TELEHEALTH: THE JOURNEY FROM VIDEO VISITS TO STRATEGIC BUSINESS TOOL By Mandy Roth at HealthLeaders April 6, 2021 New approaches to telehealth can help organizations meet their key objectives. KEY TAKEAWAYS: *Asynchronous communication increases provider efficiency and provides a way to address physician shortages. *Virtual hospitals reduce healthcare costs and support the transition to value-based care. *A cloud-based platform enables 24/7 personalized care, moving care upstream to improve outcomes and reduce the cost of care. 2020 was a remarkable year for healthcare innovation, and telehealth finally achieved scale across the industry. Driven by a need to deliver healthcare at a distance, hospitals and health systems stood up new services seemingly overnight, fanned the flames under languishing programs, or found new uses for thriving virtual care initiatives. Now that telehealth has become a fixture in the healthcare delivery firmament, it's time to examine what comes next. While current use predominantly focuses on televisits between providers and patients, and mysteries remain about reimbursement and licensure issues after COVID-19, forward-thinking healthcare executives are using the technology to enable new models of care. Health systems are employing telehealth to transform healthcare delivery in ways that address strategic business objectives: improve outcomes, reduce provider burden, enhance patient experience, improve access, and ameliorate workforce labor issues. HealthLeaders spoke to visionary leaders and digital healthcare experts who shared their insights and perspectives about what organizations should focus on now, next, and in the future to unlock the potential of telehealth. Coverage includes case studies about asynchronous care, remote monitoring, and a futuristic cloud-based platform fueled by artificial intelligence. Health systems shared details about how these initiatives work and how they evaluated the return on investment. These new approaches to telehealth can help organizations meet their strategic objectives and provide information to inspire other organizations on their own telehealth journeys. WHAT'S NOW: PRESBYTERIAN HEALTHCARE SERVICES ENHANCES EFFICIENCY WITH ASYNCHRONOUS COMMUNICATION Strategic Objectives: *Increase provider efficiency and address physician shortages *Reduce costs per patient encounter *Reduce ER and urgent care utilization At the beginning of 2020, physicians and consumers had not yet fully embraced the concept of virtual video visits; many were skeptical about the ability to deliver care effectively in this manner. Yet after the pandemic forced the adoption of virtual visits, their reputation and usage forever changed. Today, asynchronous communication faces the same hurdles. Providers and patients don't understand how it works and question its value. "It's a technology whose time has not yet come," says Oliver Lignell, vice president of virtual health at health system consultancy AVIA, which helps members accelerate their digital transformation initiatives. "It's not yet mainstream, but it should be." Presbyterian Healthcare Services, an Albuquerque, New Mexico–based nonprofit integrated healthcare delivery system, began investigating this approach to healthcare four years ago. "It's been incredibly effective," says Ries Robinson, MD, senior vice president and chief innovation officer. Between the system's nine hospitals and a health plan it offers, the organization serves a third of the state's residents. With a shortage of practitioners in New Mexico, and 70% of the care it provides covered by capitated contracts, Presbyterian needed to find a way to operate more efficiently. Asynchronous communication worked. Last year, a designated group of employed urgent care physicians handled 50,000 asynchronous visits for low-acuity care, and spent an average of two minutes on each encounter—far less than the 15–18 minutes it takes to conduct a typical video call. This form of care does not occur in real time. Depending on the platform used, a patient completes and submits an online form via secure email, text, or an app, detailing his or her complaint and relevant history. A physician receives the information, processes it, and sends a response back to the patient with instructions and prescriptions, if necessary. Presbyterian physicians usually respond within 15 minutes; some health systems using asynchronous communication allow up to 24 hours. There is no direct audio or video exchange with the patient unless the physician thinks it is warranted and escalates the encounter. Asynchronous communication offers some distinct advantages to health systems, say the experts. Synchronous care, which includes video, audio, and in-person visits, comes with an Achilles' heel: Regardless of venue, the physician spends about the same amount of one-to-one time with the patient, says digital medicine expert Ashish Atreja, MD, MPH, chief information and digital health officer at UC Davis Health in Sacramento, California. "The real growth you're going to see in value," he says, "is the ability to deliver one-to-many care." Asynchronous communication is a step in that direction. "One of the most important things asynchronous communication does is help scale response," says Ann Mond Johnson, MBA, MHA, CEO of the American Telemedicine Association. In addition, because patients can use it with a phone or the internet, it can address issues of access, she says. Robinson says the SmartExam™ platform Presbyterian is using, made by Bright.md, includes features that appeal to its physicians. It automatically enters chart-ready SOAP (Subjective, Objective, Assessment, and Plan) notes into the electronic medical record (EMR), creates billing files, and manages patient follow-up communications. "It's extremely elegant," says Robinson. SmartExam's design, which asks patients questions in an interview-style exchange, and advanced logic has earned the trust of the physicians who use it, he says. "I remember the first time [physicians] said, 'I trust it'; I thought that was kind of a funny term to use," Robinson recalls. When he asked the doctors what they meant, they explained that the tool is thorough and consistent in a way humans cannot replicate. "That's what the providers really like." Even the best medical assistant, he says, may vary in how they ask questions of patients, forget to include certain details, or package assessments differently. While Robinson says the health system has detailed financial models that justify the cost of the platform, he declines to disclose the figures, but notes, "It hasn't been an astronomical investment by any stretch of the imagination." Expenses include a one-time cost for EMR integration, ongoing charges for using the platform on a per-patient per-use basis, and marketing and promotion. He also provides formulas to calculate estimated cost savings. They include: *Better utilization of providers' time and related staffing expenses, by reducing each of 50,000 encounters from 15–18 minutes for a video encounter to two minutes for an asynchronous visit. *More appropriate ER usage. Out of 50,000 patients, 8% were redirected away from the ER. This figure is based on patient survey responses indicating they would have visited the ER had the platform not been available. With an average ER visit costing more than $500, says Robinson, "there's a significant savings." *Reduced workload at urgent care facilities. "Just assume 20,000 [of these patients] would have gone to an urgent care that we own," he says. The time and expense of urgent care staffing is used to calculate the savings. Patients also save money, says AVIA's Lignell. Nationally, he says the typical cost for an asynchronous visit is about $20, and many health systems offer these visits for free. This compares to a national average cost of $50 for a video visit and $125 for an in-person visit. There is one additional element that has contributed to the success of asynchronous visits for Presbyterian: a digital front door. Patients visit the pres.today webpage, enter their condition and insurance information, and are automatically directed to the appropriate level of care, one of which includes the option for online visits (using asynchronous care). Because of the asynchronous initiative's success, the health system is expanding its use beyond low-acuity care. Future plans involve developing new uses for the platform, capturing symptoms and history to create greater efficiencies for video visits and even in-person care. "We have gotten religion around the idea of capturing as much information as you can in a sophisticated manner before the visit," says Robinson. "You maximize the quality of care and the efficiency of the visit. We're taking that idea and pushing it forward in multiple avenues of care here at Presbyterian." Value-based care will drive further adoption of these models, says Lignell. "The advantages from a total cost of care standpoint are huge," he says. "It's much less expensive to deliver care this way." While the bulk of growth has been in low-acuity primary care, he says asynchronous care is now being explored in specialty and higher-acuity care, as well as in e-consults between providers. "The asynchronous model is proving to be incredibly efficient for health systems," says Lignell. "That's one of the reasons why it has so much promise." WHAT'S NEXT: ATRIUM HEALTH LAUNCHES A VIRTUAL HOSPITAL Strategic Objectives: *Increase bed capacity, limit staff and patient exposure to COVID-19, and conserve PPE *Reduce costs and support the transition to value-based care *Improve patient satisfaction and experience "Remote patient management is widening the aperture from the episodic-based healthcare reality that we've known for decades towards a 24/7, always-on ubiquitous reality," says Rasu Shrestha, MD, MBA, executive vice president and chief strategy and transformation officer at Atrium Health. Long before COVID-19 hit American shores, health systems began launching remote monitoring programs, particularly to manage chronic diseases. Hospital at home initiatives, or virtual hospitals, are a robust manifestation of this endeavor. While these models have demonstrated cost savings, adoption has been slow due to reimbursement issues. The pandemic offered a trifecta of motivating factors to accelerate adoption of the virtual hospital model: bed capacity issues, a need to limit staff and patient exposure, and dwindling supplies of personal protective equipment (PPE). With these issues in mind, during March 2020 a handful of clinicians approached Atrium Health administrators, suggesting that the 42-hospital Charlotte, North Carolina–based nonprofit health system consider launching a hospital at home initiative. Two weeks later it was operational, says Scott Rissmiller, MD, executive vice president and chief physician executive. In the first 10 months, the virtual hospital admitted 51,000 patients. "We are able to keep patients in their homes, protect our teammates from infection, and also protect patients," Rissmiller says. "It freed up a good bit of capacity in our acute facility," enabling the health system to reserve that space for its more acute COVID-19 patients. The virtual hospital maintains two "floors." The first floor functions as an observation unit; the second floor is reserved for patients requiring more intensive care, says Rissmiller. Any COVID-19-positive patient is admitted to the first floor of the virtual hospital and receives digital tools to monitor temperature, blood pressure, pulse, and oxygen levels. These devices deliver data via Bluetooth® to a smartphone app developed by the health system's IT department. That data feeds into the patient's EMR, fully integrating into the patient's continuum of care, Rissmiller explains. In a bunker back at Atrium Health's call center, a team of clinicians monitors data and checks in with first-floor patients daily. Second-floor virtual patients have the same home monitoring tools, but receive "much more intensive management" and frequent check-ins, he says. In addition, community-based paramedics visit homes to administer IV fluids, IV antibiotics, breathing treatments, EKGs, and other interventions. This arrangement created additional opportunities to reduce hospital bed capacity. "We were one of the first in the nation to get in-home remdesivir, one of the COVID treatments," says Rissmiller. "To receive remdesivir, you have to be on oxygen therapy, so these patients are sick." In a 10-month period, Atrium Health administered about 150 therapeutic rounds of the drug, he says, which saved about 500 hospital days that would have been required if those patients had been hospitalized. "From a quality standpoint, we do not view this any differently than if these patients were within the walls of our hospital," says Rissmiller. All measures, including length of stay as well as readmission, transfer, and mortality rates, have been almost identical to inpatient stats, and patient satisfaction has been "extremely high," he says. "Patients really would rather be in their home surrounded by their loved ones and support system." The hospital at home initiative has been a "costly endeavor," says Rissmiller. "When we realized this pandemic was going to be significant, our CEO [and President Eugene Woods, MBA, MHA, FACHE] called me and said, 'Scott, whatever you need to care for our patients and communities—do it. We'll figure out the costs later.' It freed us up to be able to do things like this." As it turned out, costs have been offset by funds from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which enable Atrium Health to bill for many of the services provided. The organization also is one of a handful of healthcare systems that are doing a pilot with the Centers for Medicare & Medicaid Services, which views virtual beds as real hospital beds. "The reimbursement is similar because of the level of service we're providing," says Rissmiller. Initially, though, "it was all upfront costs for us, but the return was in bed days." A focus on reimbursement continues "as we are now maturing the program," he says. "Our concern is that the reimbursement will go away once those [pandemic] emergency orders expire. We're working with the state, our payers, Medicare, and others to make sure that this continues to be reimbursed at a level that allows us to continue to grow it and cover our costs." "Out of necessity, COVID ultimately accelerated health systems' desire to think through their digital strategies and determine how digital fits into their overall care and business models," says Brian Kalis, MBA, managing director of digital health and innovation in consulting firm Accenture's health practice. "New models are starting to pop up, and care is shifting to the home." Strategic goals include producing outcomes that equal or exceed inpatient care, while also improving labor productivity, Kalis says. "A majority of health systems coming out of COVID are putting care at home as a key strategic focus. That requires a collection of new models to deliver care, putting different care team compositions in place, and [utilizing] technology to help a broad range of conditions for pre-acute, acute, and post-acute care." Atrium's virtual hospital has already expanded beyond COVID-19 patients. Once the surge diminished in July, Rissmiller "challenged the team to look at [the initiative] through the lens of a non-COVID world. Can this become a new way of caring for patients that makes sense to the patient and to us as a healthcare system?" There is now a list of 10 diagnoses to be considered for hospital at home care, and congestive heart failure patients have already been admitted into the virtual facility. "We're starting to branch out," he says. "We're also starting to focus on different communities to make sure that we're doing this in a way that helps with our underserved populations and gives them the resources they need to manage care at home rather than coming through the emergency department." While Atrium Health rolled out its program in two weeks, Rissmiller says, "this is something that would be incredibly hard to start up on your own if you hadn't had the 10 years of virtual experience that we've had building these capabilities, but also the confidence to be able to deliver these kinds of services at home. It takes a while for clinicians to understand that care can be delivered safely virtually. We also have a culture at Atrium Health that really enables our clinical leaders to lead and their voices to be heard. That, more than anything, is the secret sauce that's allowed for innovations like hospital at home." WHAT'S IN THE FUTURE: HIGHMARK HEALTH DEVELOPS PLATFORM TO DRIVE 24/7 CARE Strategic Objectives: *Move care upstream to improve outcomes *Reduce cost of care, patient traffic, and volume *Enable 24/7 personalized care Unleashing the potential of virtual care requires strategic innovation fueled by imagination. Highmark Health is one organization traveling along this path. To understand the power of an initiative now underway at the Pittsburgh-based payer-provider system, one must imagine the potential to do something that is currently not possible. For example, take the hypothetical case of an individual living independently at home with six medical conditions. What if real-time data alerts her care team that her health status has subtly changed? What if this alert takes the complexity of her medical history into account and offers decision-support tools to accelerate clinical action before her health deteriorates? The Living Health Model, fueled by the Living Health Dynamic Platform—a Google Cloud–based technology infused with artificial intelligence and advanced analytics—could be the missing link that will enable care to move upstream. The concept revolutionizes the current perception of telehealth and enables 24/7 care. It aims to connect the provider, patient, and payer in novel ways to improve health outcomes, reduce clinician administrative burdens, enhance patient engagement, and reduce costs, says Karen Hanlon, executive vice president and chief operating officer at Highmark Health. "We believe that we have the capabilities and resources to pull it together," says Tony Farah, MD, FACC, FSCAI, Highmark Health's executive vice president and chief medical and clinical transformation officer, who is also a practicing cardiologist. The platform will amplify the impact of remote monitoring tools, which many health systems already use for chronic disease management. By adding sophisticated data analytics, machine learning, decision support, and patient education tools, the system will support comprehensive care rather than managing diseases in silos, Farah says. "Our partnership with Google Cloud is going to not only accelerate our strategy, but also help us scale it." Data will be constantly mined to determine the "next best action" required to proactively care for a patient and formulate a personalized care plan that delivers a "curated" experience based on the patient's personal needs, says Hanlon. For patients with no apparent health conditions, the system may focus on wellness. While full realization of this concept may be years down the road, Hanlon says the first iteration of the platform will be functional at the end of 2021. Accenture cloud expert Geoff Schmidt, managing director, global lead—life sciences technology, says Highmark Health's plans align with what he's seeing in the life sciences sector. Health leaders should not think of the cloud as a capability or an IT initiative, he says; "think of it as a business transformation enabler." Cloud technology is accelerating companies' three- to five-year strategic plans, compressing those timelines down to 12 to 18 months. "We're seeing dramatic transformations and acceleration of CEO agendas because of the capability that the cloud can provide." Partnering with an outside player is a smart move for health systems that want to expedite their transformation initiatives, says Schmidt. "Major technology partners are innovating at a scale that is, just frankly, hard for payers or providers to keep up with." Prior to its partnership with Google Cloud, Highmark Health piloted "analog" proofs of concept, according to Farah. These pilots involved addressing healthcare for several patient populations, including high-risk patients with multiple comorbidities as well as individual chronic conditions like COPD, heart failure, diabetes, and hypertension. Physicians were asked to improve health outcomes in 12 months. "The patient experience went through the roof, and in almost every case—with the exception of diabetes—the total cost of care came down," says Farah. "I would say physician engagement was our secret sauce." "Consumer engagement is also a key component," says Hanlon. "There are a lot of solutions out there. They're very siloed and they're not integrated. We can have the best solutions in the world, but if the consumer and the clinician are not using them, they will have no impact." While Highmark Health does not disclose the company's investment in this platform, "you can guess that it is a fair amount," says Hanlon. In addition to activating the initiative at Allegheny Health Network, a nonprofit health system that Highmark owns and operates, "at the same time we're a health plan serving 5.6 million members," she says. "The ability to interact with all of those members is incredibly important to us. When you look across our book of business, we're probably managing somewhere in the neighborhood of $26 billion in healthcare costs a year. When we look at the investments that are needed to support that base of membership and that level of healthcare spend, we feel it's appropriate and we can justify the investment." Being both a payer and a provider imbues Highmark Health with the motivation and influence to transform healthcare delivery in this way, Hanlon says. The company is a Blue Cross Blue Shield–affiliated payer operating in three states, and also functions as a provider through the Allegheny Health Network. "By having both of those assets in the portfolio," says Hanlon, "it's easier for us to align on the path forward and the economic model." But to characterize this venture merely as a mechanism to save money misses the point, she says. The model is designed to improve patient outcomes by moving care upstream, explains Farah. "Conditions that exist today will be prevented from deteriorating, and conditions that haven't developed will be prevented—or, at a minimum, be delayed in development. That's the primary goal, and it results in a reduction in total cost of care. It flips the equation from focusing on finances to focusing on health." In addition, for the Living Health Model to be effective, it must work with entities outside of the facilities owned by the Highmark Health system, which provides health plans in Pennsylvania, Delaware, and West Virginia. Allegheny Health Network operates facilities in 29 Pennsylvania counties and portions of New York, Ohio, and West Virginia. "We're looking to have impact across all of the markets that we serve as our insurance company, not just where we own a provider asset," says Hanlon. "The progression of value-based care has been a slow march. I think this platform will be a tool to enable providers to continue down that path. Part of our focus is developing other tools we believe will be necessary for the providers to succeed in a value-based environment. We recognize that we're going to have to be a leader in helping others to move down that path." A FRAMEWORK FOR MOVING FORWARD Planning for the future of telehealth requires rethinking the present. "If the only way that you look at telehealth is as a way to replace one-to-one physical visits with a telehealth visit, you're not changing the world; you're just creating a little bit more convenience," says Roy Schoenberg, MD, MPH, president and CEO of Amwell, a Boston-based technology company that provides telehealth technology to health systems. "If you look at telehealth as a product, you're going to end up behind the competitive landscape curve. If you look at telehealth as an operating system, [it becomes a] mechanism for the digital distribution of care." Transforming the way healthcare is delivered requires changing, from the ground up, the way health systems think about their relationships with patients, Schoenberg says. Telehealth can alter dynamics related to patient traffic and volume, patient flow, transitions of care, and assumption of risk. "When you equip yourself with telehealth capabilities," Schoenberg says, "you should ask yourself, 'Does the system that I buy allow me to create new applications for telehealth that the vendor didn't think about?' [You] should imagine plans for patients that incorporate and take advantage of telehealth. The result of that is a completely different beast." This article appears in the March/April 2021 edition of HealthLeaders magazine. - https://www.healthleadersmedia.com/telehealth/telehealth-journey-video-visits-strategic-business-tool < Previous News Next News >

