What You Need to Know About the Telehealth Extension and Evaluation Act Dr. Maheu February 24, 2022 The Telehealth Extension and Evaluation Act was introduced on February 7, 2022, to ensure a continuation of public access to telehealth after the end of a public health emergency. If passed, it will allow time to gather data concerning virtual care utilization and prevent a sudden drop-off in access to care, also known as the telehealth cliff. What is the Telehealth Extension and Evaluation Act? The Telehealth Extension and Evaluation Act establishes a two-year extension for certain coronavirus-related telehealth waivers. It will extend geographic and site restrictions waivers and allow Medicare beneficiaries to access telehealth from various locations. It also provides flexibility for prescribing drugs via telehealth and extends flexible Medicare payment plans for Rural Health Centers (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs). The bill follows an advocacy letter signed by 336 organizations, co-led by the American Telemedicine Association (ATA) and others, urging Congressional leaders to continue the current telehealth waivers and pass permanent, evidence-based telehealth legislation for implementation in 2024. Key Takeaways for the Telehealth Industry The telehealth industry should be aware of the critical points of the Telehealth Extension and Evaluation Act. Extension of Medicare Payment for Telehealth Services. The CARES ACT allowed the Centers for Medicare and Medicaid Services (CMS) to waive specific Medicare coverage and payment limitations, allowing Medicare beneficiaries to receive telehealth care at home. If the Telehealth Extension and Evaluation passes, it will extend certain telehealth coverage waivers on originating site and geographic location limitations, expand the list of telehealth providers, and increase the availability of audio-only telehealth services to Medicare beneficiaries for two years after the public health emergency ends. Telemedicine Drug Prescribing. The Ryan Haight Act prohibits the prescribing of medicine without an in-person visit. Federal law allowed DEA registered practitioners to prescribe to patients without in-person visits during the pandemic. See TBHI’s previous article Telehealth Opioids, and Ryan Haight Act Update, for more information. The proposed legislation would extend this flexibility two years after the public health emergency. Extension of FQHCs and RHCs. Before the pandemic, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) could only provide telehealth services to patients near their locations. The CARES Act allowed these facilities to provide care to patients in distant areas, a practice the legislation would continue for two years after the public health emergency expires. Extension for CAHs. The 2020 Hospitals Without Walls program allowed hospitals to provide telehealth care during a public health emergency. The proposed legislation would add Critical Access Hospitals (CAHs) as distant site providers of telehealth services to continue offering off-site care. Restrictions for Certain DMEs and Lab Tests. The legislation would require an ordering physician to conduct an in-person examination of a patient no more than 12 months before ordering specific high-cost lab tests and Durable Medical Equipment (DME) products via telehealth. It would also instruct Medicare Administrative Contractors to audit practitioners and clinicians who do 90% or more of their orders of DME and lab tests via telehealth. This would continue for two years after the health emergency ends. It is meant to reduce instances of fraud and abuse. NPI Number for Telehealth Billing. Healthcare providers need a national provider identifier (NPI) number to bill Medicare directly. Under certain conditions, Medicare pays for services billed by physicians but performed by non-physician staff acting under the physician’s supervision. This practice is known as “incident to” billing. The proposed legislation requires all practitioners to obtain an NPI number to receive Medicare payment for telehealth services two years after the public health emergency. Your Advocacy Is Needed The pandemic has caused an increased reliance on the telehealth industry. If passed, the Telehealth Extension and Evaluation Act will ensure that patients can continue to access the virtual care they need. Contact your elected officials at the federal level to ask them to support this crucial bill. https://telehealth.org/what-you-need-to-know-about-the-telehealth-extension-and-evaluation-act/?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&smconv=5bc4c379-a4c1-484f-a411-33ec93777504&smlid=9&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

HHS to put $35M toward telehealth for family planning Kat Jercich November 29, 2021 The agency plans to use the funds to award about 60 one-time grants to Title X family planning providers, who must apply by February of next year. The U.S. Department of Health and Human Services announced that it would make $35 million in American Rescue Plan funding available for Title X family planning providers to strengthen their telehealth infrastructure and capacity. Title X family planning clinics help to insure access to a broad range of reproductive health services for low-income or uninsured individuals. "I’ve seen first-hand the critical role that telehealth plays in serving communities, particularly to protect so many families from COVID-19," said HHS Secretary Xavier Becerra in a statement about the grant availability. "As providers transitioned from providing in-person primary care to offering telehealth services, we were able to test, vaccinate, and act as lifelines to communities disproportionately hit by the pandemic," he said. "Increasing our investment and access to telehealth services remains critical." WHY IT MATTERS The Office of Population Affairs funds 71 Title X family planning service grantees and supports hundreds of subrecipients and thousands of service sites around the country. Family planning includes a broad range of services related to reproductive health, including contraception, sexually transmitted infections and pregnancy testing. Although abortion care can be co-located with family planning services, Title X funds cannot be used to pay for it. Although some services require in-person treatment and exams, others can be carried out via telehealth – as evidenced by grantees' use of virtual care to help their patients during the COVID-19 crisis. Still, facilities may not have adequate technology available. "During the global COVID-19 pandemic, family planning programs have accelerated the use of telehealth," said Dr. Rachel Levine, assistant secretary for health, in a statement. "These ARP funds will facilitate the delivery of quality family planning services and reduce access barriers for people living in America who rely on the health care safety net for services," she added. HHS plans to use the funds to award about 60 one-time grants to active Title X grantees. Organizations must apply by February 3, 2022, and notices of awards will be announced before the project start date of May 1, 2022. THE LARGER TREND Even as the government has moved to shore up telehealth infrastructure via funding, the question of virtual care's future continues to hang over Congress. Despite requests from hundreds of advocacy organizations, legislators have so far failed to take action to permanently safeguard telehealth after the end of the COVID-19 public health emergency – what some activists have referred to as "the telehealth cliff." "We recognize there are many unknowns related to the trajectory of the COVID-19 pandemic over the next 12 to 24 months," said American Telemedicine Association CEO Ann Mond Johnson in October. "However, we implore Secretary Becerra to provide as much predictability and certainty as possible to ensure adequate warning before patients are pushed over this looming cliff." ON THE RECORD "The pandemic has laid bare the important role that telehealth can play in our nation’s healthcare service delivery, and we are profoundly grateful for the opportunity to support continued investments in telehealth for the nation’s family planning safety net," said Jessica Swafford Marcella, HHS deputy assistant secretary for population affairs, in a statement. < Previous News Next News >

