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NEWS A collection of relevant articles providing: Telemedicine trends Industry insights Innovation updates Funding developments Legislation tracking Statutory analysis And more... Industry News Q&A: How retail healthcare, telehealth trends could evolve in 2023 Sanjula Jain, senior vice president of market strategy and chief research officer at Trilliant Health, discusses the future of virtual care and how emerging retail players will affect the industry. December 16, 2022 Read More UCHealth slashes code blues up to 70% with telehealth technologies The academic medical center uses tele-sitter and virtual ICU platforms for a program it calls Virtual Deterioration. December 20, 2022 Read More Leveraging Telehealth Platforms to Enhance Provider Workflows, Adoption Implementing a telehealth platform can positively impact provider workflows in numerous ways, including easing administrative burdens, thereby leading to greater provider adoption and satisfaction. December 28, 2022 Read More Telehealth helps stop suicidal ideation for many patients, study finds One person dies from suicide every 11 minutes in the U.S. A new study shows that telemedicine can be used to treat more severe mental illness – contrary to previous thought. December 29, 2022 Read More Telehealth May Be Rural Healthcare’s Lifeline As a new year dawns, it seems like a stock-taking time in U.S. healthcare. Skyrocketing costs, underwater margins, a depleted workforce and sicker patients have most hospitals and systems thinking existential thoughts about 2023, none more so than rural facilities. December 28, 2022 Read More

Board of Directors BOARD A message from the Chair: Stetson Berg Thanks to our work at the Alliance and a terrific Legislature, New Mexico enjoys one of the most progressive telehealth statutes in the country. That doesn’t mean our work is done. The New Mexico Telehealth Alliance exists to support New Mexico telehealth capabilities by continuing to advocate for needed policy changes, providing useful resources in a variety of formats, and creating mechanisms for convening and sharing. We offer educational webinars, online forums, links to resources, and networking opportunities. Connect with us and participate in strengthening New Mexico's access and capacity to provide care across our vast State by bringing a telehealth-related problem you need help solving, joining a committee, participating in our webinars, or sharing your expertise as a speaker. Stetson Berg CVS Chair, Executive Committee Member Steve Desaulniers BLUE CROSS BLUE SHIELD OF NEW MEXICO Vice-chair, Executive Committee Member Christine David PRESBYTERIAN HEALTHCARE SERVICES Secretary, Executive Committee Member Jerry Harrison NEW MEXICO HEALTH RESOURCES Executive Committee Member Beth Landon LANDON & ASSOCIATES Immediate past chair, Executive Committee member Robert Longstreet NEW MEXICO PRIMARY CARE ASSOCIATION Executive Committee Member Dale Alverson, MD UNM, PROFESSOR EMERITUS TOUCH-TSC, LLC Raquel Aragon WESTERN SKY COMMUNITY CARE Kate Berg UNM PROJECT ACCESS Geof Empey UNM CENTER FOR TELEMEDICINE Maggie Gunter, Phd SYNCRONYS TOUCH-TSC, LLC Annie Jung, MD NM MEDICAL SOCIETY Maggie McCowen BEHAVIORAL HEALTH PROVIDERS ASSOCIATION OF NEW MEXICO Jennifer Sandoval MOLINA HEALTHCARE NEW MEXICO Terri Stewart SYNCRONYS

AMA survey shows widespread enthusiasm for telehealth American Medical Association March 23, 2022 CHICAGO — An American Medical Association (AMA) survey released today shows physicians have enthusiastically embraced telehealth and expect to use it even more in the future. Nearly 85% of physician respondents indicated they are currently using telehealth to care for patients, and nearly 70% report their organization is motivated to continue using telehealth in their practice. Many physicians foresee providing telehealth services for chronic disease management and ongoing medical management, care coordination, mental/behavioral health, and specialty care. The survey comes as Congress recently extended the availability of telehealth for Medicare patients beyond the current COVID-19 public health emergency. Additional action by Congress will be needed to permanently provide access to Medicare telehealth services. As physicians and practices plan to expand telehealth services, they say widespread adoption hinges on preventing a return to the previous lack of insurance coverage and little to no payer reimbursement. Payers, both public and private, should continue to evaluate and improve policies, coverage, and payment rates for services provided via telehealth. “Physicians view telehealth as providing quality care to their patients, and policymakers and payers have come to the same conclusion. Patients will benefit immensely from this new era of improved access to care,” said AMA President Gerald E. Harmon, M.D. “This survey shows adoption of the technology is widespread as is the demand for continued access. It is critical that Congress takes action and makes permanent telehealth access for Medicare patients.” Physicians strongly support that telehealth via audio-only/telephone remains covered in the future to ensure equitable access. That coverage has been permitted during the public health emergency and extended for several months afterward. According to the survey, 95% of physicians report patients are primarily located at their home at the time of the virtual visit. Allowing patients to be in their home is a key component of making telehealth more accessible. Before the pandemic, Medicare patients needed to be physically located in a rural area to access telehealth services, shutting out urban and suburban patients from receiving the same benefits of virtual care. Before the pandemic, rural patients needed to travel to an “originating site,” essentially another health care facility, outside of their home to access telehealth services. The temporary extension in the omnibus will allow patients with Medicare to receive telehealth services anywhere they are located, including in their home. The AMA will continue to urge Congress to make permanent this and other policies that have offered coverage and convenience to patients. Fewer than half of respondents report being able to access all of their telehealth platforms via their electronic health records, and more than 75% report that their support technology does not automatically collect and deliver patient-reported data. Improving interoperability between platforms and support technology would improve and streamline telehealth services. Physicians perceive technology, digital literacy, and broadband internet access to be the top three patient barriers to using telehealth. In addition, only 8% of physician respondents said they were using remote patient monitoring at this time. The AMA will advocate for patient populations and communities with limited access to telehealth service, including but not limited to, supporting increased funding and planning for telehealth infrastructure such as broadband and internet-connected devices. Read the survey here. To learn more about the results, register for an AMA Telehealth Immersion Program webinar at 10 a.m. ET March 31. Media Contact: Jack Deutsch ph: (202) 789-7442 jack.deutsch@ama-assn.org About the American Medical Association The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care. < Previous News Next News >

