Transforming Homes And Communities Into Healthcare Hubs In The Post-Covid Future Ryan Hullinger and Sarah Markovitz August 2021 Hospital design experts Ryan Hullinger and Sarah Markovitz discuss the inevitable shifts in healthcare delivery as technology leads to new care settings and rethinking hospitals. The explosion of telehealth prompted by the Covid-19 pandemic has accelerated a shift in care delivery away from the hospital and clinic and into homes and communities. While hospitals have historically been the main hub of care, technology and new care models are enabling a different approach to care delivery. Rather than episodic preventative care, in which a patient periodically goes to a physician or hospital with a health concern, this new model of care is continuous and ubiquitous—with ongoing care reinforced in the home, office, school and throughout the community. There are three key aspects to this shift: advancing technology, new care settings, and the future evolution of hospitals. Advancing Technology Healthcare may follow a familiar path blazed by online retail. It was not that long ago that virtually everyone preferred in-person retail experiences to shopping online. The technology that would later make online shopping experiences superior to brick and mortar just didn’t exist. Telehealth, by comparison, is still in the dial-up days. It’s difficult to imagine now, but based on the patterns we have seen clearly in other technology sectors, it’s probable that some healthcare experiences will be better remotely than in-person—more convenient, and less stressful and time consuming. The technology that will transform telehealth is on the horizon. It will take several R&D cycles, but it will come. In fact, there’s evidence that in areas like behavioral health telehealth is already comparable in efficacy to in-person care. What might the next generation of telehealth look like? For one, rather than sequential visits with separate specialists, patients may be able to connect to a suite of caregivers, all working collaboratively to provide more coordinated, effective care. The type of continuous, convenient touch-bases and flow of information enabled by telehealth and wearable devices could be particularly effective for the elderly and those with chronic conditions, where communication and ensuring compliance with medication and preventive care are often an issue. There will also likely be an expansion in the types of care and services that can be provided, including everything from post-surgical appointments, to ED triaging, and eventually more complex tests as new diagnostic technologies emerge. Automated technologies and artificial intelligence will also play an increasingly vital role in improving health throughout the community. AI technologies are being used to scan patient records, identify patients with hypertension and diabetes, and remind physicians to check in regularly with them. Hospitals have already shown good results using telehealth, texting and improved monitoring to help vulnerable populations and those with chronic conditions. Improved telehealth and health data capabilities could extend widescale efforts like these, improving population health efforts. New Care Settings With technology acting as a facilitator, more and more forms of care, especially routine procedures, will migrate away from hospitals and clinics. The home could become the new healthcare hub, with prefabricated telehealth units for the home that integrate medical technologies with telehealth capabilities. The explosion of smart home, home health and health monitoring devices, encompassing everything from sensors that detect sudden falls to smart watches that monitor heart rate and O2 levels, is only the tip of the iceberg. With the ability to monitor health data and communicate effectively with caregivers, the home could be a crucial site for preventive medicine, chronic disease management and ongoing care. The home health model is only one possible model—the technologies that enable it may have shortcomings, or prove unaffordable to large segments of the population, further exacerbating health inequities and the digital divide. But healthcare can still be provided in a wide range of locations distributed throughout communities. Libraries, schools, community centers, homeless shelters and pharmacies could become hubs for telehealth resources and care, serving a vital role in improving the health of communities. A key consideration will be access and location—ensuring that healthy equity and care for vulnerable populations drives where these new care hubs emerge. How Hospitals May Evolve As care becomes increasingly continuous and ubiquitous, the role of the hospital may evolve. Rather than serving as a destination for all patient types, it will become increasingly specialized and streamlined, focusing on high acuity cases. They may expand their capabilities and efficiency in areas like perioperative and high-end imaging that are not available in community settings. In the process, hospitals are likely to become more compact, high performing and efficient by narrowing their focus. As part of this evolution, hospitals may also need to bolster their ability to expand capacity by 50-100% in anticipation of emergencies like epidemics, mass casualties and weather-related crises. In the last 20 years, many hospitals have invested heavily in improving patient comfort and satisfaction, and have even borrowed processes and designs directly from the hospitality industry—creating patient environments that nearly resemble hotel lobbies and guestrooms. Patient satisfaction will continue to be a driver, but the environments that promote satisfaction are likely to change drastically. New environments that convey a sense of safety and cleanness will begin to feel more comfortable than the hospitality-informed designs of the past. As this shift and gradual downsizing takes place, there may be opportunities to adapt existing space for other uses. The Covid-19 pandemic has demonstrated the dramatic impact of stress on healthcare workers. Hospitals now have an opportunity to provide sufficient and appropriate space for staff, helping to build resiliency to counter staff burnout and ensure the well-being of these truly essential workers. Hospitals could also aim to provide more community, patient and staff resources, such as spaces to demonstrate telehealth technologies and how to use them, or new hybrid offices equipped for telehealth. As technologies, new care settings, and hospitals evolve, care will become more embedded in our daily lives. The pandemic may have spurred new interest in telehealth, but the trends shaping the future of care predate social distancing. They will continue to transform how and where care is delivered, ushering in a new era of ubiquitous healthcare. Source: https://www.forbes.com/sites/coronavirusfrontlines/2020/10/26/transforming-homes-and-communities-into-healthcare-hubs-in-the-post-covid-future/?sh=133370e04153 < Previous News Next News >

