MCAP, the Vice President of Clinical Services for Operation Par, Inc., located in Florida, shares her top five tips for running group sessions and support via telehealth during COVID-19. Audience: Providers. Top Five Tips for Telehealth Implementation April 2020, 9:22 Kathy Wibberly, the Director of the Mid-Atlantic Telehealth Resource Center located at the University of Virginia Karen S. Rheuban Center for Telehealth, gives her top five tips for successful implementation of telehealth services. Audience: Executive leadership, facility directors and providers. Top Seven Telehealth Privacy Considerations April 2020, 9:41 The Center for Excellence for Protected Health Information presents key points around privacy, HIPAA, and confidentiality when providing telehealth behavioral health and addiction services, with Jacqueline Seitz, JD; CoE-PHI, Christine Khaikin, JD; CoE-PHI, and Michael Graziano. Audience: Executive leadership, facility directors and providers serving behavioral health patients. Top Seven Tips for Telehealth Billing April 2020, 18:34 A review of best practices for billing for telehealth services to ensure reimbursement during COVID-19, presented by Kathy Wibberly, PhD, the director of the Mid-Atlantic Telehealth Resource Center located at the University of Virginia. Audience: Facility directors and providers. ​ HOW DO WE REDUCE PROVIDER BURNOUT? ​ ​ Toolkit Physician Suicide and Support How to identify at-risk physicians and facilitate access to appropriate care. Offered by the American Medical Association. Audience: Executive leadership and facility directors. Provider Self-Care Toolkit How managers can support employees struggling with burnout and stress. Provided by the National Center for Post Traumatic Stress Disorder. Audience: Executive leadership and facility directors. Tips for Supporting Employee Mental Health The National Council for Mental Wellbeing offers a toolkit on Stress, Anxiety, Depression: What it Looks Like at Work and How to Provide Support. Audience: Executive leadership and facility directors. General Resources Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies Article from the National Center for Biotechnology Information, U.S. National Library of Medicine . Audience: Providers and executive leadership. Equipping Physicians to Manage Burnout Resources from the American Medical Association including a tip of the week, free learning modules, and podcasts. Audience: healthcare leaders and providers. Gratitude Practice for Nurses The Gratitude Practice for Nurses initiative is a joint effort of the American Nurses Foundation and the Greater Good Science Center at the University of California, Berkeley, aimed at cultivating the practice of gratitude within the nursing profession. Decades of research have shown that practicing gratitude is highly effective in promoting physical and psychological health, both at the individual and organizational levels. Audience: Nurses and healthcare leaders. Mental Health Support for Healthcare Providers Support from the National Alliance on Mental Health includes confidential and professional support, peer support, resources on building resiliency, and more. Audience: All medical and behavioral treatment staff and providers. Provider Burnout: Prioritizing Self-Care to Strengthen Patient Care Ideas for self-care from the American Academy of Physician Assistants. Audience: Audience: All medical and behavioral treatment staff and providers. ​ HOW DO WE USE/EXPAND TELEHEALTH IN SCHOOLS AND YOUTH PROGRAMS? ​ Toolkit National Telehealth Toolkit for Educators/Faculty Created in 2019, a group of over 45 nursing faculty from 19 U.S. states plus Canada and 28 universities, met to develop a telehealth toolkit with the goal of providing faculty with content needed to integrate telehealth across the curriculum for health professions programs. ​ Roadmap for Action: Advancing the Adoption of Telehealth in Child Care Centers and Schools to Promote Children’s Health and Well-Being School-Based Checklist and Resources Compiled by the Clearinghouse for Military Family Readiness at Pennsylvania State University this document provides a variety of checklists as well as links to additional resources. Audience: Directors of school and youth programs using telehealth. ​ Best Practice Guidelines Evaluation Considerations for Delivering Virtual School-based OT Services via Telehealth Checklist, resources and recommendations provided by the American Occupational Therapy Association. Audience: Directors of school and youth programs using telehealth. ​ General Resources How to Start and Implement a School-Based Telehealth Program ​ How to Build a School-Based Telemedicine Program in Your Community [52:21] The South Central Telehealth Resource Center, University of Arkansas for Medical Sciences offers a video on building a school-based telemedicine program. Audience: Directors of school and youth programs looking to implement a telemedicine program. Reimbursement of School-Based Telehealth Services-Report The National Academy for State Health Policy report explores how states are: Increasing their Medicaid coverage of school-based telehealth services during COVID-19; determining which services can be effectively delivered through telehealth; and supporting equitable access to telehealth services for students. Audience: Directors of school and youth programs using telehealth. ​ WHAT ARE THE BEST WAYS TO USE TELEHEALTH FOR CLINICAL SPECIALTIES? ​ Behavioral Health Best Practice Guide Introduction to telehealth for behavioral health care. Audience: Executive leadership and facility directors. Telehealth Delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) The Medical University of South Carolina offers a 2-part webinar series. Part 1 (59:26) - Provides logistics for delivering trauma-informed, evidence-based mental health services via telehealth (for example, necessary equipment, procedures, documentation, and ethical considerations) Part 2 (1:41:09) - Provides specific tips and resources for delivering Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via telehealth. Audience: Facility directors and providers. Dentistry ADA Guide to Understanding and Documenting Teledentistry Events Questions and answers plus scenarios are intended to provide insight and understanding of how care is delivered and reported when teledentistry is a facet of the process. From the American Dental Association. Audience: Dental office directors and providers. Emergency Departments Best Practice Guide: Introduction to telehealth practices for emergency departments Includes information on getting started, billing, tele-triage, tele-emergency care, virtual rounds, e-consults, and telehealth for follow-up care. Provided by the Health Resources and Services Administration (HRSA). Audience: Executive leadership, ED directors and providers. Hospice and Palliative Care Best Practices for Using Telehealth in Hospice and Palliative Care Article from the National Library of Medicine highlights the work of expert clinicians from multiple hospice and palliative care organizations to develop best practices for conducting telehealth visits in inpatient and community settings. Audience: Facility directors and providers. ​ Maternal Health UMTRC Webinar: Ohio Telehealth Billing & Reimbursement Webinar for Maternal Health May 2020, 55:22 Ohio State University and the Ohio Department of Health provide a video on how maternal health providers in Ohio can integrate telehealth into their clinical practices. Providing a deep dive into telehealth reimbursement for maternal health with an emphasis on Ohio Medicaid. Audience: Facility directors and providers. ​ Pediatrics Pediatric Telemedicine in Ambulatory and Inpatient Settings during COVID-19 and Beyond - May 2020, 1:04:51 The University of Minnesota Pediatrics Grand Rounds offers a video 1. Describes the evolution of telemedicine practice before and since COVID in pediatric ambulatory and inpatient settings. 2. Describes three elements of best practice for effective telemedicine visits. 3. Discusses the advantages and disadvantages of telemedicine in Pediatrics. 