Telehealth Industry Expected to Grow from $26.4 Billion in 2020 to $70.19 Billion by 2026, at a CAGR of 17.7% DUBLIN--(BUSINESS WIRE) August 5, 2020 The present situation of COVID-19 has a great impact on the Telehealth market, where home care services are increasing through the modes of telehealth services. Information is passed through telecommunication where a patient can access the treatment from the clinician and can take advice without approaching to the doctor and without going out for the hospital. This situation gives immense opportunity for the telehealth market players. Market Highlights The Telehealth Market is estimated to reach USD 70.19 billion by 2026, from USD 26.4 billion in 2020 and registering a CAGR of ~17.7% during the forecast period. The growing technologies in the telecommunications sector to reach the patients in time play a major role in the telehealth services, which raise the growth in the Telehealth market. Based on the application of Telehealth - Telehealth services market is segmented into three segments, including Teleradiology, Tele-consultation, Tele-ICU, Tele-stroke, Tele-psychiatry, and Tele-dermatology. Teleradiology had achieved a major share in the telehealth market in the last year due to increasing mental health issues among people. The insufficient health services providers give the scope of opportunities in the telehealth industry to fulfill the demand of the end-users. The market components cover the segments of Software & Services and Hardware. The segment of software & services accounted for the larger share of the global telehealth market in 2019. Telehealth market based on the end-user segment classified into Providers, Payers, and Patients. The end-users, such as providers segment accounted for the largest share in 2019. Telehealth segmentation is based on geography includes North America, Europe, APAC, and RoW. North America accounts for the largest share in the telehealth market in the entire world. The Telehealth market is growing enormously in the region of North American countries, which is very advanced in the technological perspective and in the advanced medical facilities. The increase of chronic diseases like cancer, asthma, and other diseases driving the adoption of the home healthcare services to avoid the expensive costs charged by hospitals, these are some aspects which increased the growth in the telehealth market in this region. In the last recent years, Europe is also another region in the telehealth market region where market players experienced tremendous growth due to knowing the awareness of remote monitoring and healthcare from home. The telehealth market is expanding globally during the forecasting period. The factors which give opportunities for this market are lack of physicians, increasing chronic diseases that need immediate attention from the physicians. However, the reimbursement or coverage of the fee, illiteracy of some people who cannot adopt the current advanced telecommunication are the challenges faced by the telehealth market. Key Players in the Telehealth Market The key players in the market are Teladoc, Doctor on Demand, GE Healthcare, SnapMD, Encounter Telehealth, GlobalMed, HelloMD, MDLIVE Inc, InTouch Technologies, Dictum Health, Inc., LLC, and American Well. Globally, advancements in the technologies and growing awareness of remote services increased the demand for telehealth services. In the coming future, emerging countries/regions play an important role in the telehealth services market. This study will help the market players to understand the key market trends, market dynamics, and end-users pain-points. The qualitative and quantitative analysis of the study will enhance the user experience of the study. The competitive analysis of the major players enables users to understand the dynamic strategies such as technology innovation, partnerships, merger & acquisitions and joint ventures of the key players This report also provides the portfolio analysis and capability analysis of the leading players. Quantitative analysis of the market enables users to understand the actual facts of the market across four major regions. Companies Mentioned AMC Health American Well Asahi Kasei Corporation Cerner Corporation Chiron Health Cisco Systems E Healthcare Imediplus Iron Bow Technologies Koninklijke Philips Medtronic Medvivo Group Medweb Siemens Healthineers AG Teladoc Health Telespecialists Vsee Zipnosis For more information about this report visit https://www.researchandmarkets.com/r/kyppo0 Contacts ResearchAndMarkets.com Laura Wood, Senior Press Manager press@researchandmarkets.com For E.S.T Office Hours Call 1-917-300-0470 For U.S./CAN Toll Free Call 1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 < Previous News Next News >