Spending Bill to Extend Telehealth, Hospital-at-Home Waivers for 2 Years Anuja Vaidya December 20, 2022 The year-end package includes two-year extensions for Medicare telehealth flexibilities enacted during the pandemic and the Acute Hospital Care at Home Program. The year-end $1.7 trillion spending bill includes provisions to extend pandemic-era telehealth and hospital-at-home waivers for two years. The legislation, released Tuesday, aims to avert a government shutdown and includes several healthcare provisions, including reducing the 2023 Medicare payment cuts to 2 percent from 4.5 percent. In a win for telehealth proponents, the sweeping bill also includes a two-year extension of telehealth-related regulatory flexibilities for Medicare beneficiaries put in place during the COVID-19 pandemic. A previous bill extended these flexibilities for five months after the public health emergency expires. Now, the waivers will remain in place through Dec. 31, 2024, if the legislation passes both the House and Senate and is enacted into law. The flexibilities include eliminating geographic restrictions on originating sites for telehealth services, enabling Medicare beneficiaries to receive services from any location, and allowing federally qualified health centers and rural health centers to continue providing telehealth services. Further, the waivers lift the initial in-person care requirements for those receiving mental healthcare through telehealth and allow for continued coverage of audio-only telehealth services. In addition to extending the Medicare telehealth waivers, the new legislation includes a two-year extension of the Acute Hospital Care at Home Program. Introduced in November 2020 by the Centers for Medicare and Medicaid Services, the Acute Hospital Care at Home Program allows treatment for common acute conditions in home settings. As of Dec. 16, 259 hospitals across 37 states were participating in the program. The safe harbor for telehealth coverage for those with high deductible health plans (HDHPs) with health savings accounts (HSAs) will also be extended by two years if the new bill passes. The safe harbor provision enables people with HDHP-HSAs to receive telehealth coverage without meeting their annual deductible first. "Today, our Congressional telehealth champions on both sides of the aisle came through for the American people and for ATA and ATA Action members, by meeting our plea for more certainty around telehealth access for the next two years, while we continue to work with policymakers to make telehealth access a permanent part of our healthcare delivery for the future," said Kyle Zebley, senior vice president of public policy at American Telemedicine Association and executive director of the association's advocacy arm, ATA Action, in an emailed press release. But the new legislation does not include a similar two-year extension for the waiver of the Ryan Haight Act. The Ryan Haight Act of 2008 required providers to meet with a patient in person before being allowed to prescribe controlled substances for that person via telehealth. The in-person visit requirement was temporarily lifted during the COVID-19 pandemic. Since then, several stakeholders, including the American Telemedicine Association and American Psychiatric Association, have asked that Congress permanently eliminate the Ryan Haight Act. The latest spending bill does, however, direct the Drug Enforcement Administration (DEA) to create final regulations regarding the circumstances under which a special registration for telemedicine may be issued. Providers obtaining a special registration for telemedicine would be allowed to waive the in-person visit requirement. Earlier this month, the American Hospital Association had also asked that the DEA clarify regulations for the special registration process and provide recommendations for an interim plan. "…the hard work continues, as we persist in pressing telehealth permanency and creating a lasting roadblock to the 'telehealth cliff,'" said Zebley. "Additionally, we will continue to work with Congress and the Biden administration to make sure that a predictable and preventable public health crisis never occurs by giving needed certainty to the huge number of Americans relying on the clinically appropriate care achieved through the Ryan Haight in-person waiver." See original article: https://mhealthintelligence.com/news/spending-bill-to-extend-telehealth-hospital-at-home-waivers-by-2-years < Previous News Next News >

