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DOJ Prosecutes Several Telemedicine Fraud Cases Center for Connected Health Policy May 2021 Department of Justice is currently on an offensive against telemedicine fraud According to an article in the National Law Review, the Department of Justice is currently on an offensive against telemedicine fraud. The article cites the following DOJ operations as evidence of the current crack down on telemedicine: *Operation Brace Yourself targeting an international fraud ring that defrauded $1 billion from Medicare for unnecessary devices. *A series of telemedicine fraud prosecutions that occurred in 2020 that found more than $1.5 billion in fraudulent Medicare billing. *On April 22, 2021 the latest crackdown came to light with charges for the owners of orthotic brace suppliers and some marketing companies for a $65 million nationwide kickback and bribery conspiracy. The scheme involved call centers soliciting customers to accept braces even though they didn’t need them and charging Medicare, Medicaid and Tricare. The telemedicine companies involved were paid illegal kickback and bribes for their doctors signing the brace orders and swearing to their medical necessity. These types of incidents are what makes some regulators warry of telehealth. With the increased widespread use of telehealth due to the pandemic, incidents of fraud will likely increase for telehealth. The key will be to ensure that the bad actions of a few don’t interfere with a modality of care that increases access and quality care for so many. Read the full National Law Review article for more information on these fraud cases. Full National Law Review article: https://www.natlawreview.com/article/doj-telemedicine-offensive-pushes-forward-new-charges < Previous News Next News >

The value of telehealth and the move to digitally enabled care — 3 insights Becker's Hospital Review In Collaboration with American Medical Association Nov. 1, 2021 During the pandemic, healthcare organizations embraced telehealth to ensure they could provide access and high quality care to their patients. Now, nearly two years later, organizations are contemplating how best to move forward, including how to safeguard and optimize opportunities to move towards digitally enabled care. During the pandemic, healthcare organizations embraced telehealth to ensure they could provide access and high quality care to their patients. Now, nearly two years later, organizations are contemplating how best to move forward, including how to safeguard and optimize opportunities to move towards digitally enabled care. During Becker's 6th Annual Health IT + Revenue Cycle Virtual Conference, the American Medical Association sponsored a roundtable discussion on this topic. The AMA's Lori Prestesater, Vice President of Health Solutions, and Meg Barron, Vice President of Digital Health Innovations, talked with healthcare executives from around the country about their digital health successes and challenges. Three insights: 1. Providers want virtual care to continue as long as their key concerns are addressed. "Physicians are enthusiastic about digital health technologies," Ms. Barron said. "However, that enthusiasm is directly tied to a solution's ability to help them take better care of patients or reduce their administrative burdens." Four key concerns consistently expressed by physicians when evaluating digital solutions are whether a solution works and has an evidence base, how providers will be compensated, what liability and privacy issues exist, and how implementation and change management will occur. 2. One of the major advantages of telehealth is improved access. Access can be widely defined; virtual technology has made significant inroads in improving access in multiple ways: COVID-19 access. The department chair of a hospital in the Northeast noted that telehealth helped them provide quick access and treatment to patients during the pandemic. "It worked extremely well in this emergency situation," he said. "Patients would call in and report symptoms, and we could make decisions about their care. We provided pulse oximeters and followed up via telehealth." Specialty access. A CMO from a Midwestern health network — who is the father of a daughter with a chronic illness — shared his personal experience with specialty care from multiple systems. "I can't imagine how my daughter could receive specialty care without telehealth. Care that was previously siloed can now be accessed nationally, if not internationally." Behavioral health access. A chief population health officer from a health system in the Midwest said telehealth access to mental health services was a big success. "Patients found the pandemic very rough, and many needed some behavioral health services, but they didn't necessarily want to try to see somebody because of the stigma associated with it," she said. "Being able to offer telebehavioral health services to our patients, and frankly, even to our employees, was a great success." 3. Challenges such as patient hesitancy, bandwidth issues and measurement of value remain. Although patients are generally positive about telehealth, some have found it difficult to onboard to telehealth platforms. One provider in the Northeast said younger patients love the ability to text and connect virtually, but elderly patients often prefer in-person visits for the human connection. Also, many healthcare organizations have faced connection issues. A West Coast CMO explained, "We have 24 hospitals, and many of them are in rural areas. We really struggled with bandwidth." Finally, measuring the value of these technologies remains a challenge. Ms. Prestesater pointed out that it can be a "many-year equation to evaluate the value for a chronically ill patient." AMA has a recently released Return on Health value framework that can help an organization quantify the comprehensive value of virtual care. Although some participants warned that virtual care may not be less expensive, it can be hard to quantify savings from things like avoiding emergency care. A Midwest hospital executive said, "Home-based care has led to a substantial reduction in visits to the emergency room and days in the hospital for us. The problem in the whole equation is it's hard to measure something that doesn't happen." < Previous News Next News >