Configuring Virtual Care to Boost Pediatric Healthcare Quality, Access eVisit December 12, 2022 Virtual care can be a boon for pediatric patients and providers alike, but the key to a successful program lies in selecting and implementing the right technology. The rise in virtual care use has spurred greater access to healthcare, enabling providers to meet patients where they are. In the case of healthcare's youngest consumers, virtual care has not only helped mitigate barriers to care but also enhanced care delivery. Pediatric patients, like their adult counterparts, used virtual care in droves during the COVID-19 pandemic. One 2021 survey shows that one in five parents said their child had a virtual visit in the past year. Further, virtual care gained popularity among parents. Another survey showed that more than 60 percent of parents said they would want to continue using virtual modalities for their child's care after the pandemic, including almost 30 percent who hadn't used it previously. As a result, healthcare providers are increasingly implementing virtual care services for their pediatric populations. But selecting the right technology, and streamlining its implementation, are essential to ensuring the success of virtual pediatric care programs. BENEFITS OF PEDIATRIC VIRTUAL CARE PROGRAMS Virtual care offers pediatric patients and their providers a myriad of benefits, including expanded access to care. Many pediatric specialists treat patients across multiple states with facilities managing large patient populations. Children with chronic illnesses often have to take time out of school to see a specialist, while their parents or guardians have to take time off work. In addition, care providers may have trouble traveling to rural communities to provide care, taking unaffordable time away from the office for long periods as they care for individual patients across regions. "Virtual care not only increases efficiency but impacts access to care in ways in-person care cannot. It has helped those who don't have access to transportation, especially in the middle of the night," says Jacquelin Solomon, Implementations Project Manager at eVisit, a telemedicine solutions provider. "A parent with a sick child being able to have increased access to care — that's a huge thing that virtual care services provide now." Telehealth has been especially useful in unlocking access to specialty care for children, such as speech therapy and behavioral health services. Before the COVID-19 pandemic, many specialty care providers didn't consider virtual care a viable option to provide care, according to Jackie Thomas, Enterprise Customer Success Manager at eVisit. But following the widespread use of virtual care during the public health emergency, providers found that it can, in fact, improve care quality, particularly for children with special needs. For instance, a 2022 pre-and post-data analysis showed wrap-around virtual care programs for children and adolescents with medical complexity demonstrated a statistically significant reduction in hospitalizations and ED visits. Virtual care can also be beneficial for providers to virtually observe an autistic child in their home environment where they are most comfortable and can best demonstrate their routine to develop an appropriate treatment plan, she adds. Further, virtual care supports pediatric care providers in several ways, including by boosting operational efficiency and clinician productivity. Care coordination, education, parental support, and care triage, in particular, become easier with virtual care, Solomon and Thomas note. KEY CONSIDERATIONS WHEN SELECTING TELEHEALTH TECHNOLOGY To ensure the success of a pediatric virtual care program, healthcare providers must select the right technology. One key factor to consider is the configurability of the platform. "You do not want your highly compensated providers trying to figure out all the nooks and crannies of a platform that isn't configured and designed to their workflow," says Jason Weinrich, Senior Director of Professional Services at eVisit. Configuring the platform to clinical workflows — rather than adjusting workflows to the platform's capabilities — can support provider adoption and continuity of care. "Having that ability to quickly access the visit from their schedule, see a patient, hand off the patient to another clinician, like a nurse educator, all from one virtual care platform allows for continuity of care," Thomas states. "It also prevents burnout for the provider by allowing an MA to support rooming the patient and the entire clinical team to work at the top of their license." Additionally, customizing virtual care platforms can allow clinicians to address social determinants of health specific to the pediatric populations they serve. For instance, adding translation services to the platform can help providers engage with patients with limited English proficiency. "Providing access to these patient populations and allowing them to have the whole platform translated into Spanish increases patient satisfaction as well as adherence to care plans for non-English speaking pediatric patients and their parents or caregivers," says Solomon. Another critical consideration is whether the virtual care platform integrates into the provider's EHR, which can further streamline workflows, eliminate redundant and duplicative tasks, and increase proper visit documentation, freeing up providers for patient care, she adds. Ultimately, pediatric virtual care programs have the best chance for success when the selected technology meets the health system’s specific needs. The only way to ensure this is through detailed conversations between vendors and clinical leaders. "Clinical leaders need to have a conversation with vendors about what workflows look like with their solution, discussing what their clinical teams are doing every day, and where the pain points are,” says Weinrich. “Vendors should be able to recommend solutions to accommodate clinical workflows across multiple specialties, supporting both scheduled and on-demand visits. Bringing that insight into the conversation as opposed to just giving you their out-of-box product is key. Build that box together." BEST PRACTICES FOR IMPLEMENTATION Implementation of virtual care that supports the digitization of pediatric care requires significant efforts to ensure new care models do not inadvertently exacerbate inequities in care. Deciding on a comprehensive project plan is the first step. Platforms should be configurable to align with established workflows while also offering innovative ways to enhance workflows for greater efficiency. Then, there needs to be discussions around platform education and adoption strategies. Vendors should partner with the health system’s training teams to ensure a successful rollout. Health systems must then walk through the workflows before putting them into action. Having your providers test everything and offer real-time feedback before going live can prevent future issues. In this way, providers can ensure that the technology will power their pediatric virtual care programs and provide the necessary flexibility as virtual care preferences shift. "You want to adjust quickly because the market's adjusting quickly because patients enjoy the access virtual care gives them," Weinrich said. "It's exciting; we see our health system clinical teams getting very excited about jumping on, doing quick testing with us to make sure things work. They are excited too about where virtual care is headed." Though virtual care use has leveled off since its peak in the early months of the pandemic, virtual care has become an integral part of the healthcare delivery model. As pediatric providers optimize their programs, the right technology can go a long way toward widening access and improving the healthcare experience for patients and their families. ___________________________________ About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/configuring-virtual-care-to-boost-pediatric-healthcare-quality-access < Previous News Next News >

Out-of-State Telehealth Aided Rural Residents Amid the Pandemic Mark Melchionna September 22, 2022 New research shows that several Medicare beneficiaries benefited from expanding out-of-state telehealth services, including rural residents and cancer survivors. September 22, 2022 - A study published in JAMA Health Forum found that many Medicare beneficiaries benefitted from the elimination of restrictions on out-of-state telehealth services during the COVID-19 pandemic, primarily those with cancer, rural residents, and those residing nearby state borders. According to the Centers for Disease Control and Prevention, 95 percent of health centers used telehealth during the COVID-19 pandemic. This sharp uptake has prompted researchers to explore the effects of telehealth and the populations that use it the most. This study examined out-of-state telehealth data from January to June 2021. They selected this time period because it followed the abrupt onset of the pandemic and included vaccine distribution efforts. Further, state-based licensing flexibilities were still in effect during the study period, enabling out-of-state telemedicine. Most flexibilities were eliminated by mid-2021, after which pre-pandemic state licensing laws were reinstated. Overall, 8.3 million Medicare beneficiaries participated in a telehealth visit between January and June 2021. Of these, 422,547 (5 percent) had one or more out-of-state telehealth visits. Through geographical analysis, researchers determined that 57.2 percent of all out-of-state telehealth visits involved patients who lived near a state border, defined as within 15 miles of a border. Upon analyzing out-of-state visits, researchers found that 64.3 percent included a primary care or mental health clinician, and 62.6 percent were preceded by an in-person visit between March 2019 and the telehealth visit involving the same patient and provider. Researchers also found that rural residents were more likely to receive telehealth from an out-of-state location, with 33.8 percent of out-of-state visits involving a rural resident versus 21 percent of within-state telemedicine visits. Also, 9.8 percent of out-of-state telehealth visits were for cancer care, the highest rate among all specialties. Based on this data, researchers concluded that Medicare beneficiaries living in rural areas, seeking cancer care, and living nearby state borders were the most likely to obtain telehealth from an out-of-state clinician. The study results also imply that these populations are highly affected by restrictions that limit out-of-state telehealth. Researchers noted a few limitations within their study, including the potential bias associated with data from the traditional Medicare population and the use of home addresses to determine the state in which a patient resides. Various studies have collected data that reveal the difficulties some patients may face when obtaining care. Highlighting the care disparities between urban and rural residents, research from June found that Native American patients often faced difficulties when accessing cancer care. This was largely due to the large geographic distance between the areas in which American Indian and Alaska Native patients reside and the locations of clinics. Due to the high prevalence of access disparities, organizations often push for regulatory expansions related to telehealth. In September, 375 stakeholders signed a letter sent to the US Senate that requested the solidification of telehealth access for two years after the COVID-19 public health emergency has ended. See original article: https://mhealthintelligence.com/news/out-of-state-telehealth-aided-rural-residents-amid-the-pandemic < Previous News Next News >