4. Proposes applications for telemedicine after the COVID-19 pandemic in your practice Audience: Facility directors and providers. Remote Monitoring Remote Patient Monitoring Toolkit The Mid-Atlantic Telehealth Resource Center designed a toolkit to help many different audiences quickly understand remote patient monitoring and define the responsibilities of each role. Audience: Facility directors and providers. ​ Substance Use Disorders Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders “This guide reviews ways that telehealth modalities can be used to provide treatment for serious mental illness and substance use disorders among adults, distills the research into recommendations for practice, and provides examples of how these recommendations can be implemented.” From the Center for Mental Health Services (CMHS) and Substance Abuse and Mental Health Services Administration (SAMHSA). Audience: Behavioral health providers and clinical supervisors. ​ Tele-Treatment for Substance Use Disorders Treating substance use disorders via telehealth requires expertise and training in addiction care. Telehealth Health and Human Services provide special considerations to keep in mind for telehealth substance use treatment. Audience: Facility directors and providers. ​ WHAT IS THE FUTURE OF TELEHEALTH? ​ Best Practice Guidelines Current State Laws and Policies for New Mexico Current state laws and policies related to telemedicine in New Mexico curated by the Center for Connected Health Policy. Audience: Executive leadership, facility directors and providers. Statute on Establishing a Patient-Physician Relationship Via Telehealth A quick reference guide for providing care with medical ethics while maintaining the patient’s well-being via telemedicine is provided by the American Medical Association. Audience: Executive leadership, facility directors and providers. General Resources A New Decade for Telehealth: A look at the rapid rise in telehealth adoption and what's required to support its growth . White paper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. Audience: Executive leadership Covering the Cost of Telehealth White paper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. “Healthcare leaders expect patient demand for digital services to continue rising — even after the COVID-19 public health crisis subsides. That in turn has healthcare organizations (HCOs) strategizing on how to cover the costs of the telehealth investments they’ll need to meet rising demands in the months and years ahead.” Audience: Executive leadership ​ How Telehealth Can Support People Living in the Community The American Telehealth Association provides background education on telehealth, increases awareness of the benefits of telehealth that support community living, and raises policy considerations for states, health plans, and providers. ​ Medicare and Medicaid COVID-19 Program Flexibilities and Considerations for Their Continuation Statements of Jessica Farb, Director, Health Care and Carolyn L. Yocom, Director, Health Care were incorporated in the Testimony Before the Committee on Finance, U.S. Senate in response to the COVID-19 pandemic to discuss flexibilities related to Medicare and Medicaid that were made available during the current public health emergency. Testimony highlights the various flexibilities and waivers implemented during the COVID-19 pandemic and provides preliminary information on how these flexibilities have likely benefited providers and beneficiaries. Audience: Executive leadership, facility directors and providers. Pending telehealth legislation and regulation in New Mexico and the United States A quick reference guide presented by the Center for Connected Health Policy. Audience: Healthcare leadership and all providers. ​ Return on Health: Moving Beyond Dollars and Cents in Realizing the Value of Virtual Care This report, jointly developed by the American Medical Association and Manatt Health Strategies (Manatt Health), expands on existing research by articulating a more robust framework for measuring the value of digitally enabled care that accounts for the various ways in which virtual care programs may increase the overall “return on health” by generating positive impact for patients, clinicians, payers and society going forward. Audience: Executive leadership, facility directors and providers. ​ Telehealth Needs & Opportunities: Emerging Findings from Non-profit Behavioral Health Providers in Northern New Mexico SPECIAL REPORT from the New Mexico Telehealth Alliance and Anchorum St. Vincent, a community health impact organization. Report resulting from a needs assessment in early 2021. Audience: Executive leadership, facility directors and providers. WHAT IS THE LATEST DATA ON TELEHEALTH USE OR HOW DO WE COLLECT DATA ON TELEHEALTH USE? Templates Telehealth Patient Experience Survey Sample survey from the FQHC Telehealth Consortium. Audience: Providers and administrators. ​ General Resources Configuring Telehealth Visits Using RPMS and EHR Presentation by the Indian Health Service from Sept. 2020 regarding standardization for national tracking and reporting. Audience: Facility directors and providers serving native and Indigenous populations. Measures of success: 5 key metrics for evaluating telehealth services White paper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. Audience: Executive leadership ​ Measuring Patient Experience and Satisfaction with Telemedicine: A Quick Guide to Survey Selection This guide offered by the California Health Care Foundation looks to support and inform quality improvement efforts at your health center. Audience: Executive leadership and facility directors. ​ Supporting today’s data-intensive clinical environments Step-by-step guidance for planning a network infrastructure that will help you advance your digital health initiatives and improve efficiency and patient outcomes. from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. Audience: Executive leadership Telemedicine and Non-Telemedicine Visit Experience Interview Guides The University of Rochester provides an interview guide designed to be conducted with patients, physicians, nurses, and office staff in an ambulatory setting. The tool includes questions to assess user’s satisfaction and perceptions of telehealth. Audience: Executive leadership, facility directors and providers. WHAT TELEHEALTH PLATFORMS ARE BEST AND OTHER TECHNOLOGY QUESTIONS? ​ Toolkits Remote Patient Monitoring Platforms: Vendor Overview Snapshot of various platforms from the FQHC Telehealth Consortium. Telehealth Platforms: Vendor Overview Snapshot of various platforms from the FQHC Telehealth Consortium. Vendor Selection Toolkit From the Mid-Atlantic Telehealth Resource Center, this provides some quick info on selecting your telehealth vendor. Audience: Directors and executive leadership. ​ General Resources AMA Telehealth Implementation Playbook Includes a vendor evaluation checklist on pages 32 to 38. Audience: Audience: Directors and executive leadership. Comparing 11 top telehealth platforms: Company execs tout quality, safety, EHR integrations Article from HealthcareIT News. Audience: Executive leadership and facility directors. ​ Growing digital health innovation means it’s time for a bandwidth checkup Whitepaper from Spectrum Enterprise, a part of Charter Communications, Inc., a national provider of scalable, fiber technology solutions serving America’s largest businesses and communications service providers. Audience: Audience: Directors and executive leadership, ​ Telehealth Technology Trends October 2020, 59:41 National Consortium of Telehealth Resources The Telehealth Technology Assessment Resource Center (TTAC) has seen a significant shift in choosing telehealth technology for providing patient care, most specifically in choosing video conferencing platforms and providing care to the patient in the home, both from the provider and the consumer perspective. TTAC will give a short overview of the changing trends being observed now and in the future. Audience: Executive leadership and facility directors. The Top 30 Tools for Improving your Telehealth Implementation Telehealth tools, hardware, software, monitoring and on-demand portals from Cambridge Brain Sciences. Audience: Executive leadership and facility directors. ​