Update on Risks of Payments in Arrangements With Telemedicine Companies: OIG Warns of Prosecution Risks and Identifies Seven Criteria for Caution When Entering Into Telemedicine Payment Arrangements, and the Advancing Telehealth Beyond COVID-19 Act Passes Andrea M. Ferrari, Nadia de la Houssaye August 26, 2022 On July 20, 2022, the Office of Inspector General of the US Department of Health & Human Services (OIG) issued a Special Fraud Alert urging healthcare practitioners to exercise caution when entering into arrangements with telemedicine companies. OIG issued this Special Fraud Alert the same day the US Department of Justice (DOJ) announced criminal charges against 36 defendants in 13 federal districts as part of the DOJ’s Nationwide Coordinated Law Enforcement Effort to Combat Telemedicine, Clinical Laboratory, and Durable Medical Equipment Fraud.[1] The Special Fraud Alert notes that OIG has recently conducted dozens of investigations of alleged fraud schemes involving companies that provide telehealth, telemedicine, or telemarketing services (collectively, Telemedicine Companies). It also notes that in many of these investigations, OIG found evidence that the Telemedicine Companies intentionally paid physicians and non-physician practitioners (collectively, Practitioners) kickbacks to generate orders or prescriptions for medically unnecessary durable medical equipment, genetic testing, wound care items, or prescription medications. The Special Fraud Alert warns that such kickback schemes implicate the federal Anti-Kickback Statute and can lead to Practitioners, Telemedicine Companies, and others that participate in the schemes being held liable criminally, civilly, and administratively. Liability may arise from (1) paying or receiving payment in violation of the federal Anti-Kickback Statute; and (2) causing submission of fraudulent claims to federal healthcare programs such as Medicare, Medicaid, and Tricare, which may constitute a violation of the federal False Claims Act and other federal laws. As a cautionary guide, the Special Fraud Alert identifies seven arrangement characteristics that may raise OIG scrutiny: 1. The patients for whom a Practitioner orders or prescribes items or services are identified or recruited by a Telemedicine Company, sales agent, recruiter, call center, or health fair, and/or through internet, television, or social media advertising for free or low-cost out-of-pocket items or services. 2. A Practitioner does not have sufficient contact with or information from the purported patient to meaningfully assess the medical necessity of the items or services ordered or prescribed. 3. A Telemedicine Company compensates a Practitioner based on the volume of items or services ordered or prescribed, which may be characterized to the Practitioner as compensation based on the number of medical records that the Practitioner reviewed. 4. A Telemedicine Company furnishes items and services only to federal healthcare program beneficiaries and does not accept insurance from any other payor. 5. A Telemedicine Company claims to furnish items and services only to individuals who are not federal healthcare program beneficiaries but may, in fact, bill federal healthcare programs. 6. A Telemedicine Company only furnishes one product or a single class of products (e.g., durable medical equipment, genetic testing, diabetic supplies, or various prescription creams), potentially restricting a Practitioner’s treatment options to a predetermined course of treatment. 7. A Telemedicine Company does not expect Practitioners to follow up with patients, nor does it provide Practitioners with the information required to follow up with patients (e.g., the Telemedicine Company does not require Practitioners to discuss genetic testing results with each purported patient). OIG advises in the Special Fraud Alert that this list of suspect criteria is illustrative and not exhaustive. Therefore, even arrangements that do not specifically fit one or more of these suspect criteria may still be suspect. However, OIG also indicates that it recognizes there are many legitimate telemedicine and telehealth arrangements, and explicitly states that the Special Fraud Alert is not intended to discourage those legitimate arrangements. Rather, OIG is using the Special Fraud Alert to encourage Practitioners (and, by extension, their advisors) to use heightened scrutiny, exercise caution, and consider the above list of suspect criteria before entering into arrangements with Telemedicine Companies. Telehealth Expansion Legislation Significantly, a week after OIG issued the Special Fraud Alert, the US House of Representatives overwhelmingly (416-12) passed the Advancing Telehealth Beyond COVID-19 Act of 2022 (HR 4040), which encourages broad use of telehealth by expanding and extending for at least an additional two years — through December 2024 — the Medicare telemedicine payment policies that were introduced for the COVID-19 public health emergency. The House bill removes geographic restrictions and expands originating sites for telehealth services, continues expansion of the practitioners eligible to provide telehealth services, allows mental health services to be provided via telehealth and telecommunications, and continues certain COVID-19 allowances for audio-only telehealth services. The bill is now pending in the Senate. [1] Press Release, US Department of Justice, Justice Department Charges Dozens for $1.2 Billion in Health Care Fraud (July 20, 2020), https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud. © 2022 Jones Walker LLP National Law Review, Volume XII, Number 238 See Original article: https://www.natlawreview.com/article/update-risks-payments-arrangements-telemedicine-companies-oig-warns-prosecution < Previous News Next News >