KFF Report on Telehealth - Medicare Use Offers Future Policy Implications Center for Connected Health Policy June 2021 Given the limitations around Medicare telehealth coverage pre-pandemic, many of these individuals had little experience with telehealth previously, offering an important perspective to inform ongoing telehealth policy considerations. More work will need to be done to further education around telehealth and ensure its availability to all communities. A Kaiser Family Foundation brief presents new information and analysis of Medicare beneficiaries’ utilization of telehealth using Centers for Medicare & Medicaid Services (CMS) survey data from between summer and fall of 2020 while CMS emergency telehealth expansions were in effect. Given the limitations around Medicare telehealth coverage pre-pandemic, many of these individuals had little experience with telehealth previously, offering an important perspective to inform ongoing telehealth policy considerations. For instance, while 64% of beneficiaries said their provider currently offers telehealth appointments, only 18% said their provider offered telehealth prior to the pandemic. However, nearly a quarter of beneficiaries said they don’t know if their provider offers telehealth appointments, with the percentage even larger among rural beneficiaries. Therefore, while expanded policies appear to have increased access to services via telehealth, more work will need to be done to further education around telehealth and ensure its availability to all communities. Additional findings from the study include: -Over 1 in 4 (27% or 15 million) of Medicare beneficiaries had a telehealth visit between the summer and fall of 2020 -The majority of Medicare beneficiaries (56%) used telephone only *Video was 28% *Both video and telephone was 16% -The share of Medicare beneficiaries who had a telehealth visit using telephone only was higher among: *Those age 75 and older (65%) *Hispanic beneficiaries (61%) *Those living in rural areas (65%) *Those enrolled in both Medicare and Medicaid (67%) The report also found that rural Medicare beneficiaries were less likely than urban beneficiaries to have a telehealth visit with a doctor or other health professional (21% vs. 28%, respectively). However, among Medicare beneficiaries with a usual source of care and whose usual provider offers telehealth, they found no significant difference between the share of rural and urban Medicare beneficiaries who had a telehealth visit (43% and 45%, respectively). They note this difference is likely driven by the fact that rural Medicare beneficiaries were more likely than urban Medicare beneficiaries to say they do not know if their usual provider offers telehealth (30% vs. 21%, respectively). Similarly, among Medicare beneficiaries with a usual source of care whose usual provider offers telehealth, they found that a larger share of Black and Hispanic beneficiaries had a telehealth visit compared to White beneficiaries (52%, 52%, and 43%). However, among the total Medicare population, the difference in the share of Black and White beneficiaries who reported having a telehealth visit was not statistically significant (30% vs. 26%), while a larger share of Hispanic beneficiaries than White beneficiaries had a telehealth visit (33% vs. 26%). They note that for Black Medicare beneficiaries, this result is likely related to the fact that nearly a quarter of Black beneficiaries overall (23%) say their usual provider does not offer telehealth appointments, compared to 12% of White beneficiaries and 15% of Hispanic beneficiaries. Looking forward, the authors suggest that since they found greater usage of telehealth amongst those with disabilities, low incomes, and in communities of color, the temporary expansions of coverage may be helping more disadvantaged populations access care. In addition, since most services are being provided via audio-only, they state going back to requiring two-way video could be a barrier for many subgroups of the Medicare population. As policymakers continue to request data on telehealth and consider making certain emergency policies permanent, many are looking to Medicare to lead the way, and this information further confirms the importance of maintaining access to all telehealth modalities in all communities, or risk potentially exacerbating existing disparities even further post-pandemic. Additional expansion and education of telehealth availability will continue to remain necessary as well. More information on the survey and analysis can be found in the full issue brief - https://www.kff.org/medicare/issue-brief/medicare-and-telehealth-coverage-and-use-during-the-covid-19-pandemic-and-options-for-the-future/. < 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 >

Study: Teletherapy program reduces OCD symptoms Emily Olsen May 23, 2022 Researchers found a 43.4% mean reduction in patient-rated obsessive-compulsive symptoms. A teletherapy program reduced symptoms of obsessive-compulsive disorder, and most patients maintained improvements up to a year later, according to a study published in JMIR. The treatment, from digital mental health company NOCD, included twice-weekly video appointments that used exposure and response prevention (ERP) therapy for three weeks. Patients then underwent six weeks of weekly half-hour video check-ins. Researchers followed up with the patients three, six, nine and twelve months after the therapy program. The study found a 43.4% mean reduction in patient-rated obsessive-compulsive symptoms as well as a 44.2% mean reduction in depression, a 47.8% mean reduction in anxiety and a 37.3% mean reduction in stress symptoms. Of the more than 3,500 patients included in the study, more than 1,600 participated in follow-up surveys. The study's authors were employed by NOCD or reported they had received payments from NOCD while conducting the study. "The effect size was large and similar to studies of in-person ERP. This technology-assisted remote treatment is readily accessible for patients, offering an advancement in the field in the dissemination of effective evidence-based care for OCD," researchers wrote. WHY IT MATTERS The study's authors noted the virtual intervention took about 12 weeks and fewer than 11 therapist hours. "Technology assistance likely played an important role in this treatment’s ability to both engage and treat a large number of patients in wide-ranging geographic locations and to achieve a high mean rate of symptom improvement and a high rate of treatment response," they wrote. "Teletherapy using video allows people in remote locations to access treatment and to be able to complete, in-session, in vivo exercises in places and situations that are most relevant to, or triggering of, their symptoms." THE LARGER TREND NOCD announced it had raised $33 million in Series B funding in September last year. That brought its total financing to $50 million, according to Crunchbase. Mental health technology funding increased 139% globally in 2021, compared with 2020, bringing in $5.5 billion, according to a CB Insights report. Meanwhile, mental healthcare makes up a large portion of telehealth utilization in the U.S. Though utilization fell nationally in February, mental health diagnoses still made up more than 64% of telehealth claim lines, according to FAIR Health's tracker. For original article: https://www.mobihealthnews.com/news/study-teletherapy-program-reduces-ocd-symptoms < Previous News Next News >