Telehealth Resources NMTHA's Telehealth Resources provide information on the following topics: New Mexico Organizations New Mexico Broadband Interstate Telemedicine Licensure Telehealth Organizations & Associations Teleheath Training COVID & Telemedicine NM Based Orgs NEW MEXICO ORGANIZATIONS Health Insight New Mexico New Mexico Association for Home & Hospice Care New Mexico Health Resources New Mexico Primary Care Association SYNCRONYS (New Mexico Health Information Exchange) University of New Mexico Center fo r Telehealth UNM Project ECHO NEW MEXICO BROADBAND NM Broadband Program Overview of Broadband Program - Videos Mapping Training Resources Strategic Planning INTERSTATE & TELEMEDICINE LICENSURE Interstate Medical Licensure Compact (NM is not yet a participant) Federation of State Medical Boards New Mexico Physician Licensure Requirements (including telemedicine) New Mexico Physician License Application instructions (see last page for telemedicine) NM Broadband Interstate Licensure TELEMEDICINE ASSOCIATIONS & ORGANIZATIONS American Telemedicine Association (ATA) Center for Connected Health Policy Center for Telehealth & e-Health Law Southwest Telehealth Resource Center National Library of Medicine National Telemedicine Initiative Office for the Advancement of Telehealth (Health Resources and Services Administration, DHHS) Telemed Associations Org. TELEHEALTH TRAINING Telemental Health Training : Providing healthcare organizations and clinicians with ethical, legal, technological, and clinical frameworks for conducting effective telehealth sessions. Telehealth Trainings : The Arizona Telemedicine Training Program and Southwest Telehealth Resource Center offer 1-day training courses on telemedicine and telehealth. National Consortium of Telehealth Resources : Building a telehealth program? Browse through our offerings from Telehealth Resource Centers. If you can’t find what you’re looking for, use our contact form or give us a call. We have an abundance of resources available! Weitzman Institute : Weitzman ECHO (Extension for Community Health Outcomes) provides specialty support for primary care providers seeking to gain expertise in management of certain complex illnesses and conditions, including COVID-19, MAT, Chronic Pain, and more. TH trainings New Mexico: A Leader in Telehealth Laws New Mexico has one of the most progressive telehealth statutes in the entire U.S. View Statutes Experts in Telehealth: An Interview Series A series of brief interviews from local and regional experts sharing experience, insights, and guidance on telehealth. Access Interviews Get answers from the NM Department of Information Technology (NM DoIT). Contact NM DoIT Broadband Questions? Contact U.S. Senator Ben Ray Lujan to discuss you r telehealth issues, ideas, and goals. Policy & Advocacy Contact Senator Lujan COVID & TELEMEDICINE NEWMEXICO.gov (Guidance for Providing Patient Care by Electronic Means During the COVID-19 Public Health Emergency.) NM Medicaid, COVID-19, and Telehealth Resources NM-HSD April 6, 2020: Special COVID-19 Supplement #3 – Guidance for New Mexico Medicaid Providers NRTRC COVID-19 and Telehealth Resources ATA COVID-19 Response Webinar Series eHealth Initiative COVID-19 News, Resources, and Events Weitzman Institute COVID-19 Resource Page An Analysis of Private Payer Telehealth Coverage During the COVID-19 Pandemic (Center for Connected Health Policy) UNM Resources: COVID-19 briefings COVID-19 practice guidelines COVID-19 therapeutic evidence Covid resources Top of Page NM Based Orgs NM Broadband Interstate Licensure Telemed Associations Org. TH trainings Covid resources

Suicide Prevention and Stigma Reduction with Dr. Alison Arnold Dr. Alison Arnold November 18, 2022 Danielle speaks with Dr. Alison Arnold, the Director Interdisciplinary Center for Community Health & Wellness at Central Michigan University (CMU). In this episode we discuss CMU's Preventing Suicide in Michigan Men (PRiSMM) program and how we utilize telehealth to address mental health disparities and increase access to care. See original article with audio: https://www.umtrc.org/podcasts/season-2-episode-19/ < Previous News Next News >