The Punctuated Equilibrium Of Telemedicine: Digital Health Solutions And Government’s Role Richard Schwabacher September 14, 2022 As Covid-19 took hold in our communities, the increase in demand and need for telehealth and other virtual care options accelerated at an unprecedented pace. As Covid-19 took hold in our communities, the increase in demand and need for telehealth and other virtual care options accelerated at an unprecedented pace. Action was taken at the state and federal levels, as well as by payers and employers, to make telehealth easily accessible. Nearly overnight, swift changes in payment, reimbursement, coverage and licensing policies were made as the pandemic disrupted every facet of life. Telehelth benefits have proven to be popular, so much so that Congress recently voted 416-12 to extend benefits. Simultaneously, investment in the digital health market has soared to a record $29.1 billion in 2021 to transform a healthcare system that could support digital capabilities. Patients, already accustomed to digital services, like banking, quickly adapted to the change. When radical change occurs in a short period of time and then finds a new balance, we call that a punctuated equilibrium. With respect to telemedicine, we don’t expect to return to life as we knew it before Covid-19 or, at the other end of the spectrum, settle in a place where high rates of telemedicine adoption were during the surges. Ultimately, there will be a new equilibrium that nestles between those two polar opposites. Despite overwhelming investment and adoption of virtual care and telehealth options by patients and providers, barriers still exist. There are specific actions government and businesses can take and should, to support healthcare programs born out of the pandemic—but only if the economics and incentives are aligned. Spotlight Moment For Laboratory Diagnostics Laboratory diagnostics has always been a critical component of healthcare—diagnosis, prevention, management, and so forth—but the pandemic put lab testing and access to it squarely in the spotlight. It became an urgent need that nearly everyone had. The value and role of laboratory diagnostics cannot be understated. According to the CDC, 70% of high-quality care depends on diagnostic testing to make medical decisions by equipping providers with the necessary information to properly address patient needs. Diagnostics are most often the healthcare tools providers rely on when diagnosing, managing and treating a variety of diseases and conditions; for instance, 12 of the 15 most clinically and economically significant disease categories in the U.S. dictate using laboratory diagnostics as the standard of care. Lack of access to laboratory diagnostics for patients has wide-ranging effects, including implications for medication nonadherence that will continue to grow as the burden of chronic diseases grows. The Role Of Government Policy The patchwork approach to solving these problems will not suffice in the long run, which is why the role of government in the sustained expansion of virtual care services is so important. Healthcare policy ought to keep pace with the evolution of healthcare technology. It’s encouraging to see the current administration invest in and promote innovation with information technology to better serve community health. The investment not only includes $34 billion initially invested through the HITECH sections of the American Recovery and Reinvestment Act but also many billions of dollars expended by U.S. industries, including laboratories. Three specific policies can help direct and reward innovation leading to better outcomes. • Ensure that all patient data needed by clinicians for individual and population care is available. While the CURES Act and the ONC CURES Act Final Rules aim to prevent data blocking, business practices among providers and payers sometimes serve as effective barriers to serving patients in their communities. ONC and CMS can refine the rules to ensure data is available in all EHRs from all appropriate sources, facilitating timely availability of all patient data wherever it is needed. • CMS should develop companion coding for telemedicine services and home-based specimen collection for lab testing. The value of telehealth is compromised if the patient must travel to a distant site for lab testing in support of the telehealth intervention. • While the government can mandate that providers report specified data, the results from home-administered testing are not available in standardized electronic formats and do not get reported. This has created barriers to public health responses in communities most at risk. What Can Businesses Do? There are ways for businesses and the government to collaborate that can improve the telemedicine landscape that benefits patients and consumers, as the clear, quantifiable health outcomes speak for themselves and can help influence further adoption and integration. For instance, the number of Medicare beneficiary telehealth visits increased 63-fold in 2020 to more than 52.7 million. While at the Mayo Clinic, ambulatory management of Covid-19 showed effective use of remote patient monitoring with a 78.9% engagement rate. These are just two examples that illustrate the increased adoption and success of making telemedicine an integral part of healthcare protocols. Companies that move to a value-based incentive model from a fee-for-service model and move toward reimbursement models that reward quality can be an alternative to the status quo. Telemedicine can be part of the solution when addressing inequities in access to care, including specialty care and at-risk populations. We already know that lack of access to laboratory diagnostics for patients has wide-ranging effects that will continue to grow as the burden of chronic diseases grows. Virtual Care Is Here To Stay Digital healthcare models are changing the landscape of the healthcare system as we know it, and this is good news for patients and providers. The changes empower patients to take more control of their health, give them more options that cater more to their needs, lower costs for “virtual-first” or “hybrid care” healthcare plans and improve access. Our collective experience during the pandemic has shown that people need healthcare and clear access points. The expanded use, adoption and successful integration of digital healthcare solutions have been received positively and have encouraged more participation. We need to continue to expand telehealth and remote options with policy that supports it—to backtrack on the progress we’ve made would be a mistake. See original article: https://www.forbes.com/sites/forbestechcouncil/2022/09/14/the-punctuated-equilibrium-of-telemedicine-digital-health-solutions-and-governments-role/?sh=523fd49e2deb < Previous News Next News >

Transgender Telemedicine and Telehealth Services: A Tremendous Asset Dr. Maheu, Telehealth.org August 2021 Telehealth services can also be effective in reaching communities not isolated by location but marginalized by identity. One of the most significant arguments for telehealth services is their ability to reach people in underserved communities. Telehealth.org described some of the foundational issues in its article The Future of Telehealth, Teletherapy, and Telemedicine. The article specifically highlighted telehealth as a means of overcoming geographic limitations. However, telehealth services can also be similarly effective in reaching communities not isolated by location but marginalized by identity. In particular, transgender telemedicine & telehealth services provide significant benefits to the trans community. Challenges Facing the Transgender Community Telehealth.org outlined many challenges facing transgender individuals seeking services in its article Transgender Telemedicine: Inequities and Barriers in Health Care Access. In seeking therapy services, one of the most substantial dissuading factors reported by transgender individuals is fear of discrimination. This fear does not come without significant evidence. Last year, the Supreme Court decided to extend trans individuals the same discrimination protections other groups already experience under employment laws. Even after that landmark decision, 38% of Americans still indicate they do not support the rights of trans people. With so-called bathroom bills and legislation that prevents trans girls and women from participating on sports teams for women, the current American legislative landscape continues to be challenging. Location and marginalization often intersect. Trans individuals living in rural areas often face a general lack of available services. Additionally, available clinicians usually do not have a trans-informed perspective. Similar concerns exist in politically conservative areas. How Transgender Telemedicine and Telehealth Services Help the Trans Community As noted above, telehealth services have already been an asset to assist individuals who are geographically isolated. It should be just as effective in reaching trans individuals in those areas as helping others. For those isolated by discrimination and fear of discrimination due to their trans status, telehealth can also help. By allowing people in the trans community to reach beyond their geographic limitations, they immediately have access to a larger pool of supportive clinicians who can provide trans-informed services. Telehealth transgender services also provide increased anonymity to a degree for trans people. In many of rural America’s small towns, people know each other by vehicle. Seeing someone’s vehicle parked in front of a mental health or drug treatment facility can often send the town’s gossip mill into a tailspin. By accessing discrete trans telemedicine or telehealth services to their homes, people avoid this harmful exposure. Can Transgender Telemedicine & Telehealth Services Continue? Trans individuals used telehealth 20 times more in the past 18 months than they ever have before. This new safe therapy avenue, however, may not last. Just two weeks ago, four states either ended many of their telehealth expansion policies or announced their intention to do so. Federally, the waivers introduced by the CARES Act will expire in October unless renewed or made permanent. The system is in transition and it may well end up leaving behind some of the progress it has made. Transgender Telemedicine and Telehealth Advocacy The time is now to reach out to your officials, state and federal, and advocate for more permanent laws that expand telehealth services and reimbursement. Sharing case examples without client identifying information and your passion for the issue could be just the sort of personal advocacy needed. Your voice may persuade elected officials to act quickly and empathetically on behalf of the trans community and everyone else who will benefit from telehealth support. Rural Transgender Report: https://www.lgbtmap.org/file/Rural-Trans-Report-Nov2019.pdf < Previous News Next News >