How Americans Feel About Telehealth: One Year Later Sykes.com April 21, 2021 In March 2020 and 2021 we polled 2,000 adults to discover their perspectives on and experience with telehealth — how have opinions changed one year into the COVID-19 pandemic? Pre-pandemic, telehealth was much more of a novelty than a necessity in the healthcare industry. The idea of contacting your doctor remotely for care was promising, but there were major hurdles — obstacles that would require time, effort, and ingenuity to overcome. Then, COVID-19 created a need for safe, distant medical care and advice. And necessity, like always, is the mother of invention (or in this case, adoption). Suddenly, millions of patients who were once walk-ins became logins, and soon, all that was necessary to get a quality checkup was a stable Wi-Fi connection. SYKES’ March 2020 telehealth survey revealed new insights on what Americans thought about the rise of virtual visits to the doctor and the concept of telehealth in general. At that point, telehealth was still a radical idea, and phrases like “new normal” had yet to overstay their welcome. Research outlined in the SYKES Fall 2020 telehealth apps report made it clear that all kinds of new users had already begun scheduling consultations in cyberspace due to COVID-19. But now, with vaccines being administered all over the world, will this mean a decline in socially distanced telehealth services too? Or will patients still want access to virtual doctor visits even after distance is no longer a factor? To find out, we asked 2,000 Americans in March 2021 how their opinions on telehealth have changed over the past year, what they’ve experienced, and what they think should stick around even after vaccines are widely available. For full story: https://www.sykes.com/resources/reports/how-americans-feel-about-telehealth-now/ < Previous News Next News >

Trends in Telehealth: CCHP's 50 State Telehealth Policy Summary Report, Fall 2022 Center for Connected Health Policy October 18, 2022 Today the Center for Connected Health Policy (CCHP) is releasing its bi-annual summary of state telehealth policy changes for Fall 2022. Additionally, we are also making available a summary chart showing where states stand on many key telehealth policies, as well as an infographic highlighting our key findings. The most current information in CCHP’s online policy finder tool may be exported for each state into a PDF document. The Fall 2022 summary report adds in two new jurisdictions, Puerto Rico and Virgin Islands, and covers updates in state telehealth policy made between July and early September 2022. Note that in some cases, after a state was reviewed by CCHP, it is possible that the state may have passed a significant piece of legislation or implemented an administrative policy change that CCHP may not have captured. In those instances, the changes will be reviewed and catalogued in the upcoming Spring 2023 edition of CCHP’s Summary Report. As in previous editions, information in the policy finder remains organized into three categories: Medicaid reimbursement, private payer laws and professional requirements. Additionally, for this edition, CCHP received support from the National Association of Community Health Centers (NACHC) through funding from the Health Resources and Services Administration (HRSA) to create a specific category on federally qualified health center (FQHC) Medicaid fee-for-service policies. FQHCs have many unique rules that apply to them that sometimes effect their ability to utilize telehealth, such as the definition of a visit/encounter in the Medicaid program. The new FQHC category takes these considerations into account and will help FQHCs be able to more easily navigate to the policies that specifically affect them. See full article: https://mailchi.mp/cchpca/just-released-cchps-50-state-telehealth-policy-summary-report-fall-2022trends-in-telehealth-policy < Previous News Next News >