  • Amazon Launches Messaging-Based Virtual Care Service

    Amazon Launches Messaging-Based Virtual Care Service Anuja Vaidya November 15, 2022 Called Amazon Clinic, the new service enables healthcare consumers to connect with clinicians via a message-based portal and receive care for common medical conditions like acne and UTIs. A few months after announcing plans to shutter its telehealth business, Amazon has launched a new virtual care clinic. Called Amazon Clinic, the message-based service is currently available in 32 states. It offers virtual care for more than 20 common medical conditions, including acne, cold sores, seasonal allergies, and urinary tract infections. The service also provides access to birth control services. Healthcare consumers can choose to receive care from a network of telehealth providers, including SteadyMD and Health Tap. After selecting a provider, the consumer completes an intake questionnaire. They are then connected with a clinician via a message-based portal. Once the consultation is over, the clinician sends a treatment plan to the patient through the portal. Clinicians can also send needed prescriptions to a preferred pharmacy or Amazon's online pharmacy. The service further allows users to exchange messages with the selected clinician for up to two weeks after the initial consultation. READ MORE: National Telehealth Use Appears to be Stabilizing "We believe that improving both the occasional and ongoing engagement experience is necessary to making care dramatically better," Nworah Ayogu, MD, chief medical officer and general manager at Amazon Clinic, wrote in a company blog post. "We also believe that customers should have the agency to choose what works best for them. Amazon Clinic is just one of the ways we're working to empower people to take control of their health by providing access to convenient, affordable care in partnership with trusted providers." Amazon Clinic costs will vary by provider. Prices will be disclosed upfront, and according to the 'frequently asked questions' section of the blog post, the prices are "equivalent or less than the average copay." The service does not yet accept health insurance, but consumers can use flexible spending and health savings accounts to make payments. They can also use their insurance to pay for medications. Amazon plans to expand the virtual care clinic to additional states in the coming months. The news comes on the heels of the technology giant announcing that it will close its Amazon Care business by the end of the year. Amazon Care included both telehealth and in-person care and was positioned as an employer-focused service. Initially open to only Amazon employees in the Seattle area, the company began offering the service to other businesses in 2021 and even signed deals to extend it to Silicon Labs, TrueBlue, and Whole Foods Market employees earlier this year. But leaders decided to shut down Amazon Care because it was "not a complete enough offering for the large enterprise customers we have been targeting, and wasn’t going to work long-term," Amazon Health Services Senior Vice President Neil Lindsay said in an internal company memo. READ MORE: Telehealth Patient Satisfaction On Par with In-Person Care During Pandemic Unlike Amazon Care, it appears that Amazon Clinic will operate as a connector, enabling consumers to gain access to telehealth provided by established virtual care companies. "By abandoning Amazon Care in favor of Amazon Clinic, Amazon is doubling down on what they are good at — going directly to the consumer," said Allison Oakes, PhD, director of research at market research firm Trilliant Health, in an email. "Capitalizing on what they are good at, it seems like Amazon will create a marketplace for providers and patients to connect, rather than employing their own network of doctors. This will allow them to keep their costs low and scale quickly. It will be interesting to learn more about the economics of a marketplace model, which traditionally are based upon allocating revenue between the provider of the good or service and the operator of the marketplace. Given long-standing prohibitions against fee-splitting, it will be interesting to understand Amazon's economic upside." Further, because of the current cash-only payment model, Amazon Clinic may only attract relatively young and healthy patients, which is unlikely to improve population health, Oakes added. The shuttering of Amazon Care and launch of Amazon Clinic follow the company's purchase of One Medical. This may point to Amazon's growing focus on a hybrid care strategy overall. "It is interesting that Amazon Clinic is doubling down on virtual-only care, despite the fact that telehealth visits have declined by 37 percent from Q2 2020 to Q1 2022," Oakes said. "They may see Amazon Clinic as the 'digital front door' for One Medical patient acquisition." READ MORE: Patients Prefer Telehealth for Primary Care, Mental Health Needs Today's announcement appears to bolster that idea, with Ayogu noting in the blog post that if healthcare consumers are seeking virtual care for a condition that may be better treated in person, the service will let them know before they are connected to a telehealth provider. "Virtual care isn't right for every problem," he wrote. Editor's note: The article was updated at 2:50 om ET with comments from Trilliant Health's Dr. Allison Oakes. See original article: < Previous News Next News >