Interstate Telehealth Use By Medicare Beneficiaries Before And After COVID-19 Licensure Waivers, 2017–20 Juan J. Andino, Ziwei Zhu, Mihir Surapaneni, Rodney L. Dunn, and Chad Ellimoottil Abstract During the COVID-19 pandemic, all fifty states and Washington, D.C., passed licensure waivers that allowed patients to participate in telehealth visits with out-of-state clinicians (that is, interstate telehealth). Because many of these temporary flexibilities have expired or are set to expire, we analyzed trends in interstate telehealth use by Medicare beneficiaries during 2017–20, which covers the period both directly before and during the first year of the pandemic. Although the volume of interstate telehealth use increased in 2020, out-of-state telehealth made up a small share of all outpatient visits (0.8 percent) and of all telehealth visits (5 percent) overall. For individual states, out-of-state telehealth made up between 0.2 percent and 9.3 percent of all outpatient visits. We found that most out-of-state telehealth use was for established patient care and that a higher percentage of out-of-state telehealth users lived in rural areas compared with beneficiaries who did not receive care outside of their state (28 percent versus 23 percent). Our collective findings suggest that the elimination of pandemic licensure flexibilities will affect different states to varying degrees and will also affect the delivery of care for both established patients and rural patients. View Full Article: https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2021.01825?journalCode=hlthaff ​ ​ < Previous News Next News >

Medicare Physicians Fee Schedule 2023 draft and the Impact on Rural Health Arizona Telemedicine Program August 16, 2022 Request a copy of the full report by navigating to the original article link. For original article: https://telemedicine.arizona.edu//event/webinar/2022-08-16-medicare-physicians-fee-schedule-2023-draft-and-impact-rural-health < Previous News Next News >

Expansion of Telehealth Services Must Be Sustained Gerald E. Harmon, MD American Medical Association President July 2021 Now it’s time to cement that success by making permanent the temporary easing of restrictions that brought the full potential of telehealth into focus. The rapid growth and large-scale adoption of telehealth services over the past 18 months has allowed physicians to deliver a broad range of badly needed services to patients nationwide in an innovative, cost-effective manner. Now it’s time to cement that success by making permanent the temporary easing of restrictions that brought the full potential of telehealth into focus. Congress can brighten this picture by passing legislation already introduced into the current session that enjoys bipartisan support. Among other steps that need to be taken, the pending legislation—CONNECT for Health Act of 2021 (S 1512) and the Telehealth Modernization Act (HR 1332)—would strip away all geographic restrictions placed on telehealth services and allow Medicare recipients to receive this care in their own homes, rather than being forced to travel to an authorized health care center to receive it. Although this provision has been waived for the duration of the public health emergency trigged by the COVID-19 pandemic, the ability to provide telehealth services directly to patients regardless of their location will be lost unless Congress acts. Physicians and their patients who have witnessed firsthand the immense benefits and value of telehealth services must not be forced to stop using these widely available tools for better health simply because the pandemic is over. Telehealth has improved health care The benefits of telehealth are obvious. Telehealth enables physicians to strengthen continuity of care, extend access outside of normal clinic hours, and ease the impact of clinician shortages in rural areas and among underserved populations. By increasing the quantity and quality of communication between patients and physicians, telehealth has strengthened the trust that lies at the center of this relationship. Telehealth can slice overall health care costs by helping physician practices and health care systems better manage diabetes, heart disease and other chronic illnesses while increasing the overall quality of care and patient satisfaction. This technology can also prevent patients from delaying care for conditions that, if undetected and untreated, can trigger emergency department visits or lengthy hospital stays. Wide-ranging case-study examples of the comprehensive value that virtual care can provide are featured in the AMA’s Return on Health research issued in May. And let’s not forget the value of telehealth services to patients with impaired mobility, the immunocompromised, frail or elderly individuals who require the aid of a caregiver to travel, and those who cannot arrange the transportation or child care they need to receive care. The enhanced opportunities telehealth affords to assess the impact of patients’ social determinants of health lays the groundwork for better treatment and improved health outcomes for historically marginalized and minoritized communities. The widespread expansion of telehealth services we have witnessed serves all of these patient populations and others in an efficient and cost-effective manner that must be sustained. While the Centers for Medicare & Medicaid Services has expanded its coverage for telehealth services during the pandemic, only action by Congress will ensure that Medicare beneficiaries will enjoy full access to those services once the pandemic is behind us. The expansion of telehealth covered by Medicare at payment parity with in-person services during the COVID-19 public health emergency includes more than 150 services, including emergency department visits, hospital admissions and discharges, critical care and home care, to name just a few. Offering this equivalency remains a critical factor in ensuring that physician practices can cover the additional costs tied to virtual care provision. How we support greater telehealth adoption Our AMA’s commitment to telehealth technologies grows stronger each day. For example, our Telehealth Immersion Program helps individual physicians, physician practices and health systems expand and optimize telehealth services through interactive peer-to-peer training sessions, curated webinars, clinical best practices, virtual care boot camps and other assets. Additional resources, including a Telehealth Quick Guide, Telehealth Playbook, and STEPS Forward™ telehealth training module, are just three more examples among many available on our website. The Digital Medicine Payment Advisory Group is a collaborative initiative convened by the AMA to help integrate digital medicine technologies into clinical practice by knocking down barriers to widespread adoption while zeroing in on comprehensive solutions for issues with coding, reimbursement, coverage and related factors. The mission of this diverse cross section of nationally recognized digital medicine experts includes: Reviewing existing code sets—particularly CPT® and HCPCS—to ensure they accurately reflect current digital medicine services and technologies. Assessing factors that affect the fair and accurate valuation of services delivered in this manner. Providing information and clinical expertise that promotes widespread coverage of telehealth, remote patient monitoring and all other digital medicine services, including increased transparency of services covered by payers and improved enforcement of parity coverage laws. The expansion of physician-based telehealth services in 2020 ranks as one of the most important advances in health care delivery in many years. Allowing this progress to slip from our hands because of outdated and arbitrary restrictions will result in higher costs and poorer health outcomes for patients everywhere. The decisions made and the policies adopted in the near future will shape the direction of telehealth services for many years to come. We urge Congress and the Biden administration to take the steps necessary to build on the progress in virtual care we’ve made thus far while laying the foundation for greater innovation going forward. < Previous News Next News >