A New Model For Healthcare: Adding Telehealth To Unclog Patient Flow ‘Hot Spots’ Dr. Corey Scurlock MD, MBA June 8, 2022 It may not match the scale of the exodus of nurses from the healthcare workforce, but a growing shortage of physicians is no less of a threat to patient care. A recent survey found that one in five doctors plan on leaving the profession in the next two years, hastening a projected shortfall of as many as 124,000 doctors by 2034. This has reached such a concerning level that the U.S. Department of Health and Human Services and U.S. Surgeon General Dr. Vivek Murthy have launched a strategic advisory to mitigate clinical burnout. More Information: https://www.forbes.com/sites/forbesbusinesscouncil/2022/06/08/a-new-model-for-healthcare-adding-telehealth-to-unclog-patient-flow-hot-spots/?sh=248c6d415725 Covid-19 and longstanding concerns about changes in the business of healthcare have left many physicians burned out. Older doctors are seeking early retirement, and younger doctors seek a more balanced work/life ratio. Many aren’t interested in some of the all-consuming specialties such as critical care, neurology, oncology and psychiatry. As with everything else in our world right now, supply is not meeting demand. Action is required, but it can’t just rely on yesterday’s solutions. Opening up more slots in medical schools won’t fill the immediate need for experienced, board-certified physicians. Buying up physician practices is largely played out, as most doctors are already employed. I would argue that we can’t wait for a new MD pipeline to open up. Instead, we need to fix the broken practice of medicine. Doctors are burned out because they are locked into 15-minute appointment cycles wrapped around the exigencies of electronic health records systems that demand complete documentation of each step, leaving little time for the “How are you, Ms. Jones?” moments. Patients are unhappy with eight-month waits for new patient appointments to confirm diagnoses of serious diseases. Within the hospital, a lack of staff and available expertise meets up with broken processes to choke off patient flow from the emergency department to laboratories to medical floors. Staff personnel stand around waiting for paperwork. Patients wait on gurneys for everything. By the time things are straightened out, the original order might no longer be appropriate for a patient. Discharge alone has become a major headache. One antidote to this is to create a hybrid model of care as I have done with my company and as my business helps other companies do. It relies on points in the care process being actively managed remotely by specialist physicians who also have a background in telehealth. These veterans should understand where timely intervention can unblock patient flow at “hot spots” in a patient’s journey caused by delays in care, inappropriate care transitions or potential patient harm. Telehealth-enabled monitoring can reduce transfers by accurately assessing patient acuity and overseeing the work of less-experienced hospital staff. Through these interactions, the goal is to see reduced patient readmissions and ED visits, shorter hospital stays and better utilization of resources. Of course, all of this begs the question: If the hospital can’t find enough specialists, how can virtual care physicians fill these roles? The answer is pretty simple, in my opinion. You bring back the joy of being a doctor. These telehealth doctors work from home, linked to pods of multi-specialists who work with the same hospitals, getting to know the staff. They can work when they like and as much as they like. They access the medical record but are called upon to solve problems, full stop. You can also make sure their work is always varied. Doctors want to heal, not master the intricacies of Epic’s latest software. With the tailwind of favorable policy and reimbursement the telehealth industry is experiencing right now, it might be an opportune time to consider this type of strategy. But as one explores telehealth as a business venture, it's important to recognize that all such business is still highly regulated, as it is in the field of care delivery. The core components of an end-to-end telehealth solution include people, process and technology. Here are some thoughts on each. • Technology: Audio-video providers have matured significantly, and increasing interoperability has enabled new entrants. Health systems have sought to standardize enterprise platforms versus best-of-breed applications. Clinical analytics tools can be overlaid on the EMR leading to simpler clinical insight gathering. While not mandatory, such systems target quality or performance metrics to support ROI. • Process: Efforts to virtualize care can be disruptive to care delivery. Consider what technology platforms to purchase, KPIs to measure and clinical workflow to create. • People: Delivering telehealth-enabled care will place the highest regulatory burden on an organization. Malpractice, state licensing and credentialing, and HIPAA, to name a few, are considerations that need to be tackled first. Secondly, your attention to provider experience is paramount to ensure a healthy and sustainable workforce to attract talent. As Covid-19 wanes, we are facing unprecedented change in the provisioning of care. New care models will emerge. Telehealth is not the only solution, but it is clear that it will be a primary one. A recent survey (registration required) of health system CEOs by the University of Colorado’s Health Administration Research Consortium put virtual care as the No. 1 strategy for future growth. For those looking for solutions to today’s healthcare challenges, here are three points to remember: • Telehealth is here to stay: It could be the great equalizer for care access and equity. • Patient flow is key: By focusing on the patient journey across the continuum, hot spots can be identified and targeted. • Clinical and operational alignment are needed: People, processes and technology can combine as a force multiplier to return greater value, but only if everyone has agreed on a care road map. As telehealth goes, we are not battling efficacy anymore; we are battling inaction and the cost such inaction creates. I believe unlocking the potential of all our nation's providers can deliver better care everywhere. It's time to imagine what the design of the next-generation, digitally-enabled clinical workforce looks like, and it's all about access and equity in care delivery. < Previous News Next News >

New MACPAC Report to Congress: Recommendations to improve mental health access include telehealth Center for Connected Health Policy June 2021 Recommended ways to improve access to mental health services for adults, children, and adolescents enrolled in Medicaid and the State Children’s Health Insurance Program (CHIP) The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2021 Report to Congress last week that recommends ways to improve access to mental health services for adults, children, and adolescents enrolled in Medicaid and the State Children’s Health Insurance Program (CHIP). While the report and recommendations did not evaluate telehealth directly, they did occasionally reference telehealth’s ability to increase access to mental health services and recommend that the promotion of telehealth be included in various programmatic guidance. For instance, the report highlights telehealth programs that connect youth to telehealth counseling services and recommends the Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issue joint guidance addressing how Medicaid and CHIP can be used to fund a behavioral health crisis continuum that includes how telehealth can be used to ensure access to crisis care. They also recommend that opportunities to cover telehealth and other technology-enabled services be described in CMS and SAMHSA guidance specific to children and adolescents with significant mental health conditions. The report additionally looks at how to promote care integration through electronic health records (EHRs) and value-based payment (VBP) programs, which include measures related to expanded use of telehealth. It also discusses the non-emergency transportation (NEMT) benefit in Medicaid, mentioning that many changes in how the program is administered are occurring which require additional data to assess its value, such as how expanded availability of telehealth services may lessen its need in certain circumstances. For more information, please access the full MACPAC report - https://www.macpac.gov/wp-content/uploads/2021/06/June-2021-Report-to-Congress-on-Medicaid-and-CHIP.pdf < Previous News Next News >

Geisinger's journey to greatly expanded telehealth Bill Siwicki April 19, 2022 The prolific health system is now able to offer telemedicine appointments to patients for primary care, urgent care and more than 70 specialties. More than 8% of total outpatient visits now are conducted virtually. Rural Pennsylvania is bigger than the states of New Jersey, Massachusetts, New Hampshire and Vermont combined. Some 75%, or 33,394 square miles, of Pennsylvania are considered rural. The geography is diverse, from rugged mountainous terrain to large stretches of farmland. High-profile health system Geisinger and its affiliated entities serve 45 predominantly rural counties throughout central and northeastern Pennsylvania, 31 of which are a part of Appalachia, a unique region of the Appalachian Mountains that cuts through the western part of the state. THE PROBLEM "Access to specialty care for many of our communities is scarce; these communities already are faced with primary care shortages, and for those who need to seek specialists and sub-specialists, long travels often are a costly and time-consuming reality," said Tejal A. Raichura, director of the center for telehealth at Geisinger. "Surveys show that rural Pennsylvanians are not taking care of themselves as well as their urban counterparts," she continued. "Fewer rural residents than their urban counterparts get the recommended exercise. Rural residents have higher rates of obesity, with almost two-thirds at risk for chronic diseases based on their sedentary lifestyle." Rural residents are in poorer physical condition, have more health risks and are more likely to lack health insurance, she added. The wage gap between urban and rural Pennsylvanians is getting wider. In fact, it has doubled in the last 30 years. Improving the quality of healthcare while lowering costs and increasing access in rural Pennsylvania counties is challenging, she said. "In 2018, Geisinger leadership committed to expanding our telehealth program and invested in a platform that could cover various elements of virtual care, including video visits to the home and our clinics, tele-stroke visits at our various inpatient units and emergency rooms, and video visits to non-Geisinger organizations, including other hospitals, skilled nursing facilities, correctional facilities, et cetera," Raichura recalled. PROPOSAL The business plan requested support for an expanded telemedicine program, one that would connect distantly located expert physicians trained in several specialties – including neurology, stroke/intensive care, pediatrics, primary care, geriatrics, psychiatry, endocrinology, rheumatology, podiatry and several others – with rural and underserved communities, allowing residents to access specialty care where they live and work. For Full Article: https://www.healthcareitnews.com/news/geisingers-journey-greatly-expanded-telehealth < Previous News Next News >