  • New Coding Modifier Offers Opportunity To Investigate Audio-Only Telehealth

    New Coding Modifier Offers Opportunity To Investigate Audio-Only Telehealth Alexander Beschloss, Ryan Van Ramshorst, Chethan Bachireddy, Christopher Chen, Andrey Ostrovsky November 18, 2022 Prior to the pandemic, Medicaid program coverage of audio-only telehealth services was limited. During the early stages of the pandemic, Medicaid beneficiaries were significantly less likely to complete telehealth visits compared to commercially insured patients. This was likely due to a series of obstacles, including: lack of access to high-quality broadband, a device with video capability, requisite digital skills, and private space to conduct the visit. For example, in 2019, roughly one in four Medicaid enrollees lived in a home without internet or with limited computer access. That said, Medicaid beneficiaries do not have significantly less access to devices with video capability (such as smartphones) than other patient populations, suggesting network connectivity poses more of a barrier than device access. Even further, nearly 50 percent of low-income patients in the US may not have requisite digital health literacy to use virtual telehealth. However, considering that 86 percent of Medicaid beneficiaries own a smartphone, it may be inferred that many more have sufficient digital literacy to engage in audio-only care rather than audio-visual telehealth. Network connectivity and low rates of digital literacy are two barriers that highlight the importance of creating the infrastructure to deliver and measure audio-only visits is of increased necessity. It was in this context that, once the pandemic struck, Medicaid agencies changed policies to augment access to telehealth services. For example, 17 state Medicaid agencies expanded reimbursement to include multiple modalities of telehealth, including audio-only. These changes particularly supported patient populations who had transportation, childcare, employment, or income barriers that prevent in-person care—challenges that are more prevalent in the Medicaid population. These policy innovations narrowed the reimbursement gap among in-person, audio-only, and audio-visual visits. In fact, the Department of Health and Human Services (HHS) recently investigated differences in patient populations who receive telehealth audio-only versus audiovisual use in 2021. For telehealth visits, Medicaid beneficiaries were more likely to use audio-only care than were privately insured patients (35.1 percent versus 45.5 percent). They discovered that compared to White patients, who used audio-only care for 38.1 percent of their telehealth visits, Latino, Black, and Asian patients did so at rates of 49.3 percent, 46.4 percent, and 48.7 percent, respectively. Patients with less than a high school education used it at 61.9 percent of their telehealth visits, compared to those with greater than a bachelor’s degree, who did such at a rate of only 32.6 percent. Across income brackets, there is an inverse relationship between household income and audio-only telehealth use. As the use of audio-only telehealth became more widespread among Medicaid beneficiaries, state Medicaid leaders needed a mechanism to measure clinical outcomes, health care costs, and patient experiences related to audio-only telehealth. Providers also needed a dedicated billing construct that could be used across public and private payers to streamline billing processes. Until recently, such mechanisms simply did not exist. And so, due to these insufficient coding constructs, several Medicaid medical directors spearheaded an application to the American Medical Association (AMA) to create a Current Procedural Terminology (CPT) modifier that would specifically designate audio-only services. In September 2021, the AMA CPT Editorial Panel accepted the addition of the CPT Modifier 93 code for synchronous audio-only telehealth, and the code became active on January 1, 2022. This article provides an overview of the rationale for and process of creating the CPT Modifier 93 code. Potential Benefits Of Audio-Only CPT Modifier Why was the creation of a new audio-only modifier necessary? Several reasons: data collection, policy implementation, health care equity, widespread need, and service specificity. The CPT 93 modifier permits differentiation among audio-only, audiovisual, and in-person care at the administrative level, which subsequently allows health service researchers to monitor and evaluate the use and clinical efficacy among these methods of care delivery. Prior to the introduction of this modifier, such high-quality analyses were impossible to do at scale. Along with the increase in all modalities of telehealth use since the COVID-19 public health emergency (63 fold increase year over year between 2019 and 2020), a survey performed by HHS (across all 50 states and the District of Columbia) discovered that 45.5 percent of all telehealth usage amongst Medicaid beneficiaries was audio-only. Taking things one step farther, several state legislatures including Washington, Connecticut, and New York have recently passed laws mandating or allowing coverage for audio-only services. Audio-only telehealth is being highly used, therefore having a mechanism to collect related data is vital. Implementing this modifier will serve as a tool for policy makers to make informed adjustments in policy around patients who use audio-only services. Implementation of this modifier will also enable claims-based research to monitor for disparities between audiovisual and audio-only care to ensure that all modalities of telehealth are provided in a sustainable, equitable, and high-quality fashion. Additionally, because different states have implemented varying strategies to cover audio-only services during the COVID-19 public health emergency (PHE), the CPT 93 modifier will help health services researchers and policy makers discern the differences between coverage approaches, information that will be crucial in standardizing telehealth data collection/storage across states. From a coding perspective, adding an audio-only modifier to existing and widely used CPT codes is a far more feasible option than alternatives such as individual payers developing their own coding modifiers. That approach would become unreasonably burdensome on providers who would subsequently have to learn and bill using the system established by each payer. Previous Codes Did Not Suffice While CPT codes for services provided through telephone exist, they do not specify the enormous range of behavioral health services, therapies, maternity-related care, post-operative guidance, and other services that have been successfully delivered via audio-only technology since the COVID-19 PHE. For example, CPT code 99441 represents a “telephone evaluation and management service; 5–10 minutes of medical discussion,” which gives no specificity regarding what type of care was delivered. In comparison, the CPT 93 modifier can be attached to theoretically any billing code that is permitted under law, thus allowing for more precise tracking and more useful follow-up research. Prior to the introduction of the CPT 93 modifier, there were seldom CPT codes that could be used to represent audio-only telehealth for specific services. Even though audio-only telehealth has been delivered at high rates, states have only been able to use temporary or workaround solutions to bill for audio-only services. For example, the Healthcare Common Procedure Coding System (HCPCS) Level II code for crisis response (CR) has been used by some states to support audio-only services during the COVID-19 pandemic. In the two and a half years since the pandemic began, however, the use of audio-only to provide health services has become normalized and may in fact now be expected by Medicaid providers and beneficiaries—a reality for which the CR code, and its temporary application, was not designed. The CPT 93 solves this challenge on a national scale. Another prior attempt to capture audio-only telehealth was the CPT modifier 95 that only indicated a telehealth service and did not differentiate between audio-only and audio-visual care. HCPCS Level II code “G0” has also been used; however, it indicates a telehealth service for diagnosis, evaluation, or treatment specific to symptoms of an acute stroke. Furthermore, CPT code 99401 can be used to reflect counseling services that may be provided via audio-only care; however, this code failed to capture all the nuance of the amount of time of care was delivered. At the end of the COVID-19 PHE, the Centers for Medicare and Medicaid Services (CMS) plans to add the “FQ” modifier on claims for HCPCS code G2080 for counseling and therapy provided using audio-only telecommunications. The HCPCS G2080 code refers to when one provides therapy services that largely exceed the amount listed in the patient’s individualized treatment plan for medication assisted treatment for opioid use disorder. This modifier exists solely for CMS’s Opioid Treatment Program and fails to account for other indications for audio-only telehealth. Creating a CPT modifier that is applicable to all service types simplifies the codification and measurement of audio-only care across all payer types. Conduct More Research On Audio-Only Telehealth Researchers, provider organizations, and policy makers must investigate and ensure that audio-only telehealth drives strong clinical outcomes. Telephone-focused care has been an important part of primary care; however, much of it was after hours, unmeasured, and not reimbursed. There is strong evidence on audio-only telehealth’s efficacy in prenatal visits and insomnia, for example. A randomized clinical control trial in a patient population of the Kaiser Permanente Washington system received audio-only cognitive behavioral therapy through the telephone demonstrated a significant benefit in improving sleep, fatigue, and osteoarthritis-associated pain. A cohort study amongst pregnant women in the Parkland Health System in Texas found that audio-only perinatal visits were not associated with changes in perinatal outcomes when compared to in-person visits in a vulnerable population. While these data are encouraging, they are sparse. Measurement of a CPT modifier may streamline the research methods used in these studies. Researchers must continue to investigate the efficacy of specific therapies when delivered via audio-only modalities. While audio-only telehealth solves several problems in health care, there are also several risks such as its potential use for inappropriate clinical indications and the risk that some may see an opportunity to overbill. An audio-only modifier—and therefore a more granular characterization of telehealth modalities—may help assuage concerns about fraud, waste, and abuse, removing existing ambiguity about the impact of different telehealth modalities on outcomes. We also know that the quality and value of these delivery modalities may vary according to the different demographics being served, including factors such as age, insurance status, payer, income, and region, among many others. Such modalities will likely vary between acuity of patient’s indication for care. Only by studying these differences amongst modalities and the populations served, can we ensure that the care delivered is equitable and valuable. Implementing the 93 modifier is a vital step toward enabling health services researchers to urgently pursue research questions that inform evidence-based policy about the best use of audio-only telehealth—especially amongst the Medicaid population. It is also essential to ensuring that the growth of audio-only health care does not create a two-tiered system between private insurance and Medicaid. For example, audio-only care may in fact be lower quality or lower value compared to audiovisual care or in-person care—although, further investigation is necessary to understand these differences. Considering that audio-only care helps remove barriers to care for underresourced patient populations, inappropriate use of audio-only care may further exacerbate the already large inequities in health care—a concern raised by both clinicians and patients. This reliance on audio-only care may also hamstring innovations that can improve the quality and access to audiovisual telehealth or in-person care. Clearly, there are legitimate concerns about the equity of audio-only health. To resolve them, more precise data and extensive investigations are necessary: Both of which will be enabled by the implementation of the CPT 93 modifier. An Opportunity For Action The new audio-only CPT 93 modifier provides meaningful potential benefits to combat barriers to care that were compounded during the COVID-19 pandemic. The new code creates a potent opportunity for conducting rigorous research into audio-only telehealth to inform federal- and state-level policy around equitable telehealth delivery. But to make the most of this opportunity, regulators, payers, providers, and researchers must take steps to increase adoption and evaluation of the audio-only modifier. To catalyze this work, large health systems should consider leading the adoption of the CPT 93 modifier while also encouraging local private providers to do the same. Payers and purchasers should consider requiring modifier submission, a step that would also facilitate further research into the field with minimal additional administrative burden on providers. Federal health agencies have a role as well. For example, the Agency for Healthcare Research and Quality (AHRQ) may increase awareness of the modifiers amongst affiliated researchers or those who use AHRQ databases while the Health Resources and Services Agency may require community health centers they fund to use the new modifier. Authors’ Note The authors would like to thank Dr. John Morgan and Amanda Brodt for their contributions to preparing this paper. Dr. Ostrovsky is an investor in the following companies, some of which provide telehealth services: . However, there are no direct conflicts of interest. See original article: < Previous News Next News >