Building Lasting Tele-Behavioral Health Programs to Address Patient Needs Kat Jercich, Healthcare IT News. August 2021 In a HIMSS21 Global Conference Digital session, two experts discuss what it's taken for the University of Rochester to spin up a virtual behavioral health program over the past nine years. Telehealth during the COVID-19 pandemic has allowed many patients – especially those in under-resourced areas – unprecedented access to behavioral healthcare. But as Michael Hasselberg, senior director of digital health at the University of Rochester, discussed with Cleveland Clinic Director of Design and Best Practices Julie Rish during a HIMSS21 Global Conference Digital session, such programs have required being nimble and adaptable in the face of changing needs. Hasselberg outlined the results of a tele-behavioral health model in effect at the University of Rochester, explaining that it grew from a pilot program aimed at primary care doctors to a full-scale initiative in nearly a decade. But the pandemic, he says, ramped up demand – and the supply had to change in response. "Like every health system in the entire country, overnight you had to flip the switch on, and essentially totally pivot to telemedicine," he said. Having the infrastructure and years of experience allowed the team to shift within about a week to providing behavioral health services nearly entirely virtually. Even as vaccines have become more readily available, Hasselberg estimates that about 60% of the team's ambulatory services are being provided via telemedicine. Interestingly, considering reports from other parts of the country, Hasselberg said the team has not encountered patient difficulties with broadband access, even in rural areas – thanks in part to state government efforts to ensure connectivity throughout the region. But one challenge, he said, has been gaining community trust and support. "Learning to build those community partnerships, identify how the stakeholders are, doing focus groups … has allowed us to be successful," he said. For other organizations looking to replicate the university's success, he said, start by reaching out to providers already in place. "Build that partnership there. Find out where their struggles may be, where the gaps may be, how you can join forces to fill those gaps and truly partner," he advised. He also suggests approaching the programs as iterative – being agile and flexible, and not allowing perfect to be the enemy of good. "Just get something out there: See what works and what doesn't work, and continue to build off of that," he said. It's also vital to remember that not every service can be done via telehealth, he said. Having a support network to assist patients with technology is enormously helpful. Rish noted that it's not just about access alone. It's also about comfort and about trust. "Having somebody from your team who can get to the community, who can be onsite – that's really important," said Hasselberg. Hasselberg said it's been useful to examine who can most benefit from telehealth because of transportation hurdles or other barriers to in-person care. "Finding parking at an academic medical center is not an easy thing to do!" he laughed. By merging that information with electronic health record data, he said, the team can get specific about how best to target services. As far as care delivery predictions, Hasselberg said he saw telemedicine as the "tip of the iceberg." "I think the future of behavioral health will be an a la carte array of options," he said. < Previous News Next News >

Legislation Legislation New Mexico Legislation ​ S.B. 93 - Broadband Access and Expansion Act H.B. 141 - ED Infrastructure Technology Definition S.B. 24 - Parity of Regulation of Telecommunication ​ Federal Telehealth Legislatio n ​ H.R. 7992 - Telehealth Act​ (2019-2020) H.R.3228 - VA Mission Telehealth Clarification Act (2019-2020) H.R.4900 - Telehealth Across State Lines Act (2019) H.R.5473 - EASE Behavioral Health Services Act (2019-2020) H.R.7233 - Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act (2020) H.R.7338 - Advancing Telehealth Beyond COVID–19 Act (2020) S.2408 - Telehealth Across State Lines Act (2019) S.3988 - Enhancing Preparedness through Telehealth Act (2019-2020) S.4039 - TELEHEALTH HSA Act (2020) S.4216 - KEEP Telehealth Options Act (2020) ​ ​ Federal Broadband Legislation ​ H .R.205 - To accelerate rural broadband deployment. H.R.4229 - Broadband Deployment Accuracy and Technological Availability Act S.4021 - Accelerating Broadband Connectivity Act of 2020 ​ ​

New Study Finds Telehealth Outperforms In-Person Care in HEDIS Measures Eric Wicklund October 06, 2022 Researchers have found that telehealth performed better than in-person care in 11 of 16 HEDIS quality performance measures, but that doesn't mean virtual care is superior to the office visit. KEY TAKEAWAYS A recent study of more than 526,000 patients receiveing care at Wellspan Health sites in 2020 and 2021 found that telehealth outperformed in-person care in 11 of 16 HEDIS quality improvement measures for primary care. The research indicated in-person care was better in medication-based measures, while telehealth scored higher in testing and counseling measures. Researchers stressed that the results show a need for health systems to integrate telehealth with in-person care, enabling patients and providers to select the venue that most suits them and the treatment. New research published in the Journal of the American Medical Association (JAMA) finds that telehealth was superior to in-person care in 11 of 16 quality performance measures for primary care. The study, conducted by researchers at the Robert Graham Center in Washington DC and Pennsylvania-based Wellspan Health, focused on more than 526,000 patients receiving healthcare services at roughly 200 Wellspan Health outpatient sites between March 1, 2020, and November 30, 2021, and used HEDIS (Healthcare Effectiveness Data and Information Set) measurements. The researchers, led by Derek Baughman, MD, of the Robert Graham Center and Wellspan Good Samaritan Hospital in Lebanon, Pennsylvania, and Yalda Jabbarpour, MD, and John Westfall, MD, MPH, both of the Robert Graham Center, said the results don't mean that health systems should close their clinics and focus on virtual care. Rather, they should offer telehealth as a part of the overall care plan, particularly for those who face barriers to accessing in-person care. The study noted that in-person care showed better results for all medication-based measures, while telehealth offered better results in testing and counselling measures, such as vaccinations, chronic disease testing, and cancer and depression screenings. "Notwithstanding the statistical significance, the clinical relevance of these findings is perhaps more meaningful at the population health level for evaluating the outcomes of adding telemedicine as a care venue," Baughman and his colleagues noted. "Moreover, telemedicine exposure (especially blended office and telemedicine care) likely simulates a likely real-life scenario for the health consumer." "Practically, these findings provide reassurance for health entities seeking to add telemedicine to their care capacity without reducing quality of care," they added. "And as we found, embracing telemedicine for enhancing certain aspects of care might be an avenue for enhancing quality performance in primary care." Baughman and his team said it wasn't clear why telehealth outperformed in-person care, though they noted that a telehealth platform offers better opportunities for care providers to reach out multiple times to patients to "engage in quality measure-promoting intervention." They also noted that some treatments, such as the initiation of a lifelong or life-changing medication program, are best begun in person, and perhaps shifted to virtual platforms for follow-up. "Future studies could provide more granularity on optimizing the specific role of telemedicine in clinical scenarios, eg, understanding whether there is an association between stages of hypertension and effect modification attributable to the management venue or an association between venue and number of blood pressure medications," they wrote. "This would provide insight on where to invest in health care infrastructure and what clinical venue would be most valuable. This could also guide venue selection for patients initiating antihypertensive therapy vs patients requiring a third antihypertensive. Such insight would promote win-win environments to increase value: improved health outcomes for patients and incentive for clinicians and health systems operating in value-based care models." Eric Wicklund is the Innovation and Technology Editor for HealthLeaders. See original article: https://www.healthleadersmedia.com/telehealth/new-study-finds-telehealth-outperforms-person-care-hedis-measures < Previous News Next News >