CMS Proposes to Extend Telehealth Flexibilities Through 2023 Thomas Sullivan Oct 24, 2021 CMS Proposes to Extend Telehealth Flexibilities Through 2023 The Centers for Medicare & Medicaid Services (CMS) proposed in the 2022 Physician Fee Schedule to extend telehealth flexibilities through 2023 instead of through the end of the COVID-19 public health emergency, which is expected to run through this year. Physician groups in comments on the rule called for a permanent solution beyond the dates set by CMS. Groups also submitted comments on MIPS Value Pathways (MVPs), ACO policies, and pending payment cuts. The final rule is expected around November 1, 2021. Telehealth Telehealth advocates called upon CMS to amend the proposed 2022 Physician Fee Schedule to permanently extend emergency measures on telehealth access and coverage that were enacted to deal with the pandemic. Many also called upon Congress to expand telehealth services. “The ATA commends the Biden Administration for their actions in support of telehealth, and we appreciate CMS’ intent to ensure Medicare beneficiaries continue to have access to quality healthcare when and where they need it,” ATA CEO Ann Mond Johnson said in its letter to CMS Administrator Chiquita Brooks-LaSure. “However, as important as the Physician Fee Schedule is, we urge Congress to act before the vast majority of Medicare beneficiaries go off the ‘telehealth cliff’ at the end of the public health emergency.” “The ATA understands that CMS is simply following Congress’ lead, though we are hopeful Congress will correct this wrong in the statute,” Johnson said. “There is no clinical evidence for an arbitrary in-person requirement before a patient can access telehealth services. However, in the proposed rule, CMS considers requiring an in-person visit, not only within the ‘six-month period prior to the first time’ the provider furnishes telehealth to the individual, as stated by law, but also within six months prior to subsequent telehealth visits. This effectively creates a new, arbitrary requirement for the patient to have an in-person mental health visit every six months should the patient plan to seek telehealth services with that provider.” The Medical Group Management Association also commented that removing services after a “predetermined or prescriptive date” could create a major administrative burden for practices already strained financially by the pandemic. “Member group practices report that adjusting workflows to operationalize the use of new telehealth codes requires additional resources, such as clinician and staff training and patient education,” MGMA said in comments. “Removing telehealth services from the covered code list will prove disruptive to both practices and patients alike, as patients have become accustomed to receiving these services virtually.” MIPS Value Pathways and ACOs The proposed rule calls for beginning use of the value pathways program in MIPS for 2023 and having it replace MIPS entirely in 2027. MVP is intended to align clinician reporting requirements, but the American Hospital Association (AHA) said it’s unclear whether the program would reduce administrative burden as expected or that it would be equitable across specialties. AHA said it “believes that unless and until CMS can address several conceptual issues with MVPs … CMS should not set a date certain for transitioning to mandatory MVP participation.” The Medical Group Management Association also had concerns, particularly about provider burden. Group purchasing organization Premier addressed the proposed rule’s changes to reporting from accountable care organizations. It applauded the more gradual move to using electronic clinical quality measures, citing the reporting burden associated with them. Premier also asked CMS to recognize that ACO reporting is “fundamentally different from reporting by clinicians and groups.” The National Association of ACOs echoed those comments. Pay Cuts In comments on the proposed rule, physician groups were also worried about a looming 3.75% cut in the 2022 Medicare conversion factor, which calculates reimbursement for procedures under fee-for-service. The cuts are mandated under a budget neutrality provision in Congress and comes after a pay bump from Congress that expires in 2022. The AMA said that it is urging CMS to work with Congress for relief on the budget neutrality issue. “CMS should exercise the full breadth and depth of its administrative authority to avert or, at a minimum, mitigate these unconscionable payment cuts,” the group added. https://www.policymed.com/2021/10/cms-proposes-to-extend-telehealth-flexibilities-through-2023.html < Previous News Next News >

Memorial Hermann to provide school-based pediatric telehealth Naomi Diaz October 18, 2022 Houston-based Children's Memorial Hermann has partnered with telehealth company Hazel Health to provide outpatient pediatric care to K-12 students in Houston. Under the partnership, schools that have agreements with Hazel will be able to offer their students access to health services via virtual telehealth sessions, according to an Oct. 17 press release. Children's Memorial Hermann pediatricians or specialists will connect with the students through the program for follow-up or long-term care management. The aim of the partnership is to increase access to pediatric care in schools across 12 counties in southeast Texas. See original article: https://www.beckershospitalreview.com/telehealth/memorial-hermann-to-provide-school-based-pediatric-telehealth.html < Previous News Next News >

