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Accessibility to Telehealth Andrew Donnellan, Nov 03, 2021 Access to accessible Telehealth should not be based on the coincidence of location, but on the coincidence of being human. Telehealth has many benefits including reduced, or eliminated travel and wait times; decreased exposure to communicative diseases; easier access to healthcare professionals and therapeutic interventions; and greater flexibility. However, for many individuals with disabilities, Telehealth and its associated benefits may be out of reach due to web inaccessibility. Benefits can become barriers because of websites’ inconsistent compatibility with screen readers, closed captions, magnifiers, speech to text software (used by individuals with limited dexterity), easy to understand instructions and hyperlinks (for individuals with cognitive disabilities), and alternative text formats. Although Telehealth companies provide guidance on ensuring accessibility by conforming to guidelines laid out in Section 508 of the 1973 Rehabilitation Act, it is only voluntary because the Act only applies to federal agencies and not private companies. So, while an individual with a disability will be met with a relatively accessible federally funded Telehealth website, that same individual may be greeted by an inaccessible private Telehealth website. But wait! What about the Americans with Disabilities Act (ADA)?! Surely it requires public accommodations like Telehealth websites to be accessible?! While the ADA does require brick-and-mortar private businesses that are labeled as public accommodations to be accessible, there is no such mandate for websites. Because of this, federal courts are split by jurisdiction on how to apply the ADA to websites: some jurisdictions say the ADA applies to all websites; some say it is inapplicable to all websites; and others conclude it applies only if the website has a connection, or "nexus," to the physical, brick-and-mortar place it represents. This lack of consistency can leave a disabled Telehealth user without an accessible Telehealth website simply because they live in a jurisdiction that does not ensure accessibility to websites. What can be done to help solve this problem? Perhaps the most comprehensive solution would be for the Department of Justice (DOJ), the federal Department tasked with enforcing the ADA, to finally answer the repeated calls by private business owners, courts, and other federal agencies for guidance by issuing a concrete rule requiring website accessibility under the ADA. However, because the Department proposed such a rule in 2010 and then withdrew from its proposal in 2017, it appears that those calls for guidance will go unanswered, save for a few amicus briefs and unofficial statements. Another, and perhaps more viable, solution is to lobby state senators to implement legislation requiring accessible Telehealth. It appears the ball has already started rolling because just this year, the New Jersey legislature has proposed a new bill that requires Telehealth to “ include accessible communication to facilitate the use of… Telehealth by individuals with a disability….” Access to accessible Telehealth should not be based on the coincidence of location, but on the coincidence of being human. Since we are all human, we all deserve accessible Telehealth — it is a right. This right will not be realized unless, and until, we stand up and demand mandated accessible websites. https://southwesttrc.org/blog/2021/accessibility-telehealth < 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

Top of Page Video Access Highlighted Webinars Clincal Innovation Business Funding NMTHA Town Hall Experts in TH Webinars, Interviews, & Videos Video Access Featured Webinar & Video Series Highlighted Videos NMTHA provi des videos by topic: Clinical Innovation Business Funding Town Hall Meeting Expert Interviews Webinars FEATURED WEBINAR NMTHA Town Hall Event: The Future of Telehealth As our world changed due to the COVID-19 pandemic, so did the world of telehealth. But, what happens next? Featuring nationally recognized speaker and telehealth pioneer Dr. Weinstein, plus Russel Toal from New Mexico's OSI. View Webinar FEATURED SERIES Experts in Telehealth: An Interview Series NMTHA brings "Experts in Telehealth" a video series interviewing experts from various areas within the Telehealth arena. View Series Featured The Modern-Day House Call. Duke City’s Medic Buddy: House Call/Telemed Hybrid August 24, 2022 Mark Maydew, CFO/COO and Kelly Spring, PA-C from Duke City Cares walk us through their Medic Buddy Mobile Medical