Membership Benefits Welcome to the New Mexico Telehealth Alliance! This members section contains exclusive content and is available to subscribed members. For information on membership benefits, please select an option below. If you're already a member, please log-in to access your exclusive content. Click here to download NMTHA virtual backgrounds (ZOOM and Google Meets compatible). Membership Benefits Learn more New Member Log-in Guide Download Add/Change Member Guide Download

2021 National Telemedicine Summit World Conference Forum, LLC Sept. 13, 2021 Key Strategies to Revolutionize & Transform Healthcare Delivery, Optimize Quality Patient Care & Outcomes, Increase Accessibility, Enhance Data Analytics, and Reduce Costs! September 13 – 14, 2021 • The Ritz-Carlton, South Beach • Miami, FL Today, telemedicine is one of the fastest growing sectors in healthcare. Specifically, COVID-19 has enhanced and accelerated the role that telemedicine plays within our healthcare system. It is reshaping the landscape of healthcare delivery in the United States, and is being recognized as the future of global healthcare. Telehealth addresses and achieves the basic tenants of Healthcare Reform: providing the population with access to improved and convenient, high quality patient centric care, enhancing outcomes, while reducing per capita expenditures. Today, more than 70 percent of hospitals throughout the United States are engaged in telehealth programs. Studies have shown that the benefits of telehealth include significantly improved outcomes, efficient care delivery as well as reduction in mortality rates, hospitalizations, length of stay, readmissions and healthcare costs. Telehealth has greatly enhanced access to quality care in rural areas and patient satisfaction has increased due to its convenience and patient centric approach. We have created an exciting, high level forum featuring knowledgeable leaders and executives from the nation's leading Hospitals and Health Systems who will share their perspectives, valuable insights and expertise on how to be best equipped for the rapidly evolving and exciting landscape of telehealth. This exclusive event targets senior level executives in order to maximize educational and networking opportunities. By attending the 2021 National Telemedicine Summit, you will learn what highly regarded Hospitals and Health Systems are doing to be prepared for the challenges that lie ahead in 2021 and beyond! We look forward to greeting you in Miami! Link: https://www.wcforum.com/conferences/telemedicine < Previous News Next News >

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

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

Extended Reality for Telehealth The technologies enabling a more fully immersive telehealth experience of the future Jordan Owens September 20, 2022 There has been a digital transformation in telehealth in the form of remote meetings and video consultations. Just a few years ago, it was considered innovative to meet with a patient over video: now it’s seen as routine. Necessity can be a catalyst for innovation and telehealth is now here to stay. But that doesn’t mean the industry has finished growing, changing — or expanding. Extended reality (XR) is a catch-all term used to describe the many and various ways that technology can enhance what we perceive with our senses: how the real and virtual worlds can combine to extend perception, observation, and — in the case of telehealth — patient care and diagnosis. Using extended reality tools like augmented reality headsets and wearable devices, healthcare workers can diagnose with better accuracy, treat patients faster, and provide an optimal level of care — even when the patient is on the other side of the country (or the world). Some of the innovative ways that people are combining telehealth and extended reality include: Wearable technology to enhance remote patient monitoring You enter a remote telehealth session with a patient. You ask them what seems to be the issue. They respond, “Well, my ring says that my sleep patterns have been disturbed for the past few nights due to elevated heart rate, and then today my temperature has gone up. Here, look at the data for yourself.” Wearable technologies — from smart watches and wristbands to patches, rings, and even headsets — help collect valuable health data. These devices are already shaping the future of telehealth by making remote patient monitoring faster, easier, and more accurate than ever before. There are currently thousands of wearable devices on the market, tracking a variety of conditions. But as sensor technology improves, the accuracy of these devices improves as well. In fact, Gartner predicts that “by 2024, miniaturizing capabilities will advance to the point that 10% of all wearable technologies will become unobtrusive to the user,” leading to rapid market growth over the next three to five years. Virtual reality environments to set remote patients at ease The immersive nature of VR makes it a great way to distract patients from the stress they’re feeling. In fact, virtual reality has already proven effective in helping anxious in-office patients relax in stressful situations — like a child receiving a vaccine. This soothing, calming effect can be replicated in telehealth as well. Virtual environments can help alleviate some of the awkwardness of remote telehealth sessions, and help the patient feel closer — both physically and mentally — to the caregiver, which can improve patient care. According to a recent paper on the use of extended reality in telehealth: “Some patients report reluctance to self-advocate during typical telehealth sessions because of poor eye contact and audio interference if more than one person speaks at a time (….) Technologies that evoke presence—the perception, feeling, and interaction with simulations as if they were real — can meaningfully impact the practice and outcomes of telehealth.” While VR technology might not yet be advanced enough to create a fully immersive telehealth experience, it could be very soon. Imagine the possibilities. Augmented reality to improve patient care and diagnosis Wearables aren’t just for patients. There are many devices on the market that can augment and enhance the skills of medical caregivers as well. Visual overlays can help practitioners improve the accuracy of incisions, find difficult veins, take patient temperatures remotely, and much more. Many of these AR headsets, like those designed by RealWear, are also voice-controlled, leaving the practitioner’s hands free to do the work that needs to be done. They can also use the headsets to contact, and even video chat with, clinical specialists to get advice and guidance — making it easier for first responders in the field to accurately diagnose and treat illnesses and injuries before the patient even arrives at the hospital. Getting started with extended reality in telehealth As with any new technology, it’s important to work with partners who provide not only general support, but also vertical-centric support. Pexip is achieving this through partnering and working closely with headset manufacturers like RealWear and Hippo. We are also working with vertical-centric partners like SimplyVideo, allowing Pexip customers to add a variety of XR functionalities to their existing video telehealth platform. Pexip’s vision for the future is centered around leveraging technology to enhance and improve what people can achieve. We’re excited for the journey ahead and hope you will join us. About the Author Jordan Owens is the VP of Architecture for Pexip. He joined Pexip in 2012 from TANDBERG and Cisco where he led the Americas Technical Support organization, the Americas Product Engineering team, and a Pre-Sales Engineering organization for the previous 10+ years of his career. At Pexip, Jordan is responsible for leading the Americas engineering organization and serving as an extension of the global R&D organization. He can be reached at jordan@pexip.com See original article: https://www.americantelemed.org/blog/extended-reality-for-telehealth/ < Previous News Next News >