Senate panel seeks to expand telehealth for Medicare mental health services Jeff Lagasse, Editor May 27, 2022 The draft suggests removing Medicare's in-person visit requirement, protecting audio-only telehealth and supporting provider use. Senate panel seeks to expand telehealth for Medicare mental health servicesThe draft suggests removing Medicare's in-person visit requirement, protecting audio-only telehealth and supporting provider use. Jeff Lagasse, Editor Photo: Kilito Chan/Getty Images The Senate Finance Committee, led by Chair Ron Wyden (D.Ore.), is seeking to make permanent some of the telehealth flexibilities enacted during the COVID-19 pandemic that pertain to mental health services. In what the committee calls a mental health "bill of rights," Wyden and ranking committee member Mike Crapo (R-Idaho), along with Senator John Thune (R-S.D.) and Senator Ben Cardin (D-Md.), released a discussion draft for telehealth policies that suggests, among other things, removing Medicare's in-person visit requirement and codifying audio-only mental health coverage. Wyden said via statement that the policies outlined in the draft "will help strengthen access, awareness and support for telehealth." Aside from nixing Medicare's in-person visit requirement, the committee's proposed policies include establishing benefit transparency for mental health services delivered via telehealth, to inform Americans with Medicare how and when they can access such services. The committee also recommended directing Medicare and Medicaid to promote and support provider use of telehealth; and incentivizing states to use their CHIP programs to establish local solutions to serve behavioral health needs in schools, including through telehealth. The telehealth discussion draft is the first legislative draft released by the committee since it began its larger mental healthcare initiative. Other discussion drafts may be released prior to a committee markup. The committee said it's committed to fully paying for any mental health package with bipartisan, consensus-driven offsets. Earlier this year, the committee announced five areas of focus for addressing shortfalls in mental healthcare: workforce, care integration, mental health parity, telehealth and youth. WHAT'S THE IMPACT? When the pandemic first began, the Centers for Medicare and Medicaid Services waived barriers to telehealth reimbursement, but those flexibilities only last for 151 days after the end of the COVID-19 public health emergency. The current PHE expires in mid-July. If again extended as expected and for another 90 days, the PHE would end in mid-October, just prior to the midterm elections. Most experts have said they expect the PHE to be extended through the end of the year. To make telehealth flexibilities permanent, CMS needs authority from Congress. Wyden says that the committee's goal is ultimately to craft a behavioral telehealth bill by this summer. Other proposed policies in the draft include requiring fee-for-service and Medicare Advantage plans to publicly post information on Medicare beneficiaries' rights to receive telehealth services for mental healthcare, plus information on approximate cost-sharing obligations for virtual mental health services. The committee also recommended: mandating that the federal government collect information on trends and care quality and give regular reports to lawmakers. requiring that Medicare give providers guidance on improving access to virtual mental healthcare for those with language barriers and hearing or vision impairments. "Telehealth, particularly for behavioral health services, has become an essential component of care, and I am pleased that we have this opportunity to improve access to telemental health care, particularly for underserved communities," said Cardin. THE LARGER TREND The draft comes at a time when mental health concerns are rising for many Americans. Earlier this month a CVS Health/Morning Consult poll showed Americans of all backgrounds, but especially those who are Black, young adults, older than 65 or who identify as LGBTQIA+, are increasingly concerned about mental health and how to access care. Results show that a majority of respondents, 59%, have experienced concerns about either their own mental health or that of family and friends. That's a 9% increase since April 2020. Another majority, 53%, agree that hearing about other people's challenges makes them more comfortable seeking out resources and care for themselves. A 2021 study showed that mental health services accounted for the most common use of telehealth during the early days of the pandemic. In the midst of skyrocketing depression rates, the findings show that more patients used telehealth for behavioral, rather than physical conditions. A report from health insurer Cigna, also released last year, made it clear that businesses have taken notice of this shift to behavioral telehealth: Some 44% of human resources decision-makers and 27% of health plan leaders said that increased access to mental health services will become a long-term solution for their organization. Some 57% of health plan leaders said they had seen the value of mental health services increase more than for most other services and benefits as a result of the coronavirus. For more information: https://www.healthcarefinancenews.com/news/senate-panel-seeks-expand-telehealth-medicare-mental-health-services < Previous News Next News >

Senator Warner Encourages DEA Action on Telehealth & Prescribing Center for Connected Health Policy May 2021 A lack of a more permanent fix to the prescribing issue could create hurdles for patients to access treatment to SUD services. Earlier this month Senator Mark Warner (D-VA) sent a letter to Attorney General Merrick Garland regarding the long-delayed regulations from the Drug Enforcement Agency (DEA) for a telehealth registry to prescribe controlled substances. In the letter, Senator Warner expressed great concern for the delay and that “the DEA’s failure to address this issue means that a vast majority of health care providers that use telehealth to prescribe controlled substances to and otherwise treat their patients have been deterred in getting them the quality care they need.” The Ryan Haight Act of 2008 allowed for certain exemptions to the use of telehealth to provide controlled substances without the telehealth provider having seen the patient in-person first, however these exemptions are narrowly tailored. Two such exemptions are: when a public health emergency (PHE) is declared, and if a provider is registered on a telehealth registry that the DEA will create. Due to the current COVID-19 PHE, providers now are able to prescribe a controlled substance without an in-person visit, but the exemption will disappear once the PHE is declared over. In 2018 under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, Congress directed the DEA to promulgate final regulations for the registry by the end of 2019. Although a December 2019 regulatory posting indicated the DEA’s intent to publish the rule, the deadline came and went without even draft regulations being released for public comments. In March 2020, a PHE for COVID-19 was declared allowing one of the exceptions for prescribing to be activated. However, the PHE is not slated to last indefinitely and many, including Senator Warner, are looking for a more lasting change. Senator Warner also sent inquiries to the previous administration regarding the status of the registry regulations that went unanswered. During COVID-19, concern for the ability of patients with substance use disorders (SUD) to access services rose as demands on health services focused on responding to the pandemic and people sheltered in place. While much of the country is beginning to open up again, a lack of a more permanent fix to the prescribing issue could create hurdles for patients to access treatment to SUD services. < Previous News Next News >