  • Suicide Prevention and Stigma Reduction with Dr. Alison Arnold

    Suicide Prevention and Stigma Reduction with Dr. Alison Arnold Dr. Alison Arnold November 18, 2022 Danielle speaks with Dr. Alison Arnold, the Director Interdisciplinary Center for Community Health & Wellness at Central Michigan University (CMU). In this episode we discuss CMU's Preventing Suicide in Michigan Men (PRiSMM) program and how we utilize telehealth to address mental health disparities and increase access to care. See original article with audio: < Previous News Next News >


    Final CY 2023 PHYSICIAN FEE SCHEDULE FACT SHEET CCHP November 1, 2022 On November 1, 2022, the Center for Medicare and Medicaid Services (CMS) released their final rule for the CY 2023 Medicare Physician Fee Schedule (PFS). CMS had previously released their proposed version on July 7, 2022. After receiving submitted feedback from the public during the comment period, CMS published the final version that, unless otherwise stated, will have policies going into effect January 1, 2023. Much of what was proposed in July remains in this final version. End of the Public Health Emergency (PHE) CMS is going forward with the policies required of the Medicare program that were in the 2022 Budget Act. These policies included allowing some of the temporary telehealth COVID policies to continue through a 151-day grace period after the end of the PHE and delaying other permanent policies: • Federally qualified health centers (FQHCs), rural health clinics (RHCs), physical therapists, occupational therapists, audiologists and speech-language pathologists remain eligible providers to be reimbursed by Medicare if they provide certain services via telehealth during this grace period. • The patient may be in the home when receiving these services and the geographic limitation would also not apply during the 151 day grace period. • Policies around the provision of mental health via telehealth that were put into law by the Consolidated Appropriations Act (CAA) passed in December 2020 and administrative policies from the 2022 PFS are also delayed during this 151 day grace period. • The temporary telehealth eligible services COVID-19 list will remain fully available during this 151-day grace period. See full fact sheet: < Previous News Next News >

  • AHA Statement Stresses Importance of Telehealth in CVD Care

    AHA Statement Stresses Importance of Telehealth in CVD Care Yael L. Maxwell November 16, 2022 With ongoing challenges related to reimbursement, access, and acceptance, the writing committee offers potential solutions. Stressing the importance of telehealth in cardiovascular care, especially given its increased prevalence during the COVID-19 pandemic, a new scientific statement from the American Heart Association (AHA) outlines the current barriers to this type of care and offers some strategies for continued access. As in-person visits were shut down in the spring of 2020, many clinicians and patients turned to telehealth, with subsequent studies and surveys showing related gains in heart failure and nonemergent cardiovascular care. Other research showed that patients who were more likely to use telehealth tended to be younger and privately insured, have more comorbidities, and be from underrepresented racial/ethnic groups. As the pandemic has waned, however, reimbursement for telephone and video visits has been a larger concern. Earlier this month, the US Centers for Medicare & Medicaid Services (CMS) released its 2023 Physician Fee Schedule, which includes continued coverage for telehealth, but only for 5 months following the end of the public health emergency, which some say is not long enough for clinicians to make long-term plans and invest in necessary infrastructure. “This paper in a way summarizes the importance of telehealth and the benefits of telehealth in patient care,” writing committee chair Edwin A. Takahashi, MD (Mayo Clinic, Rochester, MN), told TCTMD. “Payment parity is so important in sustaining telehealth. So I hope that CMS and insurance companies will see the importance highlighted in this paper and reconsider their reimbursement plans with it.” What Is Telehealth? The statement, published online this week in Circulation, begins by defining the concept of telehealth, breaking it down into clinician-to-patient visits and clinician-to-clinician consults. The former includes real-time virtual visits, either video or audio, as well as digital communication, called eVisits, initiated by either the physician or patient. The latter includes both real-time virtual consults, which may also include the patient, as well as digital exchange of low-complexity medical information between clinicians, called eConsults, or second opinions on more-complex concerns. A final hybrid category includes remote monitoring for patients and predictive analysis for clinicians—both machine initiated. Takahashi and colleagues point out some commonly used telehealth tools for cardiovascular home monitoring, including machines for monitoring risk factors like blood pressure, weight, smoking, and diet; medication tracking apps and smart pillboxes for managing medication adherence; and tools like home EGC, pulse oximeter, and pulmonary artery pressure monitoring devices. While there are an undefined number of ways in which telehealth can be useful within cardiovascular care, Takahashi said it’s most effective in tracking disease progression for heart failure and CAD, improving stroke outcomes by decreasing time to diagnosis, and monitoring PAD progression, as well as preventing ulcers and tracking patients postoperatively. The paper outlines advances in telestroke, teleradiology, and telehealth in PAD management. Challenges and Potential Solutions Many challenges remain in order for telehealth to flourish in a nonpandemic era. In his experience, Takahashi said, the biggest barrier to using telehealth relates to “having patients accept it as a replacement for inpatient visits.” But overall, challenges like infrastructure—including broadband internet and hardware for patients—to complete telehealth visits as well as reimbursement stand in the way of telehealth use more generally, he said. “In order for people to adopt and use telehealth, people need to be able to bill for using it. Otherwise, it just is not sustainable.” The statement also stresses the importance that clinician attitude, biases, and acceptance play in the success of telehealth. Difficult to use technological platforms hindered by HIPAA-compliant encryption can also make it more difficult for clinicians to access telehealth appointments. Beyond increases in reimbursement for telehealth, the authors propose a few strategies for continued success. They advocate for government programs to improve broadband internet access across the country, more research to elucidate the specific benefits telehealth can have across the spectrum of cardiovascular disease care, and increased standardization for methods in assessing telehealth quality. “The COVID-19 pandemic improved the telehealth infrastructure through necessity but also uncovered systemic weakness, limitations, and inequities,” they conclude. “Further research into barriers for telehealth implementation and equitable execution are important to ensure the delivery of high-quality care for patients.” Yael L. Maxwell by Yael L. Maxwell Editor, Fellows Forum Yael L. Maxwell is Senior Medical Journalist for TCTMD and Section Editor of TCTMD's Fellows Forum. She served as the inaugural… Read Full Bio See original article: < Previous News Next News >