October 2022: Funding and Grant Opportunities Southwest Telehealth Resource Center October 2022 SWTRC NEWSLETTER- OCTOBER 2022 Bringing you up-to-date telehealth information resources on the southwest region and the USA Funding and Grant Opportunities There are many funding and grant opportunities for community and health-related organizations wanting to increase broadband capabilities and bring in needed funds for unique community health programming. Here’s a list of funding sources in the Southwest focused on broadband and health: AZ HEALTH Legacy Foundation of Southeast Arizona Grants | Legacy Foundation of Southeast Arizona (lfsaz.org) The Legacy Foundation of Southeast Arizona (LFSAZ) is a private foundation that grants funds to nonprofit organizations promoting population health and community wellness in Cochise and eastern Santa Cruz counties. Arizona Systems Change Grants Grants Archive - Vitalyst Health Vitalyst Health Foundation provides Systems Change Grants for collaborative work designed to transform systems through changes to policies and practices to improve health in Arizona communities. Applicants from tribes and rural areas are encouraged to apply. Successful applications will propose projects designed to make a significant, sustainable impact that address the intersection of 2 or more elements of a healthy community through an equity lens. Flinn Foundation Seed Grants Program Seed Grants Program - Flinn Foundation The Flinn Foundation’s 2022 Seed Grants to Promote Translational Research Program is funding 10 research teams, affiliated with an Arizona university, research institution, or health-care system, focused on advancing new products or services to improve patient care. The proposed projects must address compelling clinical needs in the areas of precision medicine, diagnostics, devices, therapeutics, or health-care-delivery processes and have significant potential to turn bench results into viable products or systems impacting patients in Arizona and beyond. CO BROADBAND Colorado Broadband Deployment Board Grant Cycles The Broadband Fund | DORA - COPRRR (colorado.gov) Access to broadband has a strong correlation with economic well-being. Nationwide, the impact it has on the communities it connects is real and measurable. The Broadband Fund exists to connect communities and fuel economic growth in unserved areas across Colorado. The Broadband Deployment Board provides grants through the Broadband Fund to deploy broadband service in unserved areas of the state. The Board has awarded $19.6 million in grants to 29 projects since 2016. As a result, over 17,000 rural households across Colorado will benefit from Broadband Internet access. HEALTH Anschutz Family Foundation Grants Funding Details: Anschutz Family Foundation Grants - Rural Health Information Hub The Anschutz Family Foundation provides grants to organizations in Colorado that work to strengthen families and communities and help individuals become productive and responsible citizens. In 2021, 45% of funding was dedicated to efforts in rural Colorado. Colorado Capital Infrastructure – Increasing Access to Care for Coloradans of Color Funding Opportunity: Capital Infrastructure – Increasing Access to Care for Coloradans of Color | The Colorado Health Foundation This funding opportunity is designed to improve the capacity of clinics to serve more Coloradans of color with high-quality, comprehensive team-based primary care centered on patients’ preferences, needs and values. It will provide shovel-ready capital funding to safety net practices in Colorado. NV BROADBAND Broadband Funding Opportunities Funding Opportunities (nv.gov) Grants are funded on a competitive basis. The evaluation criteria and selection process is outlined in each Request for Applications (RFA). Each grant proposal is evaluated by a team of experts assembled by OSIT. Generally, proposals are evaluated based on: the quality of the proposal and adherence to RFA guidelines; the ability of the organization to accomplish the proposal’s goals; and the impact the proposal will have on Nevada. Applicants that are awarded funding are required to submit regular fiscal and programmatic reports that detail progress toward agreed upon performance metrics and meet State and/or federal reporting guidelines. Awarded projects are subject to inspection and testing prior to final reimbursement. HEALTH Notice of Special Interest (NOSI): Research on Barriers to Care and Risk of HIV-Associated Comorbidities among Vulnerable Population Groups NOT-HL-22-010: Notice of Special Interest (NOSI): Research on barriers to care and risk of HIV-associated comorbidities among vulnerable population groups (nih.gov) This opportunity is a Notice of Special Interest (NOSI) for research that analyzes barriers to care and risk of HIV-associated comorbidities among disproportionally vulnerable and affected population groups of people living with or at risk for HIV infection. Notice of Funding Opportunity (NOFO) for Community-Based Behavioral Health Services and Support SAPTAGrants (nv.gov) This Notice of Funding Opportunity (NOFO) is intended to solicit applications from private, public, non-profit and coalitions for the Community Mental Health and the Community Substance Abuse Prevention and Treatment Agency Block Grant funds which includes COVID-19 Supplemental and the American Rescue Plan Act (ARPA). Behavioral Health grants reflect Nevada's health care system's strong emphasis on coordinated and integrated care along with the need to improve services for persons in crisis or with behavioral health disorders. These funds will provide Nevada the opportunity to focus on the specific needs of our State to address gaps in the behavioral health delivery system and crisis services focusing on direct and preventative services. NM BROADBAND Connect New Mexico Pilot Program Connect New Mexico Pilot Program - New Mexico Department of Information Technology (nm.gov) The Connect New Mexico Pilot Program (“Pilot Program”) aims to bridge the digital divide and foster socioeconomic progress by providing infrastructure grants for broadband deployment to unserved and underserved communities across New Mexico. HEALTH CDC Traditional Food Sovereignty and Tribal Workforce Development Fellowship Zintellect - Climb Higher The Centers for Disease Control offers a one year fellowship in Albuquerque, New Mexico working with the Healthy Tribes Program. The program is designed to strengthen the public health infrastructure, promote cultural and traditional practices that support health and wellness, and integrate evidence-based chronic disease interventions to improve the health of tribal communities. New Mexico McCune Charitable Foundation Grants Apply - McCune Charitable Foundation (nmmccune.org) McCune Charitable Foundation Grants are awarded to New Mexico community-based organizations working in one of the following areas: leveraging opportunities in healthcare, local food industry development, strategies for rural development, capacity building in the nonprofit sector, economic development and family asset building, education transformation, building links between arts and community engagement, stewardship of community and natural resources, and influencing planning of built environments. Tribal BROADBAND NTIA Tribal Broadband Connectivity Program Tribal Broadband Connectivity Program | National Telecommunications and Information Administration (ntia.gov) A $980 million program directed to tribal governments to be used for broadband deployment on tribal lands, as well as for telehealth, distance learning, broadband affordability, and digital inclusion. NTIA Digital Equity Program Digital Equity Programs | BroadbandUSA (doc.gov) Too many communities lack access to high-speed internet. Many more can't afford it or don't know how to use it. The divide between those who have internet access and those who don't is stark. To create an equitable economy, we all need access to reliable and affordable high-speed internet. The Digital Equity Act provides $2.75 billion to establish three grant programs that promote digital equity and inclusion. They aim to ensure that all people and communities have the skills, technology, and capacity needed to reap the full benefits of our digital economy. HEALTH Support for 988 Tribal Response Cooperative Agreements Funding Details: Support for 988 Tribal Response Cooperative Agreements - Rural Health Information Hub Resources to improve response to 988 crisis contacts (including calls, chats, and texts) originating in tribal communities and/or activated by American Indians/Alaskan Natives. National BROADBAND State Digital Equity Program Department of Commerce - State Digital Equity Planning Grant Program | BroadbandUSA (doc.gov) The Digital Equity Act, established by the Infrastructure Investment and Jobs Act (IIJA), dedicates $2.75 billion to establish three grant programs that promote digital inclusion and equity to ensure that all individuals and communities have access to the skills and tools needed to for full participation in the society and economy of the United States. The goal of these programs is to promote digital inclusion and advance equity for all to ensure all communities have affordable access and can use the Internet to improve their lives, including low-income households, aging populations, incarcerated individuals, veterans, individuals with disabilities, individuals with a language barrier, racial and ethnic minorities, and rural inhabitants. State Digital Equity Planning Grant Program: $60 million formula grant program for states and territories to develop digital equity plans. FCC Affordable Connectivity Outreach Grant Program FCC Establishes Affordable Connectivity Outreach Grant Program | Federal Communications Commission The Affordable Connectivity Outreach Grant Program will provide funding to support eligible partners in their outreach efforts to increase awareness of the ACP. In the Order, the FCC recognizes the importance of accessible outreach and strongly encourages grantees to make ACP outreach funded through the grant program accessible to individuals with disabilities. A key objective of the grant program is to expand and support diverse and impactful outreach efforts to diverse communities, including persons with disabilities. The FCC encourages entities of all types and diverse organizations, including organizations serving, led, or owned by persons with disabilities, to submit applications for the Outreach Grant Program once a Notice of Funding Opportunity is released. HEALTH Barclay-Giel Seed Grants Barclay-Giel Seed Grants - PHS (phscof.org) Grants for public health projects that have a strong disease and/or injury prevention component that impacts the health of a community by promoting wellness, early detection, and early interventions. Past awards have been given for projects in rural and tribal communities. See full article: https://southwesttrc.org/resources/newsletters/2022/2022-10 < Previous News Next News >