Is telemedicine an answer to physician burnout and staffing shortages? Bill Siwicki May 24, 2022 A physician who works full time via telehealth – and in brick-and-mortar ERs on the side – discusses the benefits to herself and the industry. With the huge initial swell in the use of virtual care in the rearview mirror, many industry experts – from health plans to big tech and practicing clinicians – are considering whether a doubling down on telehealth is just what the doctor ordered for the future of patient care. Many clinicians are hungry for new opportunities that allow them to continue to serve patients without dealing with long-standing administrative burdens and the aftermath of burnout from COVID-19 in their hospitals, health systems and doctor's offices. With too many clinicians continuing to stress that they've lost passion in their careers and considering quitting their jobs altogether, experts say change is needed. The healthcare industry can't afford to lose these highly skilled clinical workers to other industries. On this note, Healthcare IT News interviewed Dr. Pooja Aysola, a practicing emergency department clinician in Boston and senior director of clinical operations at Wheel, a virtual care company. She talks about physicians' newfound familiarity with telehealth and what it means for the future, the possibility of physicians working full time in telemedicine, and how virtual care can help with staffing shortages in healthcare. Q. With the massive uptake in telemedicine during the past two years of the pandemic, clinicians have grown accustomed to delivering care virtually. What do you think this familiarity means for clinicians moving forward? A. I hadn't ever considered a career in virtual care until a few months into the pandemic. I was working in an emergency room in Boston when my shifts were cut after the hospital rolled back elective procedures. I started working in telemedicine as a temporary solution, but I ended up loving the flexibility to see patients at home and on my own schedule. I also quickly realized I didn't have to be in the same room as my patients to deliver great care. I can treat conditions such as UTIs through a screen and provide immediate value to my patients. I'm not alone in my sudden pivot from virtual-care skeptic to virtual-care advocate. Two in three clinicians now say treating patients in virtual only or hybrid care settings best fits their lifestyle, despite a significant lack of interest in telehealth before the pandemic. I'm hopeful this new trend will allow more clinicians to create career paths that work for them, rather than against them. Clinicians should have the flexibility to decide when they want to work, where they want to work, and how they want to work. If we're moving toward a hybrid care model, then we should enable clinicians to adopt hybrid careers, if that's what works best for them. In medical school, we're taught there's only one track you can follow: in-person care. But that's not the case anymore. I want every doctor and nurse to feel empowered to follow the career path that works best for them. Q. You seem to suggest that physicians looking for a change, perhaps due to burnout, can switch to telehealth full time. What would a move to virtual care look like for a physician? A. The past few years have been incredibly tough for clinicians. Burnout, frustration and fatigue are some of the many challenges facing clinicians today. Recent data shows more than half of clinicians have lost passion for their careers because of stress – and close to half believe burnout is the biggest threat to patient care today. Working in virtual care was a less-than-traditional career path before the pandemic. But now, many clinicians are considering working in virtual care to help combat burnout and increase flexibility. A move to virtual care will look different for everyone. For example, some clinicians enjoy having a set schedule each week to see patients. Others enjoy having more flexibility, where they can easily sign on after dropping their kids off at school, sign off before running an errand, or even split their time between virtual and in-person care. At Wheel, more than half of clinicians still work in a brick-and-mortar setting. One of our clinicians currently is driving around the country with her partner in an RV. She customizes her schedule based on her travel plans that day. She can see patients in the morning and go for a hike in the afternoon, or spend a few hours on the road before pulling over and seeing patients in the afternoon. Clinicians interested in telehealth should look for opportunities that prioritize and personalize their experience as clinicians. Some specific factors to consider include: What kind of electronic health record does the company use? And was the EHR created with your experience in mind? Do they offer ongoing training? And provide resources on important topics, such as "webside" manner and guidance on managing state licenses? Do they have a robust clinical quality program in place? How do they provide feedback on quality of care? Q. How can telehealth help with the staffing shortage in healthcare? A. Our current clinician staffing shortage is a national crisis. And it's only expected to get worse. According to an Elsevier study, almost half of U.S. clinicians plan to leave their jobs within the next few years. I've seen firsthand the impact shortages are having on clinician burnout and patient care. And I firmly believe this is a crisis that the entire industry must address. Ensuring clinicians feel encouraged to explore careers in virtual care, if that's what works best for them, is one of many steps to take. Another way for telehealth to help address staffing shortages is by powering the transition to what we call "virtual-first care." With virtual-first care, patients can start their care journey with telemedicine. By leaning on technology, healthcare organizations can more easily triage the patient's care needs and determine the best care setting – virtual, in-person or hybrid care. This is a more efficient way to approach care delivery while simultaneously increasing access to care. While telehealth alone is not the only solution, it is one of many steps we can take to help address staffing shortages and help ensure timely patient access to care. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/telemedicine-answer-physician-burnout-and-staffing-shortages < Previous News Next News >

Recent DOJ Fraud Charges Include Few Details and Links to Telehealth Center for Connected Health Policy June 2021 The Department of Justice (DOJ) recently announced criminal charges against a variety of individuals related to various alleged COVID-19 fraud schemes. One of the kickback schemes does appear to include a telehealth element. The Department of Justice (DOJ) recently announced criminal charges against a variety of individuals related to various alleged COVID-19 fraud schemes. Most of the new cases appear to be related to fraudulent testing claims and kickback schemes, although one of the kickback schemes does appear to include a telehealth element. According to the DOJ press release, two Florida men – a consultant as well as a Texas laboratory owner – allegedly exploited temporary telehealth waivers by offering providers access to Medicare beneficiaries for whom they could bill consultations. In return, the providers referred the patients to that laboratory for potentially unnecessary cancer and cardiovascular genetic testing. Despite potentially misleading headlines, most charges appear to only be against executives and additional details directly tying the fraud to telehealth and the correspondence, billing, and waivers in question have yet to be released. As one updated mHealth Intelligence article later noted, “the charges try to link fraud cases to telehealth coverage, but are more closely aligned with telefraud.” For more information read the full DOJ press release - https://www.justice.gov/opa/pr/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19. < 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 >