  • The Data Challenge to Prove Telehealth’s Importance Continues

    The Data Challenge to Prove Telehealth’s Importance Continues Jan Ground, PT, MBA November 17, 2022 A group of telehealth leaders from 18 states worked the past two years on proving the value of telehealth with data to convince payors and legislators that continuing reimbursement post-COVID 19 is the right thing to do. Over the course of two years, 40 people, including five physicians, four nurses, four other clinicians, and 27 telehealth leaders in provider organizations, contributed to the effort. The group chose to focus initially on video visits for those in need of mental health care. We succeeded in step one: we surveyed 16 mental health provider organizations to find out what data they were collecting, and how success was being measured in 2020. The organizations ranged from large university medical centers to private practices in nine states. Not surprisingly, the data and metrics varied widely, even across large university-based systems. For example, in response to the question “What, if anything, is being measured regarding clinical outcomes?” Four organizations reported no clinical outcomes measurements Four organizations used a wide variety of validated and commonly used clinical outcome metrics: PHQ-9 (used by 3 of 4 ) Patient Health Questionnaire ( GAD7 (used by 2 of 4) GAD-7 (General Anxiety Disorder-7) - MDCalc BASIS-24 (use) BASIS-24® — eBASIS ACES ACE.pdf ( Adverse Childhood Experiences Study EDE-Q PDFfiller - ede q online(1).pdf ( Eating Disorder Examination Questionnaire OCI-R Obsessive Compulsive Inventory - Revised (OCI-R) ( SF-12 The SF-12v2 PRO Health Survey ( Short Form Health Survey BAI beck-anxiety-inventory.pdf ( EDE-Q ede-q_quesionnaire.pdf ( Eating Disorder Examination Questionnaire EDY-Q Microsoft Word - Hilbert, van Dyck_EDY-Q_English Version_2016 ( Eating Disorders in Youth Questionnaire McMaster Family Assessment Device STAI-C-S State-Trait Anxiety Inventory for Children (STAI-CH) - Assessments, Tests | Mind Garden - Mind Garden State Trait Anxiety Inventory – Child Version – State only DERS Difficulties in Emotion Regulation Scale (DERS) ( PCL-5 PTSD Checklist for DSM-5 (PCL-5) - Fillable Form ( Post-traumatic Checklist In another question on cost savings, the survey question was “What, if anything, is being measured regarding cost savings?” 13 organizations reported no cost savings measurements Two of the three organizations reported savings measurements shared the following metrics (video visits vs in person visits) Handouts, parking vouchers, meal vouchers In person clinicians paid salary, video visit clinicians paid per hour, Future: space cost savings (video visit clinicians providing care from home) In our next effort we wanted to add payor leaders or legislators to join the conversation to determine which, if any of the metrics being used and data being collected, might convince them to support continued reimbursement post-COVID 19. The 40 participants were all associated with provider organizations with insufficient connections with payors/legislators to successfully bring them into the conversation. The group took a break and then decided on a new approach. We came up with what we THINK would be most important to payors/legislators, based on our understanding of what drives their success. Here’s the list: Compare the following data for specific groups of mental health patients (e.g., based on location, disorder, gender, age, first time vs return patients, newly diagnosed vs existing patient, prior telemedicine use, other relevant demographics, and characteristics), with or without access to care by video: number of ED visits number of hospitalizations suicide rates survey results that measure mental health status using validated tools (e.g., PHQ9) timing to access -(i.e., length of time to get patients in front of provider for first visit) provider and patient satisfaction and retention (i.e., remain in care) Interestingly, I have since learned that, in fact, there are many data sources on these topics with many peer-reviewed articles based on well-controlled studies. That leads me to a different question: Why were none of the 40 participants, including me, aware of these data sources and how to access them? It perhaps has its roots in the type of data available. Much of the data available comes from academic institutions reporting on research studies and publishing in peer-reviewed journals. These can be readily found through a PubMed or Google Scholar search using appropriate search terms (e.g., telemental health, outcomes, cost) but if one is unfamiliar with conducting this type of search these articles will not be available to review. Other sources of information include websites of the professional societies of which the providers are members (e.g., American Psychiatric Association) and government websites (e.g., Substance Abuse and Mental Health Services Administration, but one has to know about these before they can be searched. Finally is the fact that although many healthcare systems and funders collect data, they use these data for internal purposes only and simply do not publish or share them. We are currently in search of a few provider organizations interested in/willing to collect some of these data. We have not had success. If you are interested in joining this collaborative effort, please contact me at: A new thought is to focus on a current hot topic in the US, such as COVID 19, to identify data to prove (or not!) the value of care by video. Perhaps we could find an organization willing to provide some funding to more likely successfully identify organizations willing to collect the data. It should not have to be this hard! About the Author Jan Ground PT, MBA, led innovation and virtual care at Kaiser Permanente Colorado, where she worked for 18 years. She is the Colorado Liaison to the Southwest Telehealth Resource Center and the Colorado Ambassador to Telehealth and Medicine Today, an online peer-reviewed journal. Active in the American Telemedicine Association, Jan leads a group looking to prove, with data, that telehealth is worth paying for. Jan’s expertise is in leading change, and in clearly defining a problem before implementing a new approach to care. Her greatest passion is to lower the cost of the American healthcare system without lowering clinical outcomes. See original article: < Previous News Next News >

  • HHS to maintain COVID-19 public health emergency past January

    HHS to maintain COVID-19 public health emergency past January Jakob Emerson November 11, 2022 The U.S. will extend the COVID-19 public health emergency past January 11, 2023, CNBC reported Nov. 11. A 12th extension of the PHE since the first in January 2020 is also likely because of a lack of public statement from HHS warning about a termination. The agency last renewed the PHE Oct. 13 for an additional 90 days to Jan. 11, 2023 — it also told states it would provide a notice 60 days before if it did decide to end it, or Nov. 11. The PHE allows the country to continue operating under pandemic-era policies, which led to a complete overhaul of telehealth and who can use it, fast-tracked approvals of COVID-19 vaccines and treatments, and preserved healthcare coverage for millions of Medicaid beneficiaries nationwide. Eleven states also still have coinciding public health emergency orders in place. As of now, Medicare telehealth flexibilities will end 151 days after the PHE expires. In July, the House passed The Advancing Telehealth Beyond COVID-19 Act, but the legislation must still be approved by the Senate for Medicare patients to continue using telehealth through 2024. "It's not that we necessarily want to continue the PHE for a long period of time," Nancy Foster, AHA's vice president of quality and patient safety, told Becker's in October. "What has not yet happened is fully thinking through how to unwind some of the [telehealth] flexibilities we currently have, and how to perhaps make permanent some of the others." In addition, the end of the PHE will trigger a Medicaid redetermination process that will cause a major disenrollment of beneficiaries. Over the course of about a year, HHS estimates up to 15 million people could lose health coverage. Payers are prepping for the redetermination period, as they expect to lose Medicaid members and hope to switch some to ACA coverage. With the Inflation Reduction Act's extension of ACA premium tax credits through the end of 2025, the nation's largest insurers have all recently announced plans to majorly expand exchange offerings in 2023, including UnitedHealthcare, Elevance, Aetna, Cigna and Centene. The extension of the federal emergency past January may have been unexpected for insurers, as UnitedHealth Group executives told investors Oct. 14 they thought the PHE would end in January. "Our tailwinds will be weighed against one known headwind, and that is the membership attrition and related impacts on our Medicaid business as eligibility redeterminations are conducted over the course of the next year," Elevance Health's CFO John Gallina told investors Oct. 19. The extension also comes amid uncertainty around public health as winter looms. New Omicron strains — dubbed "escape variants" for their immune evasiveness — have become the dominant strains in the U.S., accounting for 40 percent of all cases in the week ending Nov. 12. Daily cases in the country are expected to grow 39 percent from Nov. 3-17. Hospital admissions trends are expected to remain stable or be more uncertain, with 1,300 to 7,300 new admissions likely reported on Nov. 25, according to the CDC. As of Nov. 4, the nation's seven-day average of new hospital admissions was 3,273. See original article: < Previous News Next News >