CMS-Supported Telehealth Will Continue To Be A Driving Force – But Watch for Greater OIG Enforcement The National Law Review March 3, 2022 As mindsets pivoted to a post-pandemic life, telehealth advocates petitioned CMS to embrace telehealth as a permanent care option, and CMS responded with regulatory action at the end of 2021. During the Covid-19 Pandemic, telehealth usage surged as patients and providers turned to it as a safer care alternative. McKinsey estimated telehealth claim volumes reached 80 times pre-pandemic levels at its peak, ultimately stabilizing at 38 times pre-pandemic levels by early 2021.1 This increase was mostly driven by CMS’ waivers and relaxation of regulatory constraints for telehealth reimbursement. But, the temporary nature of both left questions regarding telehealth’s future. In December 2021, CMS issued new regulations which, collectively, steer telehealth toward becoming a part of the telebehavioral health toolkit accepted by Medicare post-pandemic. In the CY2021 Physician Fee Schedule Final Rule2 , further discussed here, CMS broadly expanded access to telebehavioral health services. Specifically, Medicare permanently authorized payment for telehealth services furnished “for purposes of diagnosis, evaluation or treatment of a mental health disorder” under the following relaxed criteria:3. Read full article here: https://www.natlawreview.com/article/cms-supported-telehealth-will-continue-to-be-driving-force-watch-greater-oig < Previous News Next News >

Can we provide care across state lines? By Jan Ground PT, MBA, SWTRC Colorado Ambassador March 3, 2021 Snow birds. Not the kind that fly (certainly not now with COVID) but the human kind. For those of you who never heard the term before, snow birds are typically retirees who travel south in the winter to states like Arizona, New Mexico and Florida to get away from the snow and cold up north than go back up north in the summer when the heat hits the south. What does this have to do with telemedicine? A lot actually and not just with snow birds. We are a mobile population. People don’t stay in one place their entire lives anymore – we move around, we travel but when we move from one place to another we don’t get to leave our health conditions behind us. They stay with us and sometimes we just get sick when we travel. Being creatures of habit, however, most people like to have consistency in their health providers. We like to think that our PCP and specialists that we see know us and our problems, that we have a relationship. Back to the snow birds – if my cardiologist lives in Chicago and I see her during the summer I want to see her during the winter as well when I’m relaxing by the pool in Tucson staying warm. Problem is she’s back in Chicago shoveling snow so how can I see her? Telemedicine of course but it’s not that easy. An interstate compact is a contract between two or more states creating an agreement on a particular policy issue, including, but not limited to, the facilitation of licensure of clinicians in states other than that in which the clinician holds his/her home state of licensure. Currently, licensure compacts exist for physicians, nurses, physical therapists, psychologists, emergency management personnel, and speech-language pathologists/audiologists. Licensure compacts for physician assistants, counselors, advanced practice nurses, and occupational therapists are under development. Interstate Compact Models Mutual Recognition (Reciprocity) allows a clinician in a compact state ("home state") to practice in any of the other compact states without obtaining additional licensure in the remote states. The clinician’s home state license is “mutually recognized” by other compact member states. This model allows a practitioner to practice in the compact member states either using a multistate license or by obtaining a “compact privilege”. Expedited Licensure Participating U.S. states work together to significantly streamline the licensing process for physicians who want to practice in multiple states. It offers a voluntary, expedited pathway to licensure for physicians who qualify. These licenses are still issued by the individual states – just as they would be using the standard licensing process – but because the application for licensure in these states is routed through the Compact, the overall process of gaining a license is significantly streamlined. Physicians receive their licenses much faster and with fewer burdens. The Interstate Medical Licensure Compact is the only expedited licensure compact. With the national and state emergency orders related to COVID-19, the regulations requiring that licensed clinicians provide care only to patients who are physically located in the state(s) in which the clinician is licensed to practice have been relaxed. It is not known if, when, and how these regulations will change when the COVID-19 emergency orders have expired. This table summarizes what is going on in each state for a variety of providers with respect to pending (P) versus enacted (E) legislation as of January 2021. These are of course subject to change as each state makes progress in deciding what to do. FOR FULL ARTICLE SEE: https://southwesttrc.org/blog/2021/can-we-provide-care-across-state-lines Physicians www.lmlcc.org Nurses www.ncsbn.org/nurse-licensure-compact.htm Physical Therapists www.PTcompact.org Psychologists www.psypact.org Emergency Management Personnel ww.EMScompact.gov Speech-Language Pathologists Audiologists www.aslpcompact.com Occupational Therapists www.OTcompact.org Advanced Practice Nurses www.nscbn.org/aprn-compact.htm < Previous News Next News >

New Nationwide Poll Shows an Increased Popularity for Telehealth Services Center for Connected Health Policy June 2021 Expansion of telehealth is welcomed by most Americans. The American Psychiatric Association (APA) completed a new national public opinion poll finding that expansion of telehealth is welcomed by most Americans. Nearly 4 in 10 reported having used telehealth services, nearly 6 in 10 said they would use telehealth for mental health services, and more than 1 in 3 said they prefer telehealth. In addition, more individuals seem to have used telehealth via video (69%) than via phone (38%). Perception of the quality of telehealth appears to have improved as well, at 45% up from 40% last year. The results came from a recent online survey of 1,000 adults – additional information on the poll and its findings can be accessed on the APA website - https://www.psychiatry.org/newsroom/news-releases/New-Nationwide-Poll-Shows-an-Increased-Popularity-for-Telehealth-Services. < Previous News Next News >