Teletherapy Aimed to Make Mental Health Care More Inclusive. The Data Show a Different Story Jamie Ducharme June 14, 2021 Case studies suggest teletherapy can work well when it’s integrated into the traditional, in-person medical system. For years, teletherapy has been pitched as the next frontier in mental-health care. Unlike medical disciplines requiring a more hands-on approach—say, physical therapy or surgery—talk therapy has long seemed a natural and effective fit for telehealth. And by taking appointments off the therapist’s couch and into patients’ homes via their devices, advocates argued, telehealth could make counseling more accessible and convenient for everyone, with particular benefits for those who lived in health care deserts or who couldn’t regularly drive back and forth to see a clinician. The hope was that virtual therapy could help democratize a system that allowed almost 20% of white Americans to receive mental-health care in 2019, but fewer than 10% of people identifying as Black/African American, Hispanic/Latino, Asian or Pacific Islander. Then, of course, the pandemic hit, sending the U.S. health care system into a panic and shuttering clinics and private practices nationwide. Telehealth, once psychiatry’s up-and-comer, was suddenly its lifeline. With impressive speed, a system built around face-to-face visits shifted almost exclusively online. By May 2020, 85% of the American Psychiatric Association’s (APA) surveyed clinician members said they were conducting the majority of their sessions virtually, up from just 2% prior to the pandemic. It was the perfect pressure test for the promise of virtual mental-health care. If there was ever a time for teletherapy to shine, it was during the pandemic. But the data aren’t so shiny. Telehealth has indisputably improved mental-health care access—but not to such an extent that it delivers on promises of revolutionizing the mental-health system. The same problems that kept many people—particularly those who are lower-income or of color—from seeking care before the pandemic still exist, even with the expansion of telehealth. As a result, mental-health usage in the U.S. hasn’t changed as drastically as many advocates would have liked. In a series of TIME/Harris Poll national surveys conducted this winter and spring, about half of respondents reported using telehealth since the pandemic began, compared with about 25% who said they had beforehand. Increases in telehealth usage during the pandemic, broken down by demographic groups But only about 5% said they’d gotten mental-health care for the first time during the COVID-19 crisis. That suggests the expansion of telehealth didn’t bring in an influx of new patients to the mental-health system. Government data show a similar picture: about a quarter of U.S. adults received mental-health care in the winter of 2021, according to the U.S. Centers for Disease Control and Prevention (CDC), up from about 19% in 2019. That’s an improvement, but not an enormous one. The number of U.S. adults reporting mental health problems grew significantly during the pandemic, but the number of those getting treatment did not Similarly, a March 2021 study from California’s Kaiser Permanente health system found that telehealth allowed clinicians to conduct 7% more psychiatric visits in spring 2020 than 2019—but most of those were with patients who already had a psychiatric diagnosis. Among people without a pre-existing diagnosis, volume declined by more than 40%, suggesting that virtual appointments were more helpful for people already served by the mental-health system than those outside it. On the opposite U.S. coast, telehealth allowed McLean Hospital, a psychiatric institution near Boston, to increase outpatient volume by about 15%, counting both new and existing patients, but psychiatrist-in-chief Dr. Scott Rauch says there’s “absolutely the recognition that there are some populations,” like certain older adults, “that are having difficulty accessing the technology.” In fact, despite the increased availability of telehealth, the share of American adults with an unmet mental-health need increased from August 2020 to February 2021, from 9% to almost 12%, according to CDC data. That’s understandable, given elevated levels of anxiety, depression and stress during the pandemic, but it also suggests teletherapy is not a panacea. And that means the harder work is still ahead. There are lots of ways to think about access to care. The most obvious—making it easy for a patient to speak directly with a clinician, either in person or via a device—is only one. There are also financial barriers. A single therapy session can easily top $100 (without insurance) in many parts of the country, and telehealth has done little to change that. Rightly so, argues Dr. Joe Kvedar, a former president of the American Telemedicine Association, since there’s no evidence to suggest virtual therapy is lower quality than face-to-face. Be that as it may, high price tags mean both therapy and teletherapy remain unattainable for many. Another limitation: there are simply not enough therapists to go around. More than 125 million people in the U.S. live in an area with a shortage of mental-health practitioners, according to U.S. Health Resources and Services Administration estimates. Whether they’re seeing patients virtually or in the flesh, there are a finite number of mental-health professionals with a finite number of hours in their days. Rauch, from McLean Hospital, says telehealth can increase appointment capacity somewhat, mainly because patients are less likely to cancel or no-show, but “as long as it requires an hour of clinician time to deliver an hour of clinical service, expanded access won’t be drastically enhanced.” To meet demand, the U.S. needs not only more therapists generally, but also more therapists from diverse backgrounds. A 2020 study concluded that just 10% of U.S. psychiatrists identify as Black, Hispanic, American Indian, Alaska Native, Native Hawaiian or Pacific Islander. That means many patients of color can’t find a therapist whom they trust and with whom they can form a close rapport, a barrier that dissuades many people from getting the help they need or prevents them from reaping the full benefits of therapy, says Dr. Amanda Calhoun, a psychiatry resident at Yale and a fellow on the APA’s Council on Minority Mental Health and Health Disparities. “There are many patients who want a Black therapist and they can’t get it,” Calhoun says. “If we truly want to reduce the gap [in mental-health care usage] we need to make it a trustworthy system where people feel they can connect with their therapist or psychiatrist.” Patients who do not speak fluent English, or who feel more comfortable using another language, may also struggle to find a therapist with whom they can communicate freely. Increased use of language interpretation could be an essential tool for expanding access, Calhoun says. It seems naive, or at least wildly optimistic, to think telehealth could overcome some of these entrenched structural issues. And in some cases, virtual care actually worsens disparities. Some people don’t have a reliable Internet connection or a smart device, for example. About 7% of American adults don’t use the Internet at all, according to Pew Research Center, and those without advanced education and people of color—i.e., those already often underserved by the mental-health system—are least likely to be “digitally literate,” according to a 2020 Health Affairs article. Further, elderly adults, an estimated 20% of whom have some sort of mental-health condition, may struggle to navigate virtual platforms even if they have quality Internet access. And online platforms aren’t perfect. Some people feel uncomfortable sharing their most intimate thoughts through a screen, and any digital system runs the risk of malfunctioning or being hacked. That recently happened in Finland, when a data breach led thousands of patients’ sensitive appointment notes to land in hackers’ hands. Plus, teletherapy is only convenient if you’re able to step away from work and other responsibilities to conduct the call in a private place. While the pandemic has many white collar workers drowning in time at home, surrounded by devices, that’s far from a universal experience. For essential workers, a disproportionate number of whom are people of color, it may be only slightly easier to steal away for a teletherapy appointment than it would have been to schedule an in-person visit with a clinician. Perversely, teletherapy may be making it easier than ever for people who already had access to mental-health care to get it, while leaving behind the people who arguably need it most. If teletherapy isn’t doing the trick, the question then becomes how to better serve those still not getting the mental-health care they need. Calhoun says any real solution needs to take a step backward and investigate why many people either cannot or choose not to seek help. For people of color, centuries of neglect and mistreatment by the medical institution are not easily forgotten. In the 1700 and 1800s, influential American doctors coined since-discredited diagnoses like “drapetomania” (psychosis or madness causing an enslaved person to run away) and “negritude” (essentially, the “disease” of not being white). Many contemporary providers aren’t aware of those offensive diagnostic frameworks, Calhoun says, but the cultural legacy of that racism is still widely felt in communities of color. Training more clinicians from underserved backgrounds is the single most impactful way to encourage people of color to get help, Calhoun says. But that process takes time. In the interim, she says, all clinicians need to be educated about psychiatry’s problematic past so they can acknowledge and understand why some patients may not feel comfortable seeking help, and then hopefully address those issues in their own practices. Looking beyond telehealth and focusing on community-based programs—like church-run mental-health groups or the Confess Project, a nationwide initiative that trains barbers to be mental-health advocates—may also help build that trust. Case studies also suggest teletherapy can work well when it’s integrated into the traditional, in-person medical system. For the past decade-plus, Massachusetts has run a program that allows participating primary-care providers to teleconference in a psychiatrist during a child’s checkup, for example. Such programs don’t eliminate mistrust of the medical system, but they can at least make it easier to introduce people to the mental-health system. Mental-health apps—while not appropriate for patients with serious diagnoses, and clearly not an option for those without a smartphone—can also provide a cheap (or even free) stopgap measure for people struggling to find or afford an appointment with a clinician, Rauch says. And in some cases, adds Dr. Adrienne Robertson, a family medicine physician who works with the online medical startup Nurx, through which people can request prescription medicines and diagnostic tests simply by filling out a form, eliminating face-to-face interactions with providers can actually put patients of color at ease, because they can “just [be] a patient like everyone else.” Policy also plays a role. Nordic countries, like Sweden, have among the most robust and widely used telemedicine programs in the world, boosted by affordable, state-sponsored medical networks. Unlike in the U.S., where insurance limitations and out-of-pocket costs are roadblocks for some patients regardless of platform, many people in Nordic countries have a public option for virtual care. Last year, the Centers for Medicare and Medicaid Services made it easier for Medicare holders to use telehealth services, a policy that allowed more than a quarter of Medicare beneficiaries (and more than 30% of Black and Hispanic beneficiaries) to use telehealth during the fall and summer of 2020, but it’s not clear what will happen after the pandemic ends. Permanent federal action for Medicare and Medicaid holders—many of whom are low-income or elderly adults—could open up therapy to millions of people who can’t currently afford it. And changing federal policies that currently limit clinicians to treating patients located in the state where they are licensed could help even out distribution of the mental-health workforce. All of these fixes are considerably more complex than bringing appointments online; they require rebuilding the system, rather than simply shifting it to a new platform. That work needs to happen sooner rather than later, Calhoun says. Already, according to TIME/Harris Poll data, many people are returning to in-person medical appointments, both psychological and physical. In May, more than half of respondents who’d received mental-health care said they’d had an in-person appointment since the start of the pandemic, up from 37% in February. While some patients and clinicians are sure to stick with teletherapy after the pandemic, much of the system will seemingly revert back to how it was—and without concerted effort, the same problems may persist for years to come. This article can be found at https://time.com/6071580/teletheraphy-mental-health/. < Previous News Next News >