82% of Americans Want Telehealth Flexibilities Extended Mark Melchionna November 30, 2022 A recent survey indicates that 82 percent of respondents with employer-provided coverage believe that the government should extend telehealth flexibilities. A recent survey conducted by America's Health Insurance Plans (AHIP) found that a majority of respondents are requesting that the government sustain the telehealth flexibilities enacted during the COVID-19 pandemic. In 2020, the number of people using telehealth increased dramatically, largely due to the withdrawal of various regulatory restrictions as well as the new barriers imposed on in-person care. According to data from market research firm Trilliant Health, telehealth use peaked in the second quarter of 2020. Though telehealth use has waned since 2020, it remains popular among patients and providers. As a result, Congress is faced with deciding whether to continue or terminate telehealth flexibilities. A survey from the Morning Consult on behalf of AHIP’s Coverage@Work campaign collected data on patient preferences regarding telehealth and how they feel about its future. The survey polled 818 voters with employer health insurance between Nov. 11 and 13. The main survey findings related to whether patients would consider seeing a doctor through telehealth, reasons for using telehealth, and their opinions on the government extending telehealth flexibilities. The survey shows that 65 percent of those with employer-provided coverage reported being likely to consider seeing a doctor or receiving treatment through telehealth. This finding was consistent across age, income, and ethnicity groups. Also, 49 percent claimed that interest in telehealth is mainly backed by convenience, and 35 percent stated that it saves time as it eliminates the need for travel. Among all respondents, 82 percent believe that the federal government extending telehealth flexibilities is important. This included a bipartisan majority of Democratic voters (95 percent), independent voters (77 percent), and Republican voters (70 percent). Considering the survey results, AHIP concluded that respondents would advocate for the government to continue telehealth flexibilities. This is not the first indication of healthcare stakeholders seeking this end goal. In September, a letter to the US Senate composed by the American Telemedicine Association (ATA) and its advocacy arm known as ATA Action asked for a continuation of expanded telehealth access. Specifically, the letter urged the US Senate to sustain telehealth flexibilities for two years through 2024. These flexibilities included waivers put into place during the pandemic, including removing initial in-person requirements for telemental health and eliminating restrictions on the location of providers and patients engaging in telehealth. Signed by 375 stakeholders, such as Amazon, the American Nurses Association, and Bicycle Health, the letter also detailed concerns about a forced return to in-person care. Also, in March, Senators Tom Carper (D-Delaware) and Tim Scott (R-South Carolina) introduced a bill known as the Hospital Inpatient Services Act, which allowed for a two-year extension of the federal acute hospital-at-home waiver. Introduced in November 2020 by the Centers for Medicare and Medicaid Services, the waiver enables treatment for common acute conditions in home settings. This waiver was highly used throughout the COVID-19 pandemic, with 92 health systems, comprising 203 hospitals across 34 states, using it as of March 4. See original article: https://mhealthintelligence.com/news/82-of-americans-want-telehealth-flexibilities-extended < Previous News Next News >

Telehealth’s Newest Frontier: Emergency Medicine Sai Balasubramanian, M.D., J.D. May 24, 2022 Telehealth has been a prominent buzzword for the last few years. With the emergence of Covid-19 and a newfound respect for remote healthcare services, telehealth/telemedicine have been a large focus of healthcare organizations and physicians alike. The U.S. Department of Health and Human Services (HHS) provides a broad definition: “Telehealth — sometimes called telemedicine — lets your doctor provide care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.” Within the realm of this definition, telehealth doesn’t exactly sound like something that the practice of emergency medicine (EM) would embrace, given that the very nature of EM entails high acuity, critical care. Despite this paradox, however, EM as a specialty is slowly adapting in order to better utilize this transformative technology. In fact, there are a variety of different telehealth modalities slowly being introduced into the world of EM. HHS breaks it into five different potential categories of use: Tele-Triage: using telehealth modalities to determine the acuity of a patient’s injuries and the care and resources required Tele-Emergency Care: “Tele-emergency medicine connects providers at a central hub emergency department to providers and patients at spoke hospitals (often small, remote, or rural) through video or similar telehealth technology.” Virtual Rounds: monitoring emergency department patients remotely, reducing the number of physical providers and physicians needed on-site E-Consults: providers and physicians can seek consultations or specialty management for patients Telehealth for Follow-Up Care: “Telehealth technology can also be used to provide follow-up care for patients who were triaged but not sent to the emergency department, or for patients after they are discharged from the emergency department.” The American Medical Association recently published an article that corroborates this concept. Tanya Henry, Contributing News Writer for the AMA, explains that a recent AMA Telehealth Immersion Program in conjunction with American College of Emergency Physicians (ACEP) discussed innovative ways by which telemedicine can become a mainstream modality for emergency care. The article quotes the chair of ACEP’s telehealth section, Aditi Joshi, M.D.: “Emergency medicine doesn’t take place in one spot in the hospital and emergency physicians are trained to take care of emerging acute care situations in any setting,” including telehealth. Congruently, training programs are gearing up to prepare for this. Take for example The George Washington University’s (GWU) Department of Emergency Medicine, which offers a Telemedicine & Digital Health Fellowship. The program’s purpose “is to develop future leaders in telemedicine and digital health […and…] enable physicians to develop clinical competence in the delivery of telemedicine, leadership in establishing new programs, basic technical knowledge of telehealth delivery, and experience in order to significantly impact the rapidly growing and changing field of telemedicine, telehealth, remote health monitoring, and mobile health.” Thomas Jefferson University also offers something similar: the Telehealth Leadership Fellowship. This program’s core focus is four-fold: Leadership Skills Development, Entrepreneurship, Academia & Research, and Clinical Experience, all within the larger realm of telehealth. Indeed, telehealth has already rapidly expanded into other medical specialties, including neurology, cardiology, and primary care settings. Notably, an important benefit of this new modality is that it enables access to care and access to trained medical professionals for otherwise underserved populations and communities. Assuredly, time will tell the significant impact that emergency medicine joining the ranks of potential uses of telehealth will undoubtedly have in the years to come. For more information: https://www.forbes.com/sites/saibala/2022/05/24/telehealths-newest-frontier-emergency-medicine/?sh=76d5908f61cb < Previous News Next News >

Once a Temporary Convenience, Telehealth is Here to Stay Beth Wood August 2021 Multifaceted networks supporting virtual medical visits hailed as a positive legacy of pandemic Whether you call it telehealth, telemedicine, e-health, virtual or video visits, the electronic delivery of health care services is coming into its own. The coronavirus pandemic spurred federal, state and private insurance programs to offer more coverage of telehealth to encourage people to follow the stay-at-home rules established in mid-March 2020. “After this last year and the benefits we’ve seen, telehealth is definitely here to stay,” said Kiran Savage-Sangwan, speaking from Sacramento. She is the executive director of the California Pan-Ethnic Health Network, a statewide health-advocacy organization. “The way we pay for healthcare has not robustly supported telehealth in the past,” Savage-Sangwan said. “The state has taken some interim steps before making permanent policy changes. The state will be extending the flexibilities for the Medi-Cal program through the end of next year, I believe, to continue to work out some of the policy issues.” According to the Centers for Disease Control and Prevention, the number of telehealth visits increased in the first quarter of 2020 by 50 percent, compared with the same period the year before. A single week in March 2020 showed a 154 percent increase, compared with the same period in 2019. Behind those numbers was a massive effort among health providers to accommodate this change. Even for UC San Diego Health, a pioneer in telehealth, the quick transition required an all-hands-on-deck approach. “We knew the shutdown would happen, but we didn’t know when,” recalled Marlene Millen, M.D., UC San Diego Health’s chief medical information officer for ambulatory care. “But our operational leads were already prepared for increasing video visits. Over the course of one weekend in March, we trained 1,000 doctors and staff. “We converted appointments and sent patients instructions. That very Monday, when everyone was supposed to be locking down, we were able to convert a couple of thousand appointments into video visits. That’s because we had a really good structure in place.” Millen spent the entire weekend at her home desk with multiple screens open, setting up online patient visits. An internal medicine physician, she has played a role in UC San Diego Health’s development of video visits for 10 years. About two or three years ago, she said, an app-based program was launched, which made it more accessible. But it wasn’t until the insurance coverage changed that telehealth’s potential could be tested. Until the shutdown, video visits were used for patients who had extreme obstacles to making in-person appointments. “Patients we targeted for these visits were ones with medical conditions who couldn’t come into the clinic,” Millen said. “They really embraced it. I had a patient in a wheelchair that had to be carried out of the house and another with a condition that made her use the bathroom all the time. Others had immune conditions. Then there were people who had to get on three buses to get to us. “Some of those patients were in danger of getting kicked out of insurance because of their number of no-shows. Video visits improved those situations. But it wasn’t a general-use case at that time.” Support for telehealth Now that pandemic restrictions have eased, the percentage of telehealth appointments versus in-person consultations has decreased in most of California. At UC San Diego Health, Millen noted, video visits rose to 30 percent during the early 2021 surge in COVID-19 cases. Video visits now account for between 15 and 20 percent of all appointments, a figure higher than prepandemic rates. As headlines attested, the pandemic put socioeconomic disparities in access to health care in stark relief. Some believe telehealth could provide a way to distribute health access more equitably. But there are hurdles. Many low-income people live in Wi-Fi deserts. Some have limited minutes on their smartphones, and others are unfamiliar with the technology. For some, finding a quiet private place in a multiperson home can be a challenge. “California has significant disparities — particularly by race, language and region — when it comes to health care access and health care outcomes,” Savage-Sangwan said. “Certainly, telehealth was helpful during the pandemic. “When people go into a medical office, various medical professionals assist them. Someone checks you in, someone takes your weight. People support you through the process. But when you’re accessing virtual care from home, you’re going to need to get that support a different way. “What we’ve seen to be successful is for the providers’ offices to build that into their workflow. Maybe someone calls you about your doctor’s appointment and would say: `'Hey, are you set up? Do you know how to use the platform? Let me walk you through it.’ We need to support people, so they are truly engaged in their health.” What’s telehealth friendly? Colonoscopies, mammograms and MRIs are obviously not possible through telehealth (at least not yet). But a lot can get done through a video visit, including assessing a medical problem and prescribing remedies for it. Millen, of UC San Diego Health, said her telehealth patients usually followed through on her instructions. She also noted that caregivers and family members became more engaged in video visits, particularly when she asked them to help with the exam. From monitoring diabetes and diagnosing a sinus infection to doing preliminary neurological tests and conducting speech therapy sessions, the use of telehealth has been wide ranging. “Before the pandemic, I would have definitely said: `'Yeah, there are some specialties that won’t be able to do video visits at all,’ ” Millen observed. “I was surprised how well our doctors and staff figured out how to get patient history and information.” Both Millen and Savage-Sangwan of the California Pan-Ethnic Health Network think that behavioral health and counseling services are extremely telehealth friendly. Savage-Sangwan pointed out that the network’s community clinics had been experiencing a high rate of no-shows for these services before the pandemic. With telehealth, the number of no-shows dropped to almost zero. In general, telehealth has proved itself worthy of coming out of the prepandemic shadows and becoming a vital component of equitable healthcare. “I’m happy by how many video visits are still going on,” Millen said. “I was thinking it would fall off rather quickly. But there are certain doctors who really love it and certain patients who really love it. “I see it getting a little more mature. What’s happened in the last few months is that we’ve created more of a system for it that makes sense. On both sides, I think we all know when to hold it and when to fold it.” She laughed. “I mean, when to see them and when to video.” Source: https://www.sandiegouniontribune.com/news/health/story/2021-08-03/once-a-temporary-convenience-telehealth-is-here-to-stay < Previous News Next News >