Sparrow Health System uses pandemic lessons to expand its virtual care strategic plan Bill Siwicki September 28, 2022 Today, the Michigan health system is seeing more than 1,000 e-visits per month, making greater use of its patient portal and successfully addressing the behavioral health caregiver shortage. Sparrow Health System in Lansing, Michigan, began developing a virtual care strategy in October 2019 – well before COVID-19 struck – with the hope of leveraging the technology as a tool to support patient care and the organizational strategy, rather than as a stand-alone strategy in and of itself. Sparrow's initial goal was to launch on-demand, virtual urgent care to increase access and provide another front door into the health system. It intended to go live in July 2020, using Amwell as the technology and services vendor for virtual urgent care for an estimated 1,500 visits in the first year. Telehealth plans quickly changed But then, COVID-19 hit, and plans quickly changed. "With most of our practices closed in late March of 2020, we needed an immediate solution that couldn't wait until July," said Patrick Sustrich, director of retail healthcare at Sparrow Health System. "What we thought would take months took us days, and we leveraged the capability of our Epic EHR to stand up on-demand and scheduled video visits using Zoom for Healthcare and our own providers. "In the first month, we surpassed our one-year goal of 1,500 virtual visits – telephone and video," he continued. "The benefit of staffing this ourselves was that it allowed our providers to access the patient's medical record, document directly into the chart and accept all the same insurance we do for in-person visits." Once the practices reopened, most thought they would resume normal operations and transition all their visits back to in-person. But this did not happen. Patients enjoyed virtual care "Not only was COVID not over, but patients enjoyed the convenience of virtual visits, and providers saw the value of this tool," Sustrich said. "Through August 2022, we have successfully completed more than 144,000 virtual visits. "Additionally, our health system has embarked on a strategy to tend to a situation that has plagued providers since the inception of the patient portal – the overwhelming number of medical advice requests," he continued. In fact, more than 16,000 medical advice requests are received each month. This uncompensated care takes hours out of a provider's day, and a solution was badly needed. Sparrow took a multi-tiered approach to resolve this issue. "The first approach was to leverage Epic to triage medical advice requests to the correct location – one direction for billing/finance, another for medication refills and another for scheduling questions/issues," he explained. "This significantly reduced the number of medical advice requests to the provider. "Next, we launched both patient- and caregiver-initiated e-visits in an effort to convert messages requiring medical decision-making into billable visits," he said. "Monthly reports were generated to providers showing them precisely the opportunity to convert medical advice requests into e-visits." More than 1,000 e-visits per month Although caregiver-initiated e-visits have only been available since Q2 of this year, Sparrow is averaging more than 1,000 e-visits per month. Additionally, a pilot is being conducted to evaluate the impact of using a centralized nurse triage process to resolve minor patient issues, freeing up providers' time to increase access. "Our main hospital campus struggled with LOS and a lack of beds, as most hospitals did during COVID," Sustrich recalled. "We needed to leverage the bed capacity of our community hospitals. We quickly looked for a telehealth solution to prevent unnecessary transfers and keep care local. "iPads with a Zoom video link provided patient-to-provider and provider-to-provider connections," he continued. "FCC funding we received has enabled us to purchase five telemedicine carts from Amwell, allowing an offsite provider to control the camera's pan/tilt/zoom features and access a digital stethoscope." Sparrow intends to place these carts at all five offsite ED locations. In the future, it plans on expanding specialist resources to provide care across the health system. Specialists such as those focused on pulmonology, behavioral health and infectious disease could never be supported at one community hospital, but collectively, and with the help of virtual care, these specialists can serve the entire health system, he stated. Staffing a 24/7 platform "Our current 24/7 on-demand platform's wait time is under 19 minutes, with an average completion rate of more than 80%," Sustrich reported. "It is rare to find a health system staffing its own 24/7 platform while having access to the patient's medical record and the ability to document within the EHR. "Many others have contracted this service out to a third-party vendor, which I believe sacrifices patient care quality and safety," he added. Additionally, Sparrow providers staffing this platform respond to e-visits from patients without a primary care provider, conduct COVID follow-up calls, and perform QR validation in the MySparrow Portal for patients who have received the COVID vaccination outside of the health system. After-hours coverage (8 p.m. – 8 a.m.) is conducted by three ED locations offsite from the main campus. "Another metric I am very proud of is our MySparrow Portal activation rates," Sustrich noted. "Early in the pandemic, it became apparent that patient success with our virtual health services was high in patients who already had a portal account. "In response, a campaign across Sparrow's entire medical group was launched to increase MySparrow Portal activation rates," he continued. "Patient tutorials were created, and the campaign began within ambulatory practices; each practice was given a goal, implemented best practices and shared a monthly scorecard." Caregivers hitting their goals Caregivers were rewarded with gift cards when their practice hit their goal, and the hospital's foundation funded the gift cards. Within two years (April 2020 to March 2022), Sparrow saw a 152% increase in its active MySparrow Portal users (146,768 to 369,916) and increased the percentage of patients with a portal account from 55.2% to 78.8%. The challenges Sparrow faced were similar to those of most other health systems, and this caused Sparrow to build the plane while in flight and struggle with training and experience gaps, Sustrich said. "Our assets included an engaged leadership team that supported our virtual health strategy and was willing to invest in it," he said. "We also leverage Epic and its ongoing development of virtual health tools. And I would be remiss if I didn't mention the resilience of our caregivers." Sustrich points to various signs of success: • More than 70,000 successfully completed video visits in the first two years. • More than $8 million in video visit revenue. • 40,000 hours of patient drive-time saved. • A 10% increase in the SUS Score. • Patient satisfaction went from 80% to 89%. • A 20% shift from telephone to video visits. A major FCC telehealth grant "Sparrow had the top FCC grant application in Michigan and was among 62 healthcare facilities nationwide that received funding from the FCC in Round 2 of its COVID-19 telehealth grant program," Sustrich reported. "The $586,000 was used for ambulatory virtual health hardware deployment, a virtual behavioral health program to expand access and cart technology to increase communication and improve care to our community hospitals out in the region. "Hardware purchased included 115 docking stations, 140 Bluetooth digital scales, 350 headsets, 230 monitors, 115 and keyboards with mouse," he continued. "This standardized virtual health equipment across our health system makes video visits accessible to a larger number of providers, thereby positively impacting patients and increasing access to care." Because of the nationwide shortage of psychiatrists and behavioral therapists, patients find it more difficult to access mental health services. "A portion of the FCC money purchased 40 iPads housed in five emergency rooms and throughout each inpatient floor at the main hospital to access virtual behavioral health services," Sustrich said. "Additionally, psychiatrists at Sparrow's St. Lawrence campus can virtually connect with patients in the adult psychiatric, geriatric psychiatric and outpatient units through an audio/video connection. "This will decrease wait time and increase access to behavioral health services," he concluded. "Additionally, bed capacity will increase from 60% to 85% occupancy." Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/sparrow-health-system-uses-pandemic-lessons-expand-its-virtual-care-strategic-plan < Previous News Next News >