Athena Health Telehealth Adoption Report Center for Connected Health Policy May 2021 How providers are taking advantage of virtual care and their perceived benefits Athena Health began conducting research in 2020 on de-identified data from across their healthcare network (which spans the nation) to understand how providers are feeling about the increased adoption of telehealth. With the onset of COVID-19, the use of telehealth has skyrocketed, and beyond understanding the increased utilization numbers, it’s also important to understand provider adoption rates, their attitudes toward telehealth, which specialties and what services telehealth is being used in the most. An interactive infographic tool on their website can be utilized to identify the amount of care across their system that has gone virtual by specialty (primary care, mental health, cardiology, pediatrics, OB/GYN or all specialties). Users can also view by specialty how providers are taking advantage of virtual care and their perceived benefits (for example, virtual appointments are more convenient), and the reasons why providers are turning to telehealth to keep their practices running. For a complete breakdown of their findings, visit Athena Health’s interactive webpage: https://www.athenahealth.com/knowledge-hub/clinical-trends/the-athenahealth-telehealth-insights-dashboard. < Previous News Next News >

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

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

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

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New HHS-OIG Reports on Telehealth Challenges and Oversight in State Medicaid Programs Center for Connected Health Policy September 2021 Last week the Department of Health and Human Services Office of Inspector General (HHS-OIG) released two new telehealth reports, both related to the use of telehealth to deliver behavioral health services to Medicaid beneficiaries. HHS-OIG breaks up their study into two reports. Last week the Department of Health and Human Services Office of Inspector General (HHS-OIG) released two new telehealth reports, both related to the use of telehealth to deliver behavioral health services to Medicaid beneficiaries. HHS-OIG breaks up their study into two reports: *States Reported Multiple Challenges with Using Telehealth to Provide Behavioral Health Services to Medicaid Enrollees (Challenges Report) which focuses on state care delivery issues, and *Opportunities Exist to Strengthen Evaluation and Oversight of Telehealth for Behavioral Health in Medicaid (Evaluation Report), which looks closer at state data collection and evaluation efforts. The reports are both based on surveys HHS-OIG conducted with Medicaid directors from 37 states as well as various stakeholders in early 2020. The surveys were particularly focused around telemental health delivery through managed care organizations, however most stakeholders focused on general telehealth issues in their responses. While the information was gathered pre-pandemic, HHS-OIG applies the findings to support understanding and recommendations to the Centers for Medicare and Medicaid Services (CMS) around post-pandemic telehealth policy. Key Challenges: Lack of Telehealth Training and Limited Broadband In terms of challenges related to care delivery via telehealth, the number one issue reported by 32 out of 37 surveyed states, was a lack of provider and enrollee training. In HHS-OIG’s interviews, stakeholders described not only provider issues related to use of telehealth technology, but also lack of education around telehealth coverage and reimbursement policies. Lack of internet access came in as the second highest challenge, reported by 31 out of 37 states. Broadband issues raised included not only enrollees having insufficient broadband speeds, but some clinics in rural areas having no broadband access at all. Other challenges provided by state Medicaid programs included: -Concerns around how providers protect patient privacy and personal information. -Lack of interoperability between provider electronic health record systems and how to increase provider sharing of patient information. -The high costs of telehealth infrastructure, such as initial equipment costs as well as maintenance and repair costs. -A lack of licensure reciprocity across states. -A lack of understanding around telehealth consent policies. Citing how CMS has given states broad flexibility in how they structure their telehealth policies, the recommendations from the report to CMS focus on increasing creation and dissemination of additional informational and educational resources, such as best practices amongst states, funding options related to broadband and interoperability, and creating a state plan amendment template that could additionally assist states in covering some ancillary infrastructure costs. Evaluation: Telehealth Data and Oversight Within the Evaluation Report which focused more on data collection and analysis, HHS-OIG found that only 3 out of 37 states are unable to track which services are provided via telehealth, however only 2 out of 37 states have evaluated that data specific to impacts on access to behavioral health services and only one state has evaluated telehealth impacts on cost. The report notes that though other states didn’t directly evaluate telehealth data however, they did provide information on observational telehealth impacts based on their experiences with telehealth. For instance, 17 out of 37 states reported that telehealth increases access to providers and a few states also noted potential cost savings, while 6 out of 37 said the impact of telehealth on cost is largely uncertain. The final focus of the Evaluation report was related to telehealth quality assessments and oversight by Medicaid agencies. While 10 out of 37 states noted concerns around quality, one state mentioned quality as more of a clinical practice issue, and two states believed provider training could address such concerns. In regard to oversight, only 11 states were said to conduct monitoring specific to telehealth, while other states noted they oversee all services the same. HHS-OIG made much stronger and more specific recommendations when it comes to state oversight and evaluation, suggesting the need for additional telehealth specific measures by CMS, states, and managed care organizations. Looking Ahead The HHS-OIG reports highlight many of the broad issues and questions related to telehealth that have become forefront in policymakers’ minds over the past year and half, such as challenges around addressing the digital divide and how to best evaluate telehealth impacts. The recommendations point toward a few different potential post-pandemic pathways for CMS mainly around increasing education and oversight. As we’ve seen confusion grow around what state Medicaid agencies believe CMS allows them to do as permanent telehealth policy, such as around federally qualified health centers (FQHCs), perhaps the most essential recommendation made by HHS-OIG comes back to increasing coordination amongst state Medicaid agencies with CMS. The reports’ limited scope to behavioral health services through managed care organizations is also notable in terms of policy application even though state and stakeholder responses may have been more general. For instance, many states and policymakers seem to be focused around Medicaid fee-for-service policies more so than managed care, as well as reimbursement challenges, such as payment parity and similar fee schedule considerations. In addition, the HHS-OIG study did not break down any differences or feedback by telehealth modality, while many states and stakeholders have been focused on the future of audio-only availability – especially as a way to address the challenge of limited broadband access. In terms of evaluating data, while many states may have not had a data evaluation plan in place at the time of HHS-OIG survey, many now do as a result of recently enacted legislation predicated on the surge of use and attention to telehealth during the pandemic. Therefore, it may be interesting for HHS-OIG to consider conducting a similar more broad survey in a year or two after states have had more time to collect and wrap their heads around the data. Challenges Report: https://oig.hhs.gov/oei/reports/OEI-02-19-00400.pdf Evaluation Report: https://oig.hhs.gov/oei/reports/OEI-02-19-00401.pdf < Previous News Next News >