Could Telehealth Worsen Inequity? 'Not Under My Watch,' Says HHS Sec. Becerra Kat Jercich June 2021 Top health officials from HHS and VA have signaled their ongoing support for telemedicine in the long term, but also want to ensure that "technology is being used properly." In recent public appearances, U.S. Department of Health and Human Services Secretary Xavier Becerra and Veterans Affairs Secretary Denis McDonough both indicated their support for telemedicine in the long term. Even as states have moved to enact their own laws aimed at telehealth expansion, questions have persisted about a federal response. Becerra emphasizes equity in technology "We are absolutely supportive of efforts to give us the authority to be able to utilize telehealth in greater ways," said Becerra during a Washington Post live event earlier this week. "We want to make sure that we don't leave anyone behind … so that telehealth should be available to all Americans universally," Becerra continued. At the Post event, Becerra reiterated that the Biden administration is supportive of recent moves in Congress that would safeguard access to telemedicine after the COVID-19 pandemic. Becerra also emphasized the importance of making technology available to everyone, not just those with means. "That includes, of course, making sure broadband, and quality broadband, is out there for all communities," he said. When asked about the danger of telehealth exacerbating inequities – which many advocates have warned against – Beceerra said, "not under my watch." "We're going to do everything we can to include everyone. It should make no difference what Zip code you live in, in America," he said. "You should have access to whatever technologies we as a government through our taxpayer dollars make available, and so that's why we want to make sure we do this the right way and that there's accountability on both ends of the system," he continued. He also referred to concerns around spending and overutilization, which have dogged discussions of virtual care. "We want to make sure that these providers are providing a service that might not have been available had we not had telehealth, but that it also results in better quality services and treatment, because we don't want to be billed for things that don't result in better health for Americans," he said. When it came to interstate licensure, another sticky proposition, Becerra called it an "accountability issue." Though he avoided directly weighing in on whether doctors should be allowed to work outside their states, he seemed to lean against the issue. "The farther away you go from the direct connection between patient and provider, the more difficult it will be to try to provide for the accountability, quickly and fairly, for the patient," he said. "So if your doctor is 30 miles away, and you live in rural America, we can track down that doctor 30 miles away from you. But if your doctor was 3,000 miles away from you, that's a tougher sell for a consumer who is now trying to get accountability for a service that wasn't properly provided," he continued. When it came to broader technologies – beyond telehealth – Becerra pointed to the role digital health tools can play in strengthening U.S. public health infrastructure. "COVID-19 showed us where the holes are in our public health system. That's what happens when you have the most technologically advanced healthcare in the world, but it's not evenly distributed, and as a result, we had pockets in America where COVID was devastating," he said. "And technology helps us close those gaps faster, but once again, we want to make sure that technology is our friend and technology is being used properly, so accountability will be so important," he continued. Telehealth options are a hit with vets Meanwhile, VA Secretary McDonough appeared before the Senate Appropriations Committee this week to offer an update on veterans' use of telemedicine. "There were almost 230,000 visits at the end of February this year," said McDonough, as reported by the Military Times. "Nearly 2 million vets have had one or more episodes of video care. That tells us that there’s massive demand." McDonough noted that the department is working on addressing the reluctance of some staffers to pivot to virtual care. "There’s going to continue to need to be things that are done in person, but I think as a system we recognize the huge efficiency gains and and huge satisfaction gains which come from vets spending less time traveling to our facilities while still getting good care," he said. "We want to maintain it, because it’s ease of access for vets who don’t need to be seen in person," he said. The VA has faced scrutiny in other digital health arenas recently, with an Office of Inspector General audit finding that the Veterans Health Administration needs improvement when it comes to integrating non-VA medical data to veteran's electronic health records. Sen. Brian Schatz, D-Hawaii, said he'll encourage VA leaders to preserve the new telehealth options and explore avenues for Congress to enable them. "There’s going to be a tendency to want to snap back to pre-pandemic times, and I just think there’s going to be a patient revolt,” said Schatz, who praised telehealth in a recent interview for HIMSS TV. "Ten years ago, if you told someone to interact with their clinician via iPhone, it would be an insult. Now, if you can’t do that, that’s an insult," Schatz said. Source: https://www.healthcareitnews.com/news/could-telehealth-worsen-inequity-not-under-my-watch-says-hhs-sec-becerra < Previous News Next News >

Bipartisan Policy Center Report Highlights Telehealth Policy Considerations CCHP November 01, 2022 Last month, the Bipartisan Policy Center (BPC) released a comprehensive report on The Future of Telehealth After COVID-19. The report is based upon an analysis of Medicare Telehealth Utilization and Spending Impacts 2019-2021, stakeholder input and interviews, a literature review, and a national consumer survey. The BPC report examines the impact of increased access to telehealth during the pandemic and makes recommendations to policymakers on which COVID-19 policy expansions should be maintained post-public health emergency (PHE). Ultimately, BPC urges the federal government to extend emergency flexibilities for two years to preserve access while further evaluating telehealth effectiveness. In its analysis, BPC made a number of key findings showcasing telehealth’s ability to alleviate access barriers for Medicare beneficiaries, address inequities in access and outcomes for racial and ethnic minorities, low-income earners, and individuals with chronic conditions, as well as improve patient continuity of care. The report also noted that patients and providers generally feel satisfied with telehealth services. Other findings include: A decrease in telehealth utilization since initial pandemic peaks, although 2021 rates remained nearly 40 times higher than pre-pandemic telehealth visits Most telehealth visits were for primary care visits and 44% of all behavioral health visits in 2021 occurred via telehealth About 1 out of 5 telehealth visits were audio-only in 2021 Telehealth utilization was higher in urban areas and for non-white beneficiaries Beneficiaries with disabilities and dually eligible for Medicare and Medicaid were more likely to use telehealth in 2021 Medicare spending on telehealth remains a small percent of overall spending – for the outpatient codes BPC examined, telehealth spending was between 1.5% and 3.3% of total spending in 2020 and 2021 In applying its findings to policy recommendations, BPC discusses an attempt to balance competing goals, for instance the need to increase access to care against the need to ensure quality and cost-effectiveness. The report also highlights areas to focus future research and notes the need to examine telehealth outside of PHE conditions to truly generalize findings. In addition, BPC acknowledges limitations in its spending analysis that don’t factor in the potential reduction in long-term costs related to emergency room visits in correlation to increased telehealth visits. In addition to extending Medicare telehealth flexibilities for two years, key BPC recommendations to Congress and the Biden administration include: Maintain access to telehealth for Medicare beneficiaries regardless of location or medical diagnosis – including the home/patient location as an authorized originating site and removing geographic limitations (with protections to require providers to see patients in-person or refer to in-person care when necessary) Authorize FQHCs/RHCs to permanently serve as distant site providers Continue access to primary care and behavioral health services with minor adjustments post-PHE (the recommendation notes that if further research supports it, CMS could consider limiting certain services to existing patient-provider relationships – except in rural areas and for alternative payment methodology (APM) providers) Continue audio-only coverage and incorporate audio-only into telehealth definition (post-PHE audio-only restrictions should limit coverage to established patients and at patient request) Permanently expand asynchronous services beyond virtual check-ins and Alaska and Hawaii demonstration projects for both new and established patients Make Health and Human Services (HHS) 1135 temporary waiver authority permanent for future PHEs Eliminate the requirement for in-person visits for telemental health services (BPC states this is an undue burden on those who cannot access behavioral health providers in-person) Require evaluation of controlled substance prescribing via telehealth and for non-hospice, non-cancer patients, first require an in-person exam prior to prescribing substances prone to abuse (BPC additionally recommends the Department of Justice (DOJ) follow through on its requirement to create a special telemedicine registration process to allow for certain in-person requirement exemptions) Refine reimbursement rates and end broad payment parity between telehealth and in-person care to offset any cost/utilization increases, including implementing different rates for audio-only and video visits In regard to transparency and consumer protections in particular, the report also recommends clear information to beneficiaries be provided regarding benefits appropriately delivered by telehealth and ensuring that beneficiaries consent to the use of telehealth. BPC additionally recommends the ability to distinguish between traditional and fully virtual providers be determined, and that enforcement resume related to HIPAA. In regard to fraud, waste, and abuse protections, the report calls for sufficient funding to the HHS Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS) to modernize and track telehealth use, the requiring of outlier provider audits, and that high-cost durable medical equipment (DME) and laboratory tests be limited to established patients, unless providers are part of APMs. To improve data quality, the BPC suggests CMS simplify telehealth billing and develop additional guidance for providers to ensure uniformity and coding accuracy. Lastly, the BPC recommends requiring MedPAC complete a formal evaluation of post-PHE telehealth impacts on access, quality, patient outcomes, and cost to truly determine long-term trends and policies. BPC’s report is extremely thorough and highlights the many issues policymakers are facing in contemplating permanent telehealth policies. Some of BPC’s attempts to balance recommendations and exceptions to address concerns raise additional complexities behind the considerations further showcasing where policymakers and future research should focus. For instance, in terms of audio-only, BPC notes that continued coverage is critical for beneficiaries lacking broadband and technology access, although additional restrictions should be adopted to address concerns related to quality and potential for overuse. However, policymakers should consider whether these additional restrictions may ultimately limit the access the report describes as critical. In terms of payment parity, BPC notes that it has been an important tool to increase access to care and ensure that practitioners provide telehealth services. However, given payer and policymaker concerns, BPC recommends that perhaps the best post-PHE policy would be to cover certain telehealth services at higher rates than pre-PHE rates, but not necessarily equivalent to in-person rates. That may go against other recommendations in the BPC report to simplify telehealth billing, although ultimately BPC does state that CMS should look carefully at cost differentials when determining appropriate rates. Since many providers state that the cost and time of providing services via telehealth and in-person are equivalent it is important that researchers and policymakers look carefully at that issue. In addition, BPC suggests that different reimbursement rates may ensure access to in-person services, yet also states that parity in rates ensures access to telehealth services, showing the difficulty in sufficiently balancing these various considerations. Researchers and policymakers must pay careful attention to all perspectives and data around these issues in order to truly ensure telehealth’s ability to increase access to necessary health care. For additional details on BPC’s findings and recommendations, please view the report in its entirety. See original article: https://mailchi.mp/cchpca/bipartisanpolicycenter-report-highlights-telehealth-policy-considerations-recommends-2-year-extension-of-federal-flexibilities-further-research < Previous News Next News >