Telehealth May Be Rural Healthcare’s Lifeline Corey Scurlock December 28, 2022 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. According to a report by the Bipartisan Policy Center (BPC), a Washington, D.C.-based think tank, 116 rural hospitals across 31 states closed between 2010 and 2019. Many of them were small critical access hospitals. Federal Covid-19 relief funding is believed to have prevented additional closures—only two rural hospitals closed in 2021. Now, though, 631 rural hospitals are threatened with possible closure within the next few years, according to the Center for Healthcare Quality and Payment Reform. As the CEO and founder of an acute care telehealth company, I’ve observed firsthand that workforce needs are one of the primary drivers of telehealth adoption. What was once a staff shortage is now a crisis, particularly in nursing, but also among physicians. From 2020 to 2021, the total supply of registered nurses decreased by over 100,000, the largest drop in four decades. By 2025, there could be a shortage of 200,000 to 450,000 nurses in the U.S. Rural hospitals are at a particular disadvantage since they tend to have worse workforce shortages than urban hospitals. According to the BPC, “urban areas have 30.8 physicians per 10,000 residents; rural ones have 10.9 physicians per 10,000.” There are also often fewer specialists—such as cardiologists, psychiatrists, radiologists and obstetricians—in rural areas. Opportunities To Improve Care Rural hospitals have for years contracted with academic medical centers for remote episodic help with patients with clinically complex conditions, such as stroke and sepsis. To make care more affordable, we’re seeing more rural healthcare leaders embracing telehealth for supplemental care, filling in coverage gaps or for specialized consultations on complex cases so that people get the right care at the right time in the right setting. In previous articles, I wrote about how telehealth can provide clinical expertise, how telehealth specialists target “hot spots” along the patient care journey and about virtual nursing, in which veteran RNs with specialty expertise guide bedside staff and patients through the care process. Rural hospitals are in dire need of expert care at patient transition points. Virtual care often starts in what is now the front door of a hospital: the emergency room. Rural and critical access hospitals often have to park patients in the hallway as they triage. A remote intensivist steeped in critical care medicine can track the vital signs of patients and do the intake, often guiding inexperienced staff to the right site of care and helping them through tests, diagnoses and procedures. Inappropriate patient transfers are a source of inefficiencies and poor-quality care. Patients may be sent to intensive care who don’t need to be. Some can be easily treated in the ER and sent home. Others may need a complex operation, for which a transfer to a level 1 trauma center is needed. Outcomes for ER patients with delayed care are, not surprisingly, poorer. Maximizing A Stretched Workforce The BPC examined three evidence-based programs that involve using digital technology—one of which was tele-ICU—to see how they could optimize a stretched healthcare workforce and ensure that patients receive quality care in their local hospitals. Tele-ICU programs can be episodic, such as enabling two-way audiovisual communication between telehealth providers and local ICUs to get answers to questions, or they can be continuous, where a remote physician has complete access to electronic medical records, imaging systems and other databases to get timely information that informs decisions about a patient’s care. According to the BPC, “studies have demonstrated that tele-ICU programs enhanced care plans, improved clinical outcomes, reduced hospital transfers, and were associated with increased best-practice adherence.” Telehealth also facilitates the mentoring of young nurses and assesses where there are gaps in current knowledge. The BPC report mentions a study that found that 27% of hospitals with ICUs have tele-ICU capabilities. Such capabilities can potentially lead to substantial savings: The report cites a 2019 cost-benefit analysis that found that a telehealth ICU program saved $3.14 million over six months by “reducing ICU variable costs per case, decreasing length of stays and decreasing ICU mortality.” It’s a fairly straightforward story: Remote intensivists can monitor dozens of patients remotely at a time, while tele-ICU nurses can keep track of 30 to 50 patients simultaneously, compared with just three for a bedside RN. Bedside clinicians typically can deal with only one emergency at a time, while remote intensivists can handle up to four codes at once. A Path Forward Pretty soon, the pressures of the workforce shortage will likely compel many, if not most, acute care providers to adopt some virtual care across the enterprise. So it’s crucial for rural hospitals to take steps now to ingrain telehealth into their operations and make it part of the fabric of care—that way, it’s there when they need it. Here are some things for rural hospitals to think about when choosing a telehealth partner. • There are many entities offering telehealth services, ranging from large academic medical centers to consortiums of providers to vendors large and small. Make sure you have complete trust in your chosen partner. • Ensure that all of the entity’s physicians are licensed to practice medicine in your state(s). If not, they cannot order tests, prescribe medications or do anything but recommend a course of action. • Does the telehealth provider have a network of specialists in every area? For example, many vendors lack psychiatrists, who are in short supply nationally amid the explosion in demand for mental health services. • Make sure your telehealth partner understands patient flow optimization techniques that support level-loading and optimized bed utilization. Final Thoughts Through my travels and in conversations with executives across the nation, I’ve found that the word “telehealth” doesn’t sound techy anymore and that the understanding of the benefits delivered by digitally enabled care is more mature. Telehealth is now recognized as a tool that, as part of a strategic process to remedy gaps in care delivery, can be combined with change management to drive real value. Soon, in fact, “telehealth” may be replaced by “health” when we look at the evolution of care through technology. Dr. Corey Scurlock MD, MBA is the CEO & founder of Equum Medical. See original article: https://www.forbes.com/sites/forbesbusinesscouncil/2022/12/28/telehealth-may-be-rural-healthcares-lifeline/?sh=1f7657be3e9d < Previous News Next News >