State Telehealth Laws and Reimbursement Policies Report, Fall 2021 Center for Connected Health Policy October 2021 Today the Center for Connected Health Policy (CCHP) is releasing its bi-annual summary of state telehealth policy changes for Fall 2021. Our semi-annual report has gone digital Historically, our twice-yearly updates to the “State Telehealth Laws and Reimbursement Policies” report have been published as a PDF document, and included the telehealth policies for all 50 states and the District of Columbia. Earlier this year, we transitioned exclusively to our new and improved online Policy Finder. This online database allows the CCHP team to easily update each state’s information whenever there is a change, instead of waiting for the spring and fall to roll out the report. Now, you can look up (or download a PDF) of the most up-to-date information on each state from that state’s page. We hope this transition will result in more timely policy information that is easier for you to navigate and understand. Read the Executive Summary We will continue to produce bi-annual summary reports of the status of telehealth policies across the United States to provide a snapshot of the progress made in the past six months. The information for this summary report covers updates in state telehealth policy made between June and September 2021. DOWNLOAD SUMMARY This report is for informational purposes only, and is not intended as a comprehensive statement of the law on this topic, nor to be relied upon as authoritative. Always consult with counsel or appropriate program administrators. Introduction The Center for Connected Health Policy’s (CCHP) Fall 2021 analysis and summary of telehealth policies is based on its online Policy Finder database tool. It highlights the changes that have taken place in state telehealth policy between the initial release of CCHP’s Policy Finder in Spring 2021, and Fall 2021. The research for this Fall 2021 executive summary was conducted between June and September 2021. This summary offers policymakers, health advocates, and other interested health care professionals an overview of telehealth policy trends throughout the nation. For detailed information by state, see CCHP’s telehealth Policy Finder tool which breaks down policy for all 50 states and the District of Columbia. Please note that many states continue to keep their temporary telehealth COVID-19 emergency policies siloed from their permanent telehealth policies. These temporary policies are not included in this executive summary, although they are listed under each state in the online Policy Finder under the COVID-19 category. In instances where the state has made policies permanent, or extended policies for multiple years, CCHP has incorporated those policies into this report. DOWNLOAD INFOGRAPH WITH KEY FINDINGS Methodology CCHP examined state law, state administrative codes, and Medicaid provider manuals as the primary resources for the online telehealth policy database tool, from which the findings in this summary are taken. Additionally, other potential sources such as releases from a state’s executive office, Medicaid notices, transmittals or Agency newsletters were also examined for relevant information. In some cases, CCHP directly contacted state Medicaid personnel in order to clarify specific policy issues. Most of the information contained in the database tool specifically focuses on fee-for-service; however, information on managed care plans has also been included if available from the utilized sources. Every effort was made to capture the most recent policy language in each state at the time it was reviewed between the months of June and September 2021. In some cases, after a state was reviewed, they passed a significant piece of legislation. In order to incorporate those significant changes, CCHP conducted a scan for these instances in late September and incorporated language from those enacted bills where appropriate. It should be noted that even if a state has enacted telehealth policies in statute, these policies may not have been incorporated into its Medicaid program. For purposes of this summary, CCHP only counts states as reimbursing for a specific modality or removing a restriction if there is documentation to show that the Medicaid program has implemented a statutory requirement for that policy. Requirements in newly passed legislation will be incorporated into the findings section of future editions of CCHP’s summary report once they are implemented in the Medicaid program, and CCHP has located official documentation confirming this. This survey focused on three primary areas for telehealth policy including Medicaid reimbursement, private payer laws and professional requirements. Within each category, information is organized into various topic and subtopic areas. These topic areas include: Medicaid Reimbursement Definition of the term telemedicine/telehealth Reimbursement for live video Reimbursement for store-and-forward Reimbursement for remote patient monitoring (RPM) Reimbursement for email/phone/fax Consent issues Out-of-state providers Private Payer Laws Definitions Requirements Parity (service and payment) Professional Regulation Definitions Consent Online Prescribing Cross-State Licensing Licensure Compacts Professional Boards Standards Key Findings No two states are alike in how telehealth is defined and regulated. While there are some similarities in language, perhaps indicating states may have utilized existing verbiage from other states, noticeable differences exist. The main areas where changes were made over the past six months fall in the three buckets that CCHP uses to categorize information within its policy finder: Medicaid policy, private payer policy, and regulation of health professionals. Changes were also highly influenced by temporary expansions made during the COVID-19 