Are Amazon, Walmart, CVS & Dollar Store Taking Over Healthcare? Dr. Maheu, Telehealth.org August 2021 ​ Amazon, Walmart, CVS, and Dollar General are making notable strides toward increasing their healthcare footprints, positioning themselves to create a seismic shift in healthcare. Telehealth.org has been reporting such efforts for the last several years, and this week offers you an update on the latest developments on amazon care, Walmart care clinic, CVS health, and Dollar General. Amazon Care Introduced in 2019, Amazon Care launched a pilot study for employees in Seattle, quickly followed by an expansion into Washington State. Amazon Care is now expanding nationwide. In addition to developing connections with other companies, the service appears most focused on expanding into underserved rural areas. The pivotal issue to consider as Amazon grows its healthcare footprint is that Amazon currently dominates two digital areas lacking in the industry: optimizing the delivery of digital customer experiences and excelling at the automation of services. Walmart Care Clinic In 2019, Walmart announced the first of its many health centers, called Walmart Care Clinic, with these offerings: primary care, labs, X-ray and EKG, counseling, dental, optical, hearing, community health (nutritional services, fitness), and health insurance education as well as enrollment, in a growing number of their facilities. Walmart has since been keeping itself involved in telehealth developments through mergers and acquisitions. Walmart, the largest in-person retail company in the United States, recently purchased MeMD, described as an “on-demand, multispecialty telehealth provider.” As a complementary addition to the already existing Walmart health centers, MeMD will enable Walmart to provide digital behavioral, primary, and urgent care services. Walmart has also begun a collaboration with Ro, a pharmacy services telehealth app. The relationship will also Ro to sell its health and wellness products in Walmart locations while further increasing Walmart’s digital service offerings. CVS Health Although CVS and Walmart had previously worked together to deliver care through Walmart’s pharmacies, CVS Health announced in January 2019 that Walmart opted to leave the CVS Caremark pharmacy benefit management commercial and Managed Medicaid retail pharmacy networks. That same year, CVS purchased Aetna for $69 billion in cash and stock. The merger brought one of the largest providers of pharmacy services together with the third-largest US-based health insurer. The successful merger formed a healthcare giant with more than $245 billion in annual revenue. Since then, CVS Health has steadily grown its healthcare footprint and, just last week launched a new health care benefit called Aetna Virtual Primary Care. The announcement reads: Offered through the CVS Health Aetna medical insurance subsidiary, Aetna Virtual Primary Care offers members access to a diverse panel of board-certified physicians and coordinated care from a consistent team of specialists based on their health needs. Members will have a continuous relationship with a virtual care physician, beginning from their first 30-45 minute comprehensive primary care visit and extending to every visit thereafter. Existing Aetna virtual care offerings include mental health counseling, dermatology services, and 24/7 urgent care. Dan Finke, executive VP, CVS Health, and President, Aetna, explained, “The future of digital health solutions is rapidly unfolding.” He added, “Aetna Virtual Primary Care is a first-of-its-kind health care solution that provides a simple, affordable, convenient way for eligible members to receive quality primary care from a physician-led care team that knows them and is accessible from virtually anywhere.” As described in his profile, Mr. Finke “is passionate about addressing mental health stigma. He is also deeply committed to attaining health equity for all Americans by engaging public and private stakeholders to address social determinants of health through analytics-based approaches that offer new insight and opportunities into health care disparities.” Dollar General Dollar General is a smaller company, but it has an enviable foothold in rural America. Their stores are well known and trusted. Therefore, they can offer care to patients who live in areas where primary care, behavioral and other specialists are difficult to access. While analysts doubt that Dollar General would follow Walmart’s lead and build primary-care clinics, telehealth solutions are easily within their reach. Dollar General differs from Amazon due to limited floor space, small parking lots, leased rather than owned retail space, and a lack of infrastructure for filling prescriptions. However, these limited abilities did not prevent Dollar General from serving as a site for COVID-19 testing in some states. Dollar General has already partnered with Higi, a blood-pressure machine company that can be seen in some Dollar general stores. Babylon Health is a telehealth provider that has invested in Higi. Given its rural presence, Dollar General may be positioning itself for acquisition by one of the larger publicly traded telehealth companies. In July 2021, the company issued a press released stating: With 75% of the U.S. population living within approximately five miles of one of Dollar General’s 17,000+ stores, the Company recognizes the unique access it provides to rural communities often underserved by other retailers as well as the existing healthcare ecosystem. The Company’s commitment to expanding its health offerings is underpinned by its existing infrastructure, robust supply chain, and current complementary health and nutrition assortment. < Previous News Next News >

The changing landscape of telehealth: 4 federal legislative developments Naomi Diaz May 24, 2022 Federal lawmakers have introduced four bills that look to update, continue, renew and expand telehealth access for patients and providers. Below are recent federal developments for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic, according to JD Supra: HHS' $16.3 million for Title X family planning program: On May 10, HHS announced it will release $16.3 million in grants for family planning groups to expand telehealth services and infrastructure. The funds will be made available through the American Rescue Plan and will be awarded to 31 Title X family planning programs and facilities. Restoring Hope for Mental Health and Well-Being Act: The bill, introduced May 6, would provide grants to schools and emergency departments to scale up or expand pediatric mental health telehealth access. Women's Health Protection Act: Introduced May 4, this bill would protect a provider's ability to provide abortion services via telehealth. Telehealth Extension and Evaluation Act: This bill, introduced April 26, would extend telehealth flexibilities enabled by Medicare for two years following the COVID-19 pandemic. < Previous News Next News >

Telehealth Legislation Re-Introduced National Council for Behavioral Health March 12, 2021 This week, Sens. Portman (R-OH) and Whitehouse (D-RI) and Reps. McKinley (R-WV), Budd (R-NC), Cicilline (D-RI), and Trone (D-MD) re-introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. The legislation, first introduced last Congress, seeks to support the expansion of telehealth services for substance use care. The TREATS Act would allow for the prescription of medication-assisted treatment (MAT) without a prior in-person visit, and for Medicare to be billed for audio-only telehealth services. The National Council supports these efforts to expand access to needed substance use services. This week, Sens. Portman (R-OH) and Whitehouse (D-RI) and Reps. McKinley (R-WV), Budd (R-NC), Cicilline (D-RI), and Trone (D-MD) re-introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. The legislation, first introduced last Congress, seeks to support the expansion of telehealth services for substance use care. The TREATS Act would allow for the prescription of medication-assisted treatment (MAT) without a prior in-person visit, and for Medicare to be billed for audio-only telehealth services. The National Council supports these efforts to expand access to needed substance use services. < Previous News Next News >