CCHP Releases Updated Telehealth Billing Guide Center for Connected Health Policy March 16, 2021 The Center for Connected Health Policy (CCHP) has released a new updated telehealth billing guide as a follow up to its 2020 billing guide to provide a helpful tool for healthcare entities trying to navigate the complexities of billing for telehealth and virtually delivered services. The Center for Connected Health Policy (CCHP) has released a new updated telehealth billing guide as a follow up to its 2020 billing guide to provide a helpful tool for healthcare entities trying to navigate the complexities of billing for telehealth and virtually delivered services. Policy changes during the COVID-19 Public Health Emergency (PHE) have only made telehealth billing rules more nuanced. The updated billing guide addresses whether or not there is reimbursement for telehealth both generally and/or during the PHE, as well as how to correctly bill for a telehealth encounter, which is one of the most common policy questions CCHP receives as the National Telehealth Policy Resource Center (NTRC – P). Further complicating the billing process is the need to understand whether current rules are only applicable during the pandemic as well as the fact that payer policies continue to vary from payer to payer. For example, policies that apply to a Medicare beneficiary remain different than those that apply to a state Medicaid enrollee or to patients that have private insurance. DOwnload the guide here: https://www.cchpca.org/sites/default/files/2021-03/2021BillingGuideFINAL.pdf Please note, this resource is only provided as a guide and should not be considered legal advice. < Previous News Next News >