pandemic. Some states took approaches to extend their pandemic policies multiple years into the future, while others made policies (or portions of their COVID policies) permanent. Still others have not adopted their more lenient COVID policies at all. Connecticut, for example, passed a new temporary law (active until June 30, 2023) which not only requires Medicaid to reimburse for synchronous, asynchronous store-and-forward transfers, remote patient monitoring and audio-only modalities if the provider is in-network, but also places similar requirements on private payers as well. In Medicaid, it was common for states to make slight adjustments to their telehealth policies to add or clarify the services that can be delivered via telehealth, types of professionals that can deliver care through telehealth or the types of settings a patient could be in during a telehealth interaction. For example, Iowa clarified that an intern psychologist can provide telehealth services to Medicaid members. Mississippi clarified federally qualified health centers (FQHC) and rural health clinics (RHC) could be distant site providers, and added the home as an originating site. And, Arkansas now specifies that both the home is an eligible patient site and that group meetings may be performed via telemedicine. Although reimbursement for audio-only telephone has become pretty standard during the COVID-19 public health emergency (PHE), less than half of state Medicaid programs explicitly are reimbursing for the modality permanently, and many that are have placed restrictive parameters around its reimbursement. It was also common for states to make modifications to their telehealth private payer reimbursement law language to alter the definition of telehealth/ telemedicine. This typically included an expansion of the definition to be broader in scope so that it entails more than just live video, although often with some caveats. For example, Arkansas’ private payer law now stipulates that telemedicine does not include audio-only communication, unless the audio-only communication is real-time, interactive, and substantially meets the requirements for a healthcare service that would otherwise be covered by the health benefit plan. Iowa revised their law to include ‘real-time interactive electronic media’, but still excludes audio-only telephone from the definition of telehealth. Requirements around payment parity were also a common change, with eight states passing a law requiring the reimbursement amount is the same whether a service is provided via telehealth or in-person since Spring 2021. Illinois, for example, now requires reimbursement parity for in-network or tiered network health care professionals or facilities, including services provided via audio-only. Iowa is another example of a state requiring reimbursement of covered services is made on the same basis and same rate as in-person mental health services. Finally, there is a noticeable shift in telehealth policy towards tightening of professional requirements around the use of telehealth by providers. For example, Michigan passed new consent requirements for social work, athletic trainers, massage therapists, acupuncturists and veterinary medicine. Texas is another state that added practice standards (including a consent requirement and prescribing rules) for teledentistry specifically. West Virginia adopted emergency telehealth practice standard regulations to implement a previous law that passed (W. VA Code 30-1-26(b)) for five professions, including dentistry, nursing, osteopathic medicine, social work and medicine. While many states have had these types of standards for several years, the rate at which new telehealth standards are being adopted has increased significantly within the last six months. Additional findings include: Fifty states and Washington DC provide reimbursement for some form of live video in Medicaid fee-for-service. Twenty-two state Medicaid programs reimburse for store-and-forward. However, three states (NC, OH, VT) solely reimburse store-and-forward as a part of CTBS, which is limited to specific codes and reimbursement amounts. Michigan is the only state to add reimbursement for store-and-forward since Spring 2021. Additionally, three jurisdictions (MS, NH, and NJ) have laws requiring Medicaid reimburse for store-and-forward but as of the creation of this edition, don’t have any official Medicaid policy indicating this is occurring. Twenty-nine state Medicaid programs provide reimbursement for RPM. States that added RPM since Spring 2021 included Washington, Michigan and California. As is the case for store-and-forward, three Medicaid programs (NH, HI and NJ) have laws requiring Medicaid reimburse for RPM but at the time this report was written, did not have any official Medicaid policy. Additionally, two of the states (OH and CA) only reimburse the remote physiologic monitoring codes CMS does. Twenty-two states reimburse for audio-only telephone in some capacity (often limitations apply); however, Michigan only reimburses for it when used for provider to- provider electronic consultations. Eleven state Medicaid programs including Arizona, California, Maine, Michigan, Minnesota, North Carolina, Ohio, Oregon, South Carolina, Texas, Washington, reimburse for all four modalities, although certain limitations apply. While this Executive Summary provides an overview of findings, it must be stressed that there are nuances in many of the telehealth policies. To fully understand a specific policy and all its intricacies, the full language of it must be read utilizing CCHP’s telehealth Policy Finder. Below are summarized key findings in each category area contained in the Policy Finder as of September 2021. Read more: https://www.cchpca.org/resources/state-telehealth-laws-and-reimbursement-policies-report-fall-2021/ < Previous News Next News >