Permanent Pay, Originating Site Policies Boost Access to Virtual Addiction Services Victoria Bailey Dec. 29, 2021 By making temporary reimbursement and site-originating policies permanent, legislators could help increase access to virtual opioid use disorder treatment, according to a new report. December 20, 2021 - Lawmakers have the power to solidify access to virtual opioid use disorder treatment by introducing policies that ensure reimbursement parity, solidify audio-only telehealth coverage, and expand the list of eligible originating sites, according to an issue brief from the Pew Charitable Trusts. During the COVID-19 pandemic, telehealth proved to be a successful care modality for delivering opioid use disorder treatment to individuals across the country. The Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services (SAMHSA) lifted their restrictions and allowed buprenorphine prescribers to initiate medication treatment via telehealth without requiring an in-person visit first. However, these regulations are temporary and are set to expire once the public health emergency ends. In order to ensure access to virtual opioid use disorder treatment, state Medicaid agencies and policymakers should make these and other telehealth regulations permanent, Pew said. Legislatures should require public and private payers to reimburse providers for all opioid use disorder treatment services delivered via telehealth, including clinical assessments, prescriptions, medication management, and counseling sessions. Additionally, ensuring reimbursement for a variety of providers — including physicians, nurse practitioners, physician assistants, and mental health professionals — could help solidify the virtual treatment process. According to Pew, states that offered coverage for buprenorphine prescribing via telehealth saw positive patient outcomes that were similar to in-person services. Policymakers should also establish payment parity between telehealth and in-person opioid use disorder treatment services under public and private payers alike. “Without assurances of sufficient reimbursement rates, providers may be unwilling to invest in telehealth infrastructure for their practices, or they may find it infeasible to increase the use of telehealth for OUD treatment,” researchers wrote in the brief. Medicaid programs can ensure reimbursement parity for telehealth services without submitting a plan amendment to the Centers for Medicare and Medicaid Services (CMS). Thirty-eight states and Washington D.C. have established payment parity for certain telehealth services, but not all programs include opioid use disorder services in their provisions. Originating-site restrictions must also be addressed, Pew researchers said. Some states allow patients to use telehealth but only from certain clinics that can serve as an originating site. By expanding the list of eligible originating sites to include the patient’s home, policymakers could make accessing virtual care more convenient for individuals. Medicare currently allows individuals to receive telehealth-based opioid use disorder treatment from their homes, according to the brief. Past studies have shown that patients can initiate buprenorphine safely and successfully while remaining in their homes. In addition, patients seemed to prefer receiving treatment from home. Further, Medicaid programs should make audio-only telehealth policies permanent to facilitate access to virtual care, Pew researchers recommended. Audio-only coverage is set to expire when the public health emergency ends. Ensuring that providers receive reimbursement for audio-only opioid use disorder services may help address care disparities and benefit underserved communities that tend to use the care modality most often, including Black and Hispanic populations, individuals with limited English proficiency, and communities with inadequate broadband access. At least 15 Medicaid programs offer reimbursement for audio-only telehealth as of February, but some states only provide coverage for certain services, the brief noted. Finally, Pew researchers recommended that policymakers allow correctional settings to offer telehealth-based opioid treatment. Jails and prisons typically allow incarcerated individuals to receive healthcare via telehealth but the option to receive virtual opioid use disorder treatment is far less common, the brief stated. If states allocated funding to these institutions, they could invest in the necessary telehealth resources to establish virtual opioid treatment services. A few correctional facilities, including one in Minnesota and one in Massachusetts, currently offer buprenorphine treatment, counseling sessions, and clinical assessments through telehealth. Even with these policy changes, states may face additional barriers to offering virtual opioid treatment services including a lack of funding for infrastructure and poor broadband access. Pew researchers suggested that states consider partnering with the National Consortium of Telehealth Resource Centers to receive assistance with launching a telehealth program. Additionally, state and local governments can leverage funding from the American Rescue Plan Act to invest in expanding internet access to communities that need it. https://mhealthintelligence.com/news/permanent-pay-originating-site-policies-boost-access-to-virtual-addiction-services < Previous News Next News >