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

Report: Telehealth Programs Increase Workload for Nurses and Support Staff Katie Adams December 20, 2022 Many providers think their telehealth program increases the workload for nurses and support staff, according to a recent report. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators. Telehealth isn’t as widely utilized as it was at the dawn of the pandemic, but the care modality is definitely here to stay. However, many providers believe their telehealth program increases the workload for nurses and support staff, according to a recent report from research firm Sage Growth Partners. Providers also said they don’t think physicians enjoy using telehealth visits to treat patients. In 2023, hospitals and physician practices will have to focus on making their telehealth workflows more efficient, which may involve partnering with third-party administrators, the report said. In September, Sage Growth Partners surveyed 95 health system executives and 75 leaders of physician practices. Practices with fewer than five physicians were excluded from the survey. Most respondents said that their organizations will focus on optimizing and sustaining their current telehealth programs in 2023 rather than expanding them. In fact, only about 10% of participants — 11% of hospitals and 8% of practices — said they are looking to grow their telehealth offerings next year. Health system executives were more likely than practice leaders to say that telehealth visits should make up a higher percentage of their ideal in-person-to-telehealth visit mix. Health system leaders said the mix should be 30% telehealth and 70% office. Among practice leaders, the ideal mix looks more like 20% and 80%. Their difference of opinion also extended to another question on how they think telehealth utilization will grow by visit type over the next two years. Health system leaders said that utilization will fall slightly for most visit types — even behavioral health. They said that 36% of behavioral health visits were delivered via telehealth in September, but they expect this to fall to 33% in September 2024. Urgent care and telepathology were the two visit types for which health systems leaders predicted telehealth growth — they expect telehealth utilization to increase from 3% to 7% for urgent care and from 2% to 4% for telepathology. Practice leaders expected telehealth utilization to increase slightly or remain the same for most visit types. Specialty care was the only exception — for this visit type, practice leaders predicted utilization to fall from 23% to 20% over the next two years. Both groups agreed that telehealth actually increases burden on staff though practice leaders seem to feel it more acutely. More than half of practice leaders said telehealth has increased support staff’s workload, and 28% said it generates more work for nurses. Among health system executives, 35% said telehealth increased support staff’s workload, and 30% said it creates more work for nurses. Additionally, less than half of total respondents (46% of hospitals and 47% of practices) agreed that telehealth increases physician satisfaction and physicians like using telehealth visits to treat patients. A key reason for this is that many providers are operating their telehealth programs using inefficient workflows, according to the report. Nearly 60% of survey respondents said they have not yet created new workflows for telehealth visits. Instead, hospitals and physician practices are still relying on workflows that mirror in-person visits. In 2023, providers will need to improve these workflows, and many will consider bringing on the help of third-party telehealth administrators, such as Amwell or Caregility, the report said. Hospitals are more than twice as likely to use third-party partners to administer telehealth services — with 20% of hospitals doing this compared to 9% of practices. Hospitals were also more likely to say they would change their telehealth administering party over the next two years — with 44% of hospitals saying this compared to 25% of practices. Photo: Anastasia Usenko, Getty Images See original article: https://medcitynews.com/2022/12/report-telehealth-programs-increase-workload-for-nurses-and-support-staff/ < Previous News Next News >

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

Telehealth: How Asynchronous Communication Creates Provider Efficiencies Many Roth, Health Leaders April 2021 Presbyterian Healthcare Services reduces online "visits" to two minutes per encounter versus 15 to 18 minutes for real-time virtual visits. 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, perceptions 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 MULTIPLE ADVANTAGES 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. HOW TO CALCULATE COST SAVINGS 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. THE POTENTIAL TO GROW BEYOND LOW-ACUITY CARE 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." Source: https://www.healthleadersmedia.com/innovation/telehealth-how-asynchronous-communication-creates-provider-efficiencies < Previous News Next News >

Why College Students Should Make the Most of Telehealth Justin Weinger August 2021 Telehealth means not having to miss class and then need to play catch up. This is a huge win, especially when you’re going to college full-time. Whether you’re a freshman or just about finished with your degree, you probably don’t have a lot of free time. So, when it comes to squeezing in routine healthcare, you might think you don’t have the time. However, thanks to the advances made in telehealth, you can now take care of your health from the comfort of your dorm. Here are four reasons why you should consider using telehealth for your medical care. No Need to Miss Class As exciting as it is to venture into young adulthood, it’s easy to feel overwhelmed with a heavier course load. Even if you’re still living at home and attending classes online, transitioning from high school to college means having less time to take care of yourself. Telehealth makes taking care of yourself a lot easier. In fact, telehealth means not having to miss class and then need to play catch up. This is a huge win, especially when you’re going to college full-time. Improved Health We’ve all heard of the freshman 15, so if you find yourself with a little more around your middle, utilizing telehealth services can help you lose the weight safely. In addition, having online access to medical professionals ensures that you receive proper medical care faster than you would sitting in the ER. With that said, you should also head to the nearest hospital if you’re having a medical emergency. You can also discuss ways to ward off common illnesses that are prevalent amongst college students. Meningitis, for example, has a high occurrence rate in college students, so it’s always best to know whether you’re suitable for the vaccine. If not, your medical provider can recommend ways to decrease the risk of contracting it. Online Support System Growing up isn’t easy, even when you think you have it all figured out. It’s not uncommon for college students to develop anxiety, depression and other mental health issues while going to college. In addition to reviewing specific guides that support the mental health of college students on and off campus, you can use telehealth services to manage your wellbeing as well. There are a variety of psychological services available online for college students, all of which are confidential. Personalized Care If you’ve ever been to a busy doctor’s office, you might have gotten the feeling that you were just one of many. Not to say that you doctor doesn’t care about you, but medical offices are known to book more appointments than time may allow, leaving you with less than 10 minutes to explain what the issue is and hear your doctor’s remedy. Online medical care gives you a more personalized experience, possibly better than what you’re used to having in person. You can also schedule your appointment when you have more time to discuss your problems without feeling like you need to rush to get everything done. Many doctors or nurse practitioners schedule virtual appointments early in the morning or after hours in the evening. This also works out well for your doctor. Although they may have virtual appointments booked one after another, they don’t have the same distractions they may encounter with in-person office visits. This allows them to give you their undivided attention. Source: https://telemedicine.arizona.edu/blog/why-college-students-should-make-most-telehealth < 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 >

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 >