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: https://mhealthintelligence.com/news/amazon-launches-messaging-based-virtual-care-service < Previous News Next News >

HHS Awards Nearly $55 Million to Increase Virtual Health Care Through Community Health Centers Dr. Maheu June 3, 2022 Virtual care has been a game-changer for patients, especially during the pandemic… This funding will help health centers leverage the latest technology and innovations to expand access to quality primary care for underserved communities. Today’s announcement reflects the Biden-Harris Administration’s commitment to advancing health equity and putting essential health care within reach for all Americans. n February, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded nearly $55 million to 29 HRSA-funded health centers. Funding was earmarked to increase virtual health care access and quality for underserved populations through telehealth, remote patient monitoring, digital health tools for patients, and health information technology platforms. This telehealth funding builds on over $7.3 billion in American Rescue Plan funding invested in community health centers over the previous year to help reduce the impact of the COVID-19 pandemic. Health centers quickly expanded their use of virtual health care to maintain access to essential primary care services during the pandemic. The number of health centers offering virtual visits grew from 592 in 2019 to 1,362 in 2022, an increase of 130 percent. The February telehealth funding will reportedly be used to enable health centers to sustain an expanded level of virtual health care and identify and implement new digital strategies. HRSA Administrator Carole Johnson added: Today’s awards will help ensure that new ways to deliver primary care are reaching the communities that need it most… Our funding will help health centers continue to expand their virtual work while maintaining their vital in-person services in communities across the country. The press release also explained that the more than 1,400 HRSA-supported health centers in this country serve as a national source of primary care for at-risk communities. They are community-based and patient-directed organizations that deliver affordable, accessible, and high-quality medical, dental, and behavioral health services to nearly 29 million patients each year. As of late January, health centers have delivered over 19.2 million vaccine doses, with 68 percent going to racial or ethnic minority patients. More than 90 percent of health center patients are individuals or families living at or below 200 percent of the Federal Poverty Guidelines (about $55,000 per year for a family of four in most states) and approximately 62 percent are racial/ethnic minorities. For more information: https://telehealth.org/hhs-awards-nearly-55-million-to-increase-virtual-health-care-through-community-health-centers/?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

Over-the-Phone-Therapy: Rand Report Findings Dr. Maheu May 8, 2022 Preference for Over-the-Phone Therapy Visits A recently published RAND Corporation report confirms telehealth can improve healthcare access and high utilization of over-the-phone-therapy visits, also known as audio-only telehealth visits. Suggestions regarding reimbursement are included. However, the report cautions that more research is needed to ensure the equitable delivery of quality healthcare when using audio-only telehealth. In a bid to assist healthcare centers, the California Healthcare Foundation established a quality assurance program, the Connected Care Accelerator program (CCA), in July 2020. RAND researchers worked with 45 CCA health centers in compiling the report, “Experiences of Health Centers in Implementing Telehealth Visits for Underserved Patients During the COVID-19 Pandemic.” RAND Report Findings The RAND report found that the number of clinical visits remained the same during the study period compared to before COVID-19. However, over-the-phone therapy for behavioral health issues was a standout in terms of services received by patients. Audio-only visits were favored for both primary health and behavioral health practitioners when the study started. Many primary health visits had reverted to in-person consultations, but over-the-phone therapy for behavioral health care remained high by the end of the study. There were significant differences in video consultations across health centers, particularly behavioral healthcare. Health centers transitioning from audio-only telehealth visits to video visits had varying degrees of success. Of those that transitioned to video visits, the most successful shared these characteristics: Telehealth video platforms were easy to use. Clinicians obtained leadership support and staff training. Everyone involved experienced a sense of urgency. Patients were willing to try the technology. Health center staff who took part in the study noted that it was challenging to set up video calls, which led to the preference for over-the-phone therapy. Also significant were the changes in the telehealth reimbursement policy. Audio Telehealth Can Bridge the Digital Gap According to the RAND report, healthcare centers had varying degrees of success in implementing telehealth. The availability of digital assets is one of the barriers to entry regarding telehealth access. The report suggested that telehealth phone calls offer the next best option where other telehealth resources are lacking. The American Medical Association (AMA) issued a brief, Equity in Telehealth: Taking Key Steps Forward, which recently provided more data about audio-only telehealth. The report points out that one in five adults in the US does not have broadband, which means that these people cannot avail themselves of the benefits of video-based telehealth. The study also reported that 15% of patients don’t have a smartphone to facilitate a video connection with a provider. AMA suggests that hospitals and healthcare providers should invest in initiatives to broaden the reach of telehealth for the inclusion of marginalized communities. According to the brief, some health centers have increased their support staff to help bridge the digital gap. They have also made available wi-fi and telehealth booths. The AMA report also states: The AMA urges health plans to be required to cover telemedicine-provided services on the same basis as in-person services and not limit coverage only to services provided by select corporate telemedicine providers. Telehealth Reimbursement for Over-the-Phone-Therapy In recent years, telehealth reimbursements and healthcare coverage changes are another reason why over-the-phone therapy and audio-only telehealth visits have gained popularity. Before the pandemic, telehealth reimbursement for over-the-phone therapy was rare. Medicare and many states did not classify audio-only calls as part of telehealth services. Many have now increased telehealth reimbursement to include audio-only telehealth visits. See TBHI’s previous articles related to telehealth reimbursement for more information: 7 States Change Telehealth Coverage for Telehealth Reimbursement Telehealth Expansion: 6 Additional States Announce Telehealth Coverage Audio-Only & Other Telehealth Services Approved for Reimbursement Moving Forward with Over-the-Phone-Therapy and Audio-Only Telehealth Reimbursement It is difficult to monitor how audio-only telehealth visits are now being used because historically there were no codes and modifiers on the claims applications. Medicare and Medicaid providers have recently added audio-only modifiers and coding to their listings. See Telehealth Reimbursement Alert: 2022 Telehealth CPT Codes Released. Data collection regarding telehealth phone calls will be forthcoming as a result. There is a general belief that over-the-phone therapy is open to improper use and can lead to increased costs and inequitable use. Data transparency may help mitigate this belief as clinicians’ preference for other modalities is revealed. See Audio-Only Telehealth: A Classic Solution to a Modern Crisis. RAND Report Recommendations The RAND report concluded that audio-only telehealth policies should be limited until evidence is better gathered and understood since audio-only telehealth data is lacking. Implementing policies with in-person and video requirements and different telehealth reimbursement rates is recommended. It pointed out that healthcare centers and professionals need support and resources for effective telehealth implementation. Professional training is also available. A complementary and recently published report described telehealth systems’ use, access, and quality. It showed how telehealth reimbursement and services have spread into all primary forms of healthcare to the satisfaction of providers and their clients. Over-the-phone therapy will remain an essential part of ensuring that clients receive the care they need until we bridge the digital divide. Policymakers need to balance their concerns with interpretations that support audio-only telehealth policies to reduce digital inequities while efforts are made to reduce the digital divide. < Previous News Next News >