Telehealth QA – Is it all it’s QAcked up to be? Trudy Bearden, PA-C, MPAS February 16, 2022 In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the fourth in the series. Require expertise and excellence in telehealth service delivery. Expertise with telehealth requires deliberate practice which builds on or modifies existing skills, usually with the help and guidance of a coach or teacher with targeted feedback on what to improve and how to improve those skills. Send staff through telehealth training either internally or externally. The California Telehealth Resource Center Telehealth Course Finder is a great place to start for external telehealth trainings. Provide peer review of telehealth sessions by inviting a trusted clinician to join a telehealth visit – with patient permission. Debrief after the session to provide feedback and to discuss what went well, what did not go well and what changes can be made to improve Implement written triage protocols that are easily accessible by all staff to clarify which patients or patient issues are appropriate for telehealth and which need to be seen in person. Make a commitment to exceptional service delivery. Solicit and act on patient and staff feedback. Consider including a patient partner or advisor in these efforts. Below are some sample staff and clinician satisfaction survey questions. Some institutions may already incorporate some of these into their existing patient feedback systems (e.g., Press Ganey) so check to see if they are before duplicating efforts. Sometimes it’s best to collect feedback simply and in real time by asking, “How was your visit? What could have gone better?” Read full article here: https://southwesttrc.org/blog/2022/telehealth-qa-it-all-it-s-qacked-be < Previous News Next News >

NM Telehealth Workgroup Hosted by the New Mexico Telehealth Alliance 7/29/2021 New Community Forum for NM Healthcare Peers on Telehealth Topics This is a monthly community forum to discuss telehealth issues with your healthcare peers. The intent is to help New Mexican systems advance remote care. Topics will change monthly and be directed by what the group members ask for. Hosted by the New Mexico Telehealth Alliance, our first session on July 29 is a collaboration with Presbyterian Healthcare Services and the University of New Mexico. We will explore audio only post-pandemic billing using HCPCS code G2252. Register here: https://www.eventbrite.com/e/nm-telehealth-community-forum-registration-163947169397 < Previous News Next News >

Majority of Americans Value the Convenience Associated with Telehealth Mark Melchionna December 07, 2022 New survey results released by AHIP showed that most Americans highly value the simplicity and convenience associated with telehealth and support making pre-deductible telehealth coverage permanent. America's Health Insurance Plans (AHIP) described survey results indicating that Americans value the convenience associated with telehealth, with 69 percent saying they prefer it over in-person care for this reason. As the COVID-19 pandemic became increasingly severe, many patients and providers began to use telehealth at a higher frequency. This was supported by federal and state governments allowing flexibilities that removed barriers to this type of care, leading to improved patient access. The high level of telehealth use has continued during the pandemic, even following the drop in COVID-19 severity as vaccines and treatments became widely available. According to the FAIR Health Monthly Telehealth Regional tracker, telehealth use increased by 10.2 percent in May. A survey released by AHIP aimed to gather information regarding Americans' opinions on telehealth. Conducted by NORC at the University of Chicago and using the AmeriSpeak panel, the survey polled 1,000 Americans, 498 of whom have employer-provided or individual market coverage, regarding telehealth use within one year prior. The survey was fielded in October. Among the portion of survey respondents who were commercially insured, 40 percent claimed to have used telehealth within a year prior, and 53 percent claimed to have used it between two and five times within a year prior. About 69 percent of commercially insured telehealth users said they used telehealth due to the associated high level of convenience compared to in-person care, 78 percent stated that telehealth made the process of seeking out healthcare easier, and 85 percent said there is an adequate number of providers available via telehealth for their subjective needs. Also, 73 percent of commercial telehealth users stated that Congress should make permanent arrangements that allow for the coverage of telehealth services prior to paying their full deductible. Further, female telehealth users were almost four times as likely than men to say they participated in a telehealth appointment because they lacked childcare or eldercare, the survey shows. “Patients and providers accept – and often prefer – digital technologies as an essential part of health care delivery,” said Jeanette Thornton, executive vice president of policy and strategy at AHIP, in a press release. “Telehealth can be just as effective as in-person care for many conditions and allows patients to receive more services ‘where they are.’ That’s why health insurance providers are committed to strengthening and improving both access and use for the millions of Americans who use telehealth for their health care needs.” A report from July found similar patient opinions of telehealth. Released by CVS Health, the 2022 Health Care Insights Study reported survey results from two separate questionnaires. Around 92 percent of respondents stated that convenience is a critical factor when selecting a primary care provider. The surveys also reported that many consumers find virtual appointments more convenient than in-person visits because they didn’t have to leave home (41 percent), they didn't have to pay for transportation (37 percent), and they saved time (37 percent). See original article: https://mhealthintelligence.com/news/majority-of-americans-value-the-convenience-associated-with-telehealth < Previous News Next News >