  • Expanded Medicare Telehealth Coverage for Opioid Use Disorder Treatment Services Furnished by Opioid Treatment Programs

    Expanded Medicare Telehealth Coverage for Opioid Use Disorder Treatment Services Furnished by Opioid Treatment Programs Sunny J. Levine Hannah E. Zaitlin Nathaniel M. Lacktman November 09, 2022 Starting January 1, 2023, Medicare will cover telehealth-based treatment services delivered by federally-accredited opioid treatment programs (OTPs), commonly referred to as “methadone clinics.” This new reimbursement is intended to further the Centers for Medicare and Medicaid Services’ (CMS) objectives in its 2022 Behavioral Health Strategy, with a particular focus on improving access to substance use disorder (SUD) prevention, treatment, and recovery services. To this end, CMS added several expansion opportunities for OTPs, including telehealth coverage. However, these flexibilities do not extend to SUD treatment provided outside an OTP, such as office-based opioid treatment (OBOT) services. Details of the new coverage rules are contained in the 2023 Physician Fee Schedule (PFS) Final Rule (Final Rule), and summarized below. Background and History of Medicare Telehealth Coverage of SUD Treatment Prior to the federal COVID-19 Public Health Emergency (PHE), to initiate treatment with buprenorphine at an OTP, a practitioner needed to perform a complete in-person physical evaluation. The Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administrating (SAMHSA) waived this requirement for the duration of the PHE, allowing medication-assisted treatment (MAT) practitioners to initiate treatment with buprenorphine via audio-video telehealth and/or audio-only telephone communications without an initial in-person evaluation (subject to state law restrictions). This temporary exemption only applies to OTP patients treated with buprenorphine; it does not apply to new patients treated with methadone. CMS also extended coverage for SUD treatment services provided via telehealth. While Medicare telehealth services fall under Section 1834(m) of the Social Security Act, which generally limits payment for telehealth services to patients located in specific types of medical settings (originating sites) in mostly rural areas, the SUPPORT Act amended Section 1834(m), by removing the originating site and geographic limitation for telehealth services provided to individuals with a diagnosed or co-occurring mental health disorder (including a SUD) delivered on or after July 1, 2019. In 2020, CMS established a new Part B benefit category for opioid use disorder (OUD) treatment provided by OTPs. The covered benefit includes MAT for patients with OUD, a leading treatment modality that combines prescribing FDA-approved medication (e.g., methadone and buprenorphine) with counseling and other behavioral therapy, to provide a whole person approach. Subsequently, the Consolidated Appropriations Act of 2021 (CAA) permanently removed the geographic restrictions and added the patient’s home as a qualifying originating site for telehealth services provided for the diagnosis, evaluation, or treatment of a mental health disorder. Under the CY 2022 PFS final rule, CMS revised the definition of “interactive telecommunication system” to allow the use of audio-only communications technology for telemental health services under certain conditions when the beneficiary is located at their home. New Changes to Medicare OTP Telehealth Services Under the Final Rule, CMS made the following changes relating to OTP telehealth services: 1. OTPs can use the OTP intake add-on code to bill for the initiation of buprenorphine treatment through two-way interactive audio-video communication technology, as clinically appropriate, and in compliance with all applicable requirements (provided such flexibilities are authorized by DEA and SAMHSA at the time service is furnished). 2. Audio-only telephone calls can be used to initiate buprenorphine treatment at OTPs when two-way audio-video communications technology is not available to the beneficiary, and all other requirements are met. 1. CMS interprets “not available to the beneficiary” to include “circumstances in which the beneficiary is not capable of or has not consented to the use of devices that permit a two-way, audio/video interaction because in each of these instances audio/video communication technology is not able to be used in furnishing services to the beneficiary.” 3. After the initiation of buprenorphine treatment, OTPs can continue to use audio-only telephone calls to perform periodic patient assessments when two-way audio-video is not available (provided such flexibilities are authorized by DEA and SAMHSA at the time service is furnished). This flexibility will be in place until the end of CY 2023. CMS Recognized Broad Stakeholder Support for Telehealth SUD Treatment In comments to the new rules, stakeholders lauded the benefits of two-way audio-video communications technology used to initiate treatment with buprenorphine. CMS concurred, noting it is “of critical importance to individuals who have limited ability to attend in-person appointments or who are disincentivized to do so due to perceived stigma and fear.” CMS also acknowledged that audio-only flexibilities “further promote equity for individuals who are economically disadvantaged, live in rural areas, are racial and ethnic minorities, lack access to reliable broadband or internet access, or do not possess devices with video functions.” CMS declined to address comments relating to issues outside the scope of the final rule, including: 1) comments related to allowing prescribers to initiate buprenorphine treatment for SUDs without an in-person evaluation in other settings (outside of OTPs); 2) coordinating with DEA to create a special registration for telehealth providers under the Ryan Haight Act; and 3) developing an add-on code for Contingency Management. While the final rule does not extend coverage to OBOT treatment – which has proven a successful treatment option during the COVID-19 PHE – it evidences CMS’s view of technology as a viable way to provide life-saving SUD treatment to vulnerable beneficiaries. © 2022 Foley & Lardner LLP National Law Review, Volume XII, Number 313 See original article: < Previous News Next News >