Q&A: How retail healthcare, telehealth trends could evolve in 2023 Emily Olsen December 16, 2022 Sanjula Jain, senior vice president of market strategy and chief research officer at Trilliant Health, discusses the future of virtual care and how emerging retail players will affect the industry. As another year shaken by the lingering COVID-19 pandemic ends, stakeholders are still exploring how virtual care trends that accelerated in 2020 will affect the healthcare industry long term. Though telehealth use spiked out of necessity during the early months and remains higher than pre-pandemic levels, utilization has slowed over the past two years. Meanwhile, big retail companies and pharmacies are offering more care options to patients. Sanjula Jain, senior vice president of market strategy and chief research officer at Trilliant Health, sat down with MobiHealthNews to discuss the future of virtual care, how big retail entrants will affect the industry, and the importance of care coordination between traditional health systems and emerging retail players. MobiHealthNews: What are some of your big takeaways from 2022 when you're thinking about telehealth, digital health and other tech-enabled care? Sanjula Jain: A big thing that I'm thinking a lot about is that patients aren't coming back to care, despite all the investments in more supply or access points, whether that be virtual care access points or new retail entrants or traditional urgent care. We've just had this huge mismatch between supply and demand. We're kind of post-vaccines; we have Americans returning to work to some extent. A lot of folks are going into an office a couple of days a week, folks are traveling, yet they're not going back to see their doctors. We've tried to make care more convenient and more accessible. And some of these new supply points are lower cost, and yet, they're still not engaging. I think there are many reasons for that. COVID scared away a lot of patients, and I think we're starting to see signs of more distrust in the healthcare system. And then cost and affordability, with a lot of the price pressures and inflation and recession discussions. That's going to continue to be a factor. There's a lot of health consequences for when patients don't actually engage in necessary healthcare. MHN: What do you think is the future of virtual care when you're looking at 2023 and beyond? Jain: The market for virtual care is a commoditized market. So, we're seeing that generally it's being used amongst a discrete subset of the population. And we have to think about, who are the individuals who like to use virtual care and what are they using it for? Primarily, as a health economist, I think a lot about substitute goods. We are seeing that virtual care is really only a substitute good for behavioral health. It's both a clinical and financial substitute, right? Clinically, having some distance between you and your provider in a behavioral health interaction is probably preferred when you're talking about your feelings and being very vulnerable. And there's no lab work or poking and prodding that actually needs to happen. So it's a viable clinical alternative. Financially, we've been talking a lot about payment parity. Because behavioral health interactions often don't need imaging and lab work, you're kind of making the same amount for an office visit that you are in a virtual care environment. For other use cases like primary care, we see that's not actually the case. The patient goes in for a virtual care visit, and then what really ends up happening is the physician says, "I need you to come in to get some imaging done or get some lab work done." The payment parity, despite the policy incentives to increase telehealth payment rates, it's not true parity. And so, that's why we don't see the full substitute effect. When you boil the ocean down, you see that the market for telehealth continues to be pretty discrete and concentrated to a handful of consumers. That's really where I think the future is, thinking about whether they will continue to use it. The data shows that, in the pandemic, we've seen this tapering. When Americans are given the option for in-person or virtual, they're still preferring to go in-person with that exception of behavioral health. So, I think the market is going to have to be more realistic about the total addressable market size in terms of discrete number of users, the number of visits per user, and then invest accordingly. I think that's a large part of why we've seen a lot of struggling amongst some digital health players, because I think they've overestimated the amount of utilization of virtual care modalities. But the number of discrete users just isn't up to par with what individuals had estimated it to be. MHN: Going back to those retail entrants, Amazon made a ton of news this year. Walgreens, CVS, Walmart — they're also boosting their care delivery operations. How do you think these moves will affect the healthcare industry overall? Jain: It ultimately comes down to, who is your customer or your consumer or patient persona? Who is Amazon actually going after? Who is their target patient population, and for what services? Amazon is really focusing on more low-acuity services, and health systems are particularly good at the higher acuity things like surgeries. What Amazon and other new entrants mean is that they provide the consumer with more care options. But it also creates a need to coordinate care better and create these really strong referral relationships. To go back to my earlier point about patients not coming back, of the patients we do see coming back, we're seeing them really seek out care in these low-acuity, commoditized care settings. They're going in for flu and strep, but they're not getting their screenings. It's going to be really important for groups like Amazon to coordinate with health systems to actually get patients to go follow up for those necessary services and figure out how to refer them out. MHN: How do you think the growth of these retail players will affect patients? Jain: I think it's a bit of a toss up. For some patients, they're going to view it as a better experience, because they can get what they want when they want it. But I think from a clinical perspective, it creates a lot of risks and challenges for the health of the patient. There really isn't someone owning the care or steering the patient through their healthcare journey. Have you gotten this lab workup? Have you gotten this mammogram? For some of these more retail players, it's consumer-directed. You can walk into urgent care and you can go to a telehealth visit, and it's really up to the consumer. But healthcare is complicated, and the average consumer may not have all the necessary information to go make those decisions. I think that there's a lot of positives to retail players in terms of catering to consumer preferences and providing care in a more convenient way. But for a lot of complex care, acute care — that every American is going to need at some point in their life — there is a little bit more fragmentation. MHN: Do you think there's an appetite among health systems to partner with Walgreens or CVS or Amazon and say, "If you see someone, send them to me when they need a cancer screening?" Jain: Absolutely. So, I actually just this week was with one of the health systems, talking to their leadership team. That's very much a conversation that is happening in the boardrooms — what is the right partnership structure with some of these new entrants and primary care providers? I think the challenge is, you could have those great partnerships. But ultimately, it's the consumer and the patient that's still having to make the decision. Are they going to follow up on those recommendations? Where are they going to go next? So, I think it's something that we're going to have to spend more time thinking about as an industry, how to coordinate that care for that patient over time, but with more choice and options in the market. See original article: https://www.mobihealthnews.com/news/qa-how-retail-healthcare-telehealth-trends-could-evolve-2023 < Previous News Next News >