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

Broadband Funding Frameworks and Updates Center for Connected Health Policy July 2021 The report released last month suggests the need for $106 - $179 billion to future-proof networks and get higher broadband speeds to those that currently need them. Addressing Gaps in Broadband Infrastructure Availability and Service Adoption: A Cost Estimation & Prioritization Framework is an analysis conducted by ACA Connects, an association representing small and rural broadband providers which projects that broadband funding levels should be higher than recent federal funding proposals offer. The report released last month suggests the need for $106 - $179 billion to future-proof networks and get higher broadband speeds to those that currently need them. Although President Biden’s initial proposal put $100 billion toward broadband, the latest bipartisan agreement, or Bipartisan Infrastructure Framework, currently only designates $65 billion to broadband. The details of the new agreement are still unclear and issues of contention remain. It is also, uncertain how the funding is proposed to be allocated. Some articles and insiders suggest the majority of the funding will be given to states and the rest split between smaller federal programs, leaving out the FCC, which is the main agency currently administering broadband programs. In addition, the White House recently released fact sheets for each individual state, to show the needs and impacts the framework proposes to provide across the country. As additional details come together, the ACA Connects study framework could be helpful for policymakers in determining both appropriate funding levels and allocations to truly improve and expand broadband access. In particular, the report recommends policymakers look at their funding priorities through an availability lens and an adoption lens, both of which require setting eligibility thresholds. For instance, how will “unserved” be defined and which households should be eligible for support. In addition, they suggest funding allocations be determined by what subsidy amount would actually be needed by each household and how many are likely to participate. Using such calculations, the analysis provides sample funding approaches and cost assessments in addition to its overall estimate. The report suggests that with $35-67 billion the U.S. could increase broadband availability to 19 million locations. Whether policymakers will consider the analysis remains as unknown as whether they will complete the current federal infrastructure deal as proposed. One thing does remain clear - even if a deal is finalized and passed, how the funding is targeted will remain vital to its success at improving broadband access. For more information review the ACA Connects full analysis - https://acaconnects.org/wp-content/uploads/2021/06/Addressing-Gaps-in-Broadband-Infrastructure-Availability-and-Service-Adoption-ACA-Connects-and-Cartesian-June2021.pdf. < Previous News Next News >

CONNECT for Health Act Recently Reintroduced Center for Connected Health Policy May 2021 CCHP Breaks Down Key Elements in New Fact Sheet * < Previous News Next News >

The Center for Connected Health Policy (CCHP) released its bi-annual summary of state telehealth policy changes for Spring 2022 Center for Connected Health Policy Spring 2022 The Center for Connected Health Policy’s (CCHP) Spring 2022 analysis and summary of telehealth policies is based on its online Policy Finder. It highlights the changes that have taken place in state telehealth policy between the Fall 2021 Summary Report, and Spring 2022. The research for this Spring 2022 executive summary was conducted between January and April 2022. This summary offers policymakers, health advocates, and other interested health care professionals an overview of telehealth policy trends throughout the nation. For detailed information by state, see CCHP’s telehealth Policy Finder which breaks down policy for all 50 states and the District of Columbia. The Center for Connected Health Policy (CCHP) is releasing its Spring 2022 Summary Report of the state telehealth laws and Medicaid program policies catalogued in CCHP’s online Policy Finder tool. Prior to Spring 2021, this same information was released at least twice a year in the form of a 500+ page PDF report titled, “the State Telehealth Laws and Reimbursement Report” since 2012. With the transition to the online Policy Finder, users are able to navigate each state’s updated information as soon as CCHP makes it available. Additionally, the information from the online tool can be exported for each state into a PDF document using the most current information available on CCHP’s website. CCHP plans to continue to produce these bi-annual summary reports of the status of telehealth policies across the United States in the Spring and Fall each year to provide a snapshot of the progress made in the past six months. CCHP is committed to providing timely policy information that is easy for users to navigate and understand through our Policy Finder. The information for this summary report covers updates in state telehealth policy made between January and mid-April 2022. For full report: https://www.cchpca.org/2022/05/Spring2022_ExecutiveSummaryfinal.pdf < Previous News Next News >

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 >