New Study Pitches Telehealth as Safer Than the Doctor’s Office Eric Wicklund, mhealthintelligence August 2021 In a nod to the value of telehealth in primary care, researchers have found that a person visiting the doctor's office shortly after a visit from someone with the flu has a much higher chance of getting the flu as well. A new study makes a strong case for telehealth as an alternative to the doctor’s office, particularly during flu season. Researchers from the University of Minnesota School of Public Health, Harvard Medical School and the university’s T.H. Chan School of Public Health and athenahealth have found that people who visit their doctor’s office after someone infected with the flu has visited that office are much more likely to come down with the flu themselves. That same increase wasn’t seen in people seeking treatment for issues like urinary tract infections. The study, published this month in Health Affairs, suggests that primary care providers embrace virtual visits as a means of reducing that chance of infection. “It’s a widely accepted fact that patients can acquire infections in hospital settings, but we show that infection transmission can happen when you visit your doctor’s office, too,” Hannah Neprash, an assistant professor at UM’s School of Public Health and one of the study’s authors, said in a news release issued by the university. “Our findings highlight the importance of infection control practices and continued access to telemedicine services, as health care begins to return to pre-pandemic patterns,” she added. "In-person outpatient care for influenza may promote nontrivial transmission of these viruses. This may be true for other endemic respiratory illnesses too, including COVID-19, but more research is needed." The study, which tracked office visits from a national sample of insurance claims and EHR data compiled by athenahealth, is reportedly the first to connect the dots between office visits and the progression of a flu outbreak. According to that data, patients visits their primary care provider were almost 32 percent more likely to contract the flu within two weeks if that PCP had seen someone with the flu within the previous two weeks. In addition, that office would then serve as an incubator for the flu, infecting more patients over time. Neprash and her fellow researchers say their study supports the need for “triage to telemedicine” policies in clinics and medical offices when a patient shows signs of a contagious viral infection like the flu. “Given that upper respiratory symptoms are among the most common reasons for any patient to see a physician, these results highlight the importance of protocols to mitigate the risk for transmission,” the study notes. “Clinically, many of these patients will be at low risk for complications with telemedicine evaluation.” It also suggests that care providers develop “strict infection control practices” whenever a patient showing signs of the flu or a similar virus need to be seen in person. This would include mask-wearing, hand hygiene and putting patients in separate exam rooms that can be decontaminated after a visit. Finally, the study makes a case for continued support for telehealth coverage at a rate equal to in-person care. “Lawmakers in Congress are actively debating the future of telemedicine policy and how it should be reimbursed after the worst of the COVID-19 pandemic recedes,” the study notes. “It is possible that telemedicine reimbursement after the pandemic will be restricted to certain specialties or diagnoses or reimbursed at a rate low enough that many clinicians decide to forgo telemedicine as a mechanism for care delivery. Our results argue that clinically, for infection control, telemedicine should remain a financially viable option for clinicians to provide care for viral respiratory symptoms. < Previous News Next News >

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 >

Updated Version of CONNECT for Health Act Introduced in Congress Center for Connected Health Policy May 4, 2021 Last week an updated version of the CONNECT for Health Act was introduced in Congress. Last week an updated version of the CONNECT for Health Act was introduced in Congress. The bill, which was first introduced in 2016 but has been repurposed in this newest version to remove restrictions on telehealth for mental health, stroke care and home dialysis in certain circumstances. It also addresses several of the restrictions in Medicare, including geographic limitations, expanding originating sites to include the home, restrictions on federally qualified health centers (FQHCs) and rural health clinics (RHCs) reimbursement and gives the Secretary of Health and Human Services the ability to waive other telehealth restrictions permanently. For more information, see the press release, or read the bill’s summary published by Senator Schatz office. Stay tuned for a deeper dive and further analysis from CCHP next week. Press Release: https://www.schatz.senate.gov/press-releases/schatz-wicker-lead-bipartisan-group-of-50-senators-in-reintroducing-legislation-to-expand-telehealth-access-make-permanent-telehealth-flexibilities-available-during-covid-19-pandemic Summary: https://www.schatz.senate.gov/imo/media/doc/CONNECT%20for%20Health%20Act%20of%202021_Summary.pdf < Previous News Next News >

Amazon rolls out its telehealth service nationwide Annie Palmer, Bertha Coombs February 8, 2022 Amazon is launching its telehealth program, known as Amazon Care, nationwide and has signed up a handful of new companies to use its services. Amazon is rolling out its telehealth service, known as Amazon Care, nationwide, the company announced Tuesday. Amazon Care launched in 2019 as a pilot program for employees in and around the company's Seattle headquarters. The program provides virtual-care visits, as well as free telehealth consultations and in-home visits for a fee from nurses for testing and vaccinations. It has since expanded into more of a primary care service. To read this full article: https://www-cnbc-com.cdn.ampproject.org/c/s/www.cnbc.com/amp/2022/02/08/amazon-care-telehealth-service-launches-nationwide.html < Previous News Next News >

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

A Decade of Telehealth Policy: A New Report From CCHP Mei Kwong- Center for Connected Health Policy August 2022 Ten years ago, in the early months of 2012, the Center for Connected Health Policy (CCHP) faced a decision of potentially great significance. The U.S. Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy (FORPH) Office for the Advancement of Telehealth (OAT) had released a Funding Opportunity Announcement for their Telehealth Resource Center Grant Program and the incumbent contractor for the National Telehealth Resource Center for Policy (NTRC-P) contract would not be reapplying. After weighing the pros and cons of acting as the NTRC-P, CCHP decided to take the plunge and applied. On September 1, 2012, CCHP officially started its work as the federally designated National Telehealth Policy Resource Center and have been serving that role for the past decade. To mark CCHP’s ten-year anniversary as the NTRC-P, we are releasing a look back on telehealth policy in the United States. For the past decade, CCHP has tracked and followed policy development for all 51 jurisdictions in the United States (District of Columbia included) as well as at the federal level providing us with the unique opportunity to observe and study the development of telehealth policy in the United States on both the state and federal levels. This past decade also happens to be the period that encompasses some of the most significant telehealth policy developments seen thus far in the United States. The report is not intended to be an in-depth study on telehealth policy development and history as that could easily be an entire novel given the complexities and nuances that would need to be considered. The National Telehealth Resource Center for Policy Ten-Year Anniversary Report is intended to capture some of the highlights, significant changes, and environmental factors that have had an impact on telehealth policy development in the nation. Considering the increased interest in telehealth policy, CCHP believes this report also will be useful to provide context on how telehealth policy came to be where it is today, particularly for those who may be newer to the field. Additionally, the report is meant to be a celebration of the time CCHP has spent as the NTRC-P including the contributions the organization has made to the telehealth field. This report is dedicated to the memory of Mario Gutierrez, CCHP Executive Director from 2011-2017. Mario was the original visionary who decided in 2012 that CCHP should apply for the project. A special thank you must also be extended to CCHP staff, both past and present, who have truly been the engine that continues to drive the work of the organization forward. Special acknowledgment must be made of Laura Stanworth, Deputy Director, and Christine Calouro, Senior Policy Associate, both who have been with CCHP from the beginning of its role as the NTRC-P and who, along with myself, have seen this past decade of telehealth policy development, including producing all information and navigating CCHP through those first few months of the COVID-19 pandemic. We hope you will enjoy this report and find the information useful. CCHP looks forward to continuing on the ever evolving telehealth policy journey with all of you. See full report: https://mailchi.mp/cchpca/a-decade-of-telehealth-policy-our-10-year-anniversary-report < Previous News Next News >