Emergency Broadband Benefit Resources Center for Connected Health Policy April 2021 FCC recently posted a new consumer FAQ on the Emergency Broadband Benefit Program, which the FCC is still working to make available but hopes to have in place for signup by the end of April 2021. The Federal Communications Commission (FCC) recently posted a new consumer FAQ on the Emergency Broadband Benefit Program, which the FCC is still working to make available but hopes to have in place for signup by the end of April 2021. The program will help households struggling to pay for internet service during the pandemic. The FAQ provides answers to common consumer questions on benefit eligibility, how the discount will be applied to broadband service costs, and program length. It also includes information on the enhanced Tribal benefit and the connected device benefit. Additional questions can be sent to broadbandbenefit@fcc.gov and webinars, informational materials, and upcoming trainings can be found here: https://www.usac.org/about/emergency-broadband-benefit-program/webinars-and-trainings/ FCC Consumer FAQs: https://www.fcc.gov/consumer-faq-emergency-broadband-benefit < Previous News Next News >

Events Networking, Education, Advocacy: Happy hours Meetings Webinars Conferences Legislative hearings And more... Mark your calendars! Upcoming Conferences Want to post your event e-flyer here? Contact us! THURSDAY, MAY 16 – FRIDAY, MAY 17, 2024 EMBASSY SUITES BY HILTON Albuquerque, New Mexico Upcoming Networking Event Post-Event News Past Networking Event Coming Soon! The NMTHA 2024 Events Calendar is currently under construction... Check back soon for upda tes!

Endocrine Society Provides Guidance for Appropriate Use of Telehealth Mark Melchionna October 07, 2022 The Endocrine Society published a policy perspective covering various factors, such as clinical and patient factors, which could help determine subjective care needs and whether telehealth use is appropriate. October 07, 2022 - Aiming to enhance personalized care, the Endocrine Society created a policy perspective containing five aspects of care that can help clinicians decide when using telehealth is appropriate. With 18,000 members spread across 122 countries, the Endocrine Society is focused on promoting efforts to treat all hormone-related conditions, including diabetes, obesity, and hormone-related cancers. Amid the rapid growth of telehealth that resulted from the COVID-19 pandemic, healthcare stakeholders anticipate that telehealth will continue to pave its way into various aspects of clinical care. Published in The Journal of Clinical Endocrinology & Metabolism, the Endocrine Society policy perspective describes five aspects of care that can assist the process of determining when telehealth is appropriate. “Clinicians will need to draw upon their own knowledge of each patient and their clinical goals to decide when to incorporate telehealth into their care,” said the policy perspective's first author Varsha G. Vimalananda, MD, a physician-scientist at the VA Bedford Healthcare System and an associate professor of medicine at Boston University School of Medicine, in a press release. “Telehealth visits can be considered as an option each time we schedule an appointment. Patient preference should be elicited, and decisions guided by weighing the factors we describe in the perspective piece.” The five aspects of care to be considered when deciding whether telehealth is appropriate for a patient are clinical factors including whether an in-person exam is necessary, patient factors such as access to transportation and comfort level with technology, the patient-clinician relationship, the physical surroundings of the clinician, and the availability of infrastructure needed for telehealth visits. Telehealth is playing an increasingly valuable role in a personalized healthcare, but physicians and patients need to discuss how it fits into the care plan they are deciding on, according to the policy perspective. "Moving forward, endocrine care is likely to involve a hybrid of in-person and telehealth visits, and thus the decision to use telehealth for any given patient will not be made at a single time point but rather considered in a longitudinal context," the perspective states. Previous studies have indicated that various benefits that arose from telehealth expansion. For example, a study published in September found that increased telehealth use during the pandemic led to a drop in opioid overdose risk. Researchers studied data from before and during the pandemic, which indicated that the likelihood of receiving opioid use disorder services and medications was higher in the mid-pandemic patient group that had increased access to telehealth. Further, telehealth continues to be used widely across the country. Recent data from FAIR Health shows that telehealth use rose 1.9 percent nationally from June to July and that it increased in three of the four US census regions: the Midwest, the South, and the West. See original article: https://mhealthintelligence.com/news/endocrine-society-provides-guidance-for-appropriate-use-of-telehealth < Previous News Next News >

Common Wealth Fund Analyzes State COVID-19 Telehealth Changes Center for Connected Health Policy July 2021 Recommending Longer Term Expansion Data to Determine Permanent Policies The Commonwealth Fund recently released an issue brief titled, States’ Actions to Expand Telemedicine Access During COVID-19 and Future Policy Considerations, to help inform future policy considerations for telehealth post-pandemic. Focusing on private insurance coverage, the authors reviewed pre-pandemic state telehealth statutes as well as state emergency actions related to telehealth between March 2020 and March 2021. The study found that 22 states made telehealth policy changes, mostly in regard to audio-only coverage, cost-sharing requirements, and reimbursement parity. Audio-only coverage and reimbursement parity were the most popular changes made to ensure expanded access to telehealth. Notable pre-pandemic findings include: -35 states required private insurance telehealth coverage -25 states required insurers to limit cost-sharing -15 states required private payer reimbursement parity -3 states explicitly required audio-only coverage Notable policy expansions during the pandemic included: -5 additional states required telehealth coverage -4 new states eliminated cost-sharing for services via telehealth -10 states added a requirement for private payer reimbursement parity -18 states moved to require audio-only coverage The report also looked at methods of emergency telehealth expansion by states, finding that policy changes came in a combination of legislation, executive orders, and other agency actions such as bulletins and notices. The study found 8 states passed legislation, but that the primary method was administrative action, given its ability to be made quickly. Administrative changes also appeared to often hinge on existing statutory authority or executive orders creating such authority. As part of the study’s methodology, the authors additionally interviewed insurance regulators in 10 states that had made telehealth expansions. Regulators highlighted the importance of audio-only coverage, both for older patients and their ease of use, as well as patients with behavioral health conditions that find it more comfortable. While some regulators expressed concerns related to increased costs with audio-only coverage, others highlighted billing parameters and how insurers have the ability to determine which audio-only visits qualify for reimbursement. The regulators also noted that almost all insurers were supportive of the temporary expansions, but that they’d likely oppose long-term payment parity requirements, even though one regulator commented how the work may be the same for a visit via telehealth as in-person. Interviews also revealed an insurer desire to pay lower rates for their third-party corporate telehealth providers, which regulators said may be less costly but also may fragment care, which can result in lower quality care and higher health care costs. The report also covers existing research around the benefits of telehealth and suggests the need to address insurance and audio-only coverage long-term to reduce access issues and stabilize the coverage landscape for providers to continue investing in telehealth use. The study concludes with the recommendation that maintaining telehealth expansions may benefit payers and consumers if telehealth can be shown to reduce health care costs. This will require access to longer-term information to monitor its use, including stakeholder workgroups and formal data collection mechanisms. Of course, longer-term data requires longer-term expansions, which could trend states toward temporary extensions in the short-term, such as those recently enacted in Connecticut and proposed in California. As policymakers continue the call for telehealth data, the primary response from researchers seems to be the same call. In addition to telehealth expansion impacts on health care costs, the issue of improved access to care must remain a primary focus of data collection and evaluation as well to truly result in equitable policy adoption. For more information on the actions states took to expand telehealth during COVID-19, read the Commonwealth Fund’s issue brief in its entirety - https://www.commonwealthfund.org/publications/issue-briefs/2021/jun/states-actions-expand-telemedicine-access-covid-19. CCHP’s Policy Finder tool can also be used to look up COVID telehealth policy documents by state. New Mexico policy finder - https://www.cchpca.org/new-mexico/. < Previous News Next News >

Frequently Asked Questions Regarding Licensure & Telehealth Mei Wa Kwong, JD September 12, 2022 ​ This video addresses the most frequently asked questions CCHP receives regarding licensure and telehealth for example: (1) What does the law says if your patient is going on vacation to another state, but still needs your services? (2) Do you really need a license in another state if you’re just consulting with a provider who is already licensed in that state? (3) ….and many more! View the PPT for this video here. See original video: https://www.cchpca.org/resources/frequently-asked-questions-regarding-licensure-telehealth/ < Previous News Next News >