  • Patients Prefer Telehealth for Primary Care, Mental Health Needs

    Patients Prefer Telehealth for Primary Care, Mental Health Needs Mark Melchionna October 31, 2022 A recent report shows that amid a return to in-person care, telehealth use has dropped among some populations, but it is still a popular modality for accessing primary and mental healthcare. October 31, 2022 - A recent report shows that although in-person care is the preferred channel of care, telehealth use remains highly used among young adults and those engaging in primary care and mental health services. Published by Stericycle Communication Solutions, the report was created in collaboration with Ipsos. It is based on a survey of 1,004 adults, 18 and older, from the continental US, Alaska, and Hawaii, conducted between July 5 and 8. In May 2022, over two years after the start of the pandemic, the FAIR Health Monthly Telehealth Regional Tracker reported an overall 10.2 percent increase in telehealth use. But while evaluating patient preferences related to healthcare access, the 2022 Stericycle Communication Solutions US Consumer Trends in Patient Engagement Survey shows that telehealth use has dropped amid a return to in-person healthcare. Within the year preceding the survey, 45 percent of adults claimed to have used telehealth on at least one occasion, while 25 percent only used it one to two times. This represents a drop from a previous survey, which showed that 39 percent of respondents used telehealth one or two times in the year prior. The report also noted that only 26 percent of older adults accessed telehealth one or more times within the past year. But the share of young adults between 18 and 34 that used telehealth remained high, reaching 61 percent. Further, the report showed that in-person care is popular among healthcare consumers. In total, 44 percent of survey respondents indicated that they prefer in-person visits. However, of those who are open to telehealth, patients prefer virtual visits for certain types of care, including primary care (55 percent) and mental healthcare (45 percent). On the other hand, patients do not prefer virtual visits for specialties such as dermatology, pediatrics, ENT, cardiology, urology, gynecology, orthopedics, and pulmonology. Patient satisfaction with telehealth is high. Among survey respondents, 90 percent indicated that their telehealth experience was either good or excellent. The top reasons for a patient choosing telehealth were convenience (58 percent) or safety (43 percent). Also, 24 percent said that telehealth helped them access a better provider. The report concluded that more evaluation is necessary to continue to optimize telehealth. For instance, since some patients requested in-person care for certain conditions, providers must consider the types of appointments that may be preferred via telehealth and invest accordingly, the report states. Several reports have provided further insight into patient satisfaction with telehealth. A study from the Journal of the American Geriatrics Society in October found that although patients over 65 preferred in-person care, they were also highly satisfied with telehealth. Using a seven-point scale, researchers evaluated the extent to which patients of this age felt satisfied with virtual care. They found that the median patient satisfaction score was six. More research from September found that telehealth continues to play a significant role in healthcare due to the satisfaction it provides patients. Following a survey, researchers found that 67 percent of patients claimed to have used telehealth within the preceding year. Of this population, 94 percent stated their intention to use telehealth again. See original article: < Previous News Next News >

  • CMS Releases Final Calendar Year (CY) 2023 Physician Fee Schedule

    CMS Releases Final Calendar Year (CY) 2023 Physician Fee Schedule CCHP November 08, 2022 Last week, the Center for Medicare and Medicaid Services (CMS) released the final rule for the CY 2023 Medicare Physician Fee Schedule (PFS). CMS finalized many of their telehealth proposals, which primarily focused on what services will be covered by the program and what will happen immediately following the end of the public health emergency (PHE), including during the 151-day grace period included in the 2022 Budget Act. CMS clarified that the list of services that were temporarily allowed to be delivered via telehealth and reimbursed by Medicare during the PHE, will still be allowed during the 151-day grace period. Additionally, CMS added more of the temporary telehealth PHE list codes to a category of services that would remain through the end of 2023. The rule also reiterates the requirement for an in-person visit in the first 6-months of an initial telehealth mental health visit and every 12 months afterward (with exceptions), and clarifies that won’t be implemented until 152 days after the end of the PHE. They will address the specifics around coding and reporting these types of services through guidance and a sub-regulatory process in the future to ensure a smooth transition after the PHE ends. Stay tuned for an in-depth In Focus write up from CCHP on the 2023 PFS next week, as well as a new factsheet focused on the telehealth elements in the final rule. See original article: < Previous News Next News >

  • State Telehealth Laws and Reimbursement Policies Report, Fall 2022

    State Telehealth Laws and Reimbursement Policies Report, Fall 2022 CCHP October 2022 The Center for Connected Health Policy’s (CCHP) Fall 2022 Summary Report of the state telehealth laws and Medicaid program policies is now available as well as updated information on our online Policy Finder tool. The most current information in the online tool may be exported for each state into a PDF document. The following is a summary of the current status of telehealth policy in the states given these new updates. CCHP provides these bi-annual summary reports in the Spring and Fall each year to provide a snapshot of the progress made in the past six months. CCHP is committed to providing timely policy information that is easy for users to navigate and understand through our Policy Finder. The information for this summary report covers updates in state telehealth policy made between July and early September 2022. Read the executive summary While this Executive Summary provides an overview of findings, it must be stressed that there are nuances in many of the telehealth policies. To fully understand a specific policy and all its intricacies, the full language of it must be read utilizing CCHP’s telehealth Policy Finder. For further information, visit We hope you find the report useful, and welcome your feedback and questions. You can direct your inquiries to Amy Durbin, Policy Advisor or Christine Calouro, Policy Associate at . A special thank you to CCHP Policy Associate Veronica Collins for her invaluable contributions to this report. INTRODUCTION The Center for Connected Health Policy’s (CCHP) Fall 2022 analysis and summary of telehealth policies are based on information contained in its online Policy Finder. The Summary Report provides highlights on certain aspects of telehealth policy and the changes that have taken place between now and the previous edition, Spring 2022. The research for this edition of the Summary was conducted between July and early September 2022. This summary offers the reader an overview of telehealth policy trends throughout the nation. For detailed information by state, see CCHP’s telehealth Policy Finder which breaks down policy for all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands. Please note that many states continue to keep their temporary telehealth COVID-19 emergency policies siloed from their permanent telehealth policies. These temporary policies are not included in this summary, although they are listed under each state in the online Policy Finder under the COVID-19 category. In instances where the state has made policies permanent, or extended policies for multiple years, CCHP has incorporated those policies into this report. See full report: < Previous News Next News >

  • HIMSSCast: How emerging tech is opening new avenues in telehealth, RPM

    HIMSSCast: How emerging tech is opening new avenues in telehealth, RPM Mike Miliard October 28, 2022 Virtual therapeutics, voice recognition and fast-evolving artificial intelligence tools are transforming home-based care, says Robin Farmanfarmaian, co-author of the new book How AI Can Democratize Healthcare. Remote patient monitoring and other forms of virtual care are fast finding footholds in healthcare as patients get acquainted with these new care modalities, and as health systems learn to appreciate the cost efficiencies they offer. But telehealth and RPM are still in their early days, and fast-changing as they're augmented with other new and emerging digital health and artificial intelligence technologies. Robin Farmanfarmaian, a longtime Silicon Valley entrepreneur and co-author of the new book, How AI Can Democratize Healthcare, joined us recently to discuss how the growing momentum toward home-based care is being impacted by leading-edge innovations such as natural language processing, digital therapeutics and more. leading-edge-technologies-are-transforming-telehealth-and-rpm (1).mp3 Talking points: Where remote patient monitoring is now, and where it's headed How AI is changing how virtual care is delivered New approaches to patient engagement and experience What's next for digital therapeutics and other app-based interventions Innovative use cases for NLP and machine learning models More about this episode: The intersection of remote patient monitoring and AI How remote patient monitoring is moving into the mainstream AI-powered telehealth improves PT care at Essen Health Care Mayo Clinic working with Memora Health on virtual postpartum care AI-powered RPM can help address the rural neonatal care crisis How remote patient monitoring improves care, saves money AI and IoT device connects with concierge platform for RPM Twitter: @MikeMiliardHITN Email the writer: Healthcare IT News is a HIMSS publication. See original podcast: < Previous News Next News >