Care service. Duke City Cares is not only making house calls but connecting patients when needed to physicians via telemedicine via this mobile service. Performing a Physical via Telemedicine April 15, 2022 Dr. Tarun Girotra, Clinical Educator and Assistant Professor of Neurology at the University of New Mexico. Dr. Girotra presents various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. CLINICAL Leveraging Telehealth for Behavioral Health in Challenging Times December 14, 2022 Molly Brack, Clinical Director at the Agora Crisis Center and Wendy Linebrink-Allison, Program Manager of the NM Crisis Line and Elizabeth Glantz, 988 Project Manager with NM Behavioral Health Services Division. Presentation on how crisis line services can assist in closing gaps and build bridges for people who experience mental, emotional, and behavioral health and substance use concerns which do not replace community services, but fill in the gaps and create connections to support people in communities. Performing a Physical via Telemedicine April 15, 2022 Dr. Tarun Girotra, Clinical Educator and Assistant Professor of Neurology at the University of New Mexico. Dr. Girotra presents on the various levels of physical exam documentation over telemedicine and demonstrates how to perform the best possible physical exam during a telehealth visit. Addressing Provider Burnout December 01, 2021 Rick Vinnay, LCSW, CEAP - The Solutions Group EAP and Wellness Programs, and Pierce Ferriegel, CEO - The Community Lighthouse. Rick Vinnay and Pierce Ferriegel each have a different vantage point and discuss what their organization experienced and how they managed burnout. Telemedicine Clinical Specialties October 27, 2021 Dr. Randy Nederhoff, Neonatology, Dr. Rina Patel-Trujillo, Endocrinology, and Dr. David Phelps, Medical Director, PHS Urgent Care Clinics. For this webinar we bring you three medical specialists and their experience using telemedicine. They cover conducting a physical exam via telemed, using telemed for endocrinology, primary care, specialty care, surgical specialties and neonatal care. Telemedicine Clinical Specialties: Behavioral Health October 20, 2021 Lora Blazina, LPCC, Clinical Supervisor at The Mountain Center, Santa Fe’, Dr. Caroline Bonham, Vice Chair of Community Behavioral Health Policy, Department of Psychiatry and Behavioral Sciences, and Dr. Marita Campos-Melady, Clinical Psychologist and Director of Specialty Behavioral Health Therapy services at Presbyterian Medical Group. In this webinar we have three speakers as we explore tele behavioral health - the challenges, the successes and the innovations when using telehealth for serious mental illnesses, complex trauma, use in BH and medical settings and for adults as well as children. Expanding Your Telemedicine Services September 29, 2021 Dr. Elizabeth Krupinski, Phd, Southwest Telehealth Resource Center, and Dr. Van Roper, University of New Mexico. Whether you have been using telemedicine for 1 year or 10, Drs. Krupinski and Roper have some ideas for making the most of your telemedicine services, which can contribute to further sustaining your practice. Telehealth and COVID: Lessons Learned February 17, 2021 Van Roper, PhD, FNP-C, Associate Clinical Professor. This presentation covers telehealth basics, primary care specific applications, and lessons learned in the implementation of telehealth in small rural clinics during the COVID-19 pandemic. Care Integration in the Time of Covid: Focus on Patient Experience January 13, 2021 Elizabeth Krupinski, PhD, Southwest Telehealth Resource Center. This presentation focuses on ensuring patients have a positive experience during telemedicine encounters, starting from the first encounter at scheduling through the actual visit with the provider. Topics include incorporating the entire care team in telemedicine encounters and finding relevant quality indicators to measure success. INNOVATION The Ups and Downs of Digital Innovation in Healthcare November 16, 2022 Alex Carter, certified Physician Assistant, Presbyterian Healthcare Services’ Innovation Hub. A sought after speaker on this topic, Alex's presentation includes TytoCare as a case by which to discuss a system-wide Telehealth implementation, and get real with the many challenges they have. She weaves in other projects and tools as well. Rethinking How We Connect Hospitals, Specialists and Patients September 21, 2022 Darcy Litzen, MS, BSN, RN, VP of Sales for AmplifyMD. Physician video visits became necessary during the pandemic and are now widely accepted. But what if we take them a step further and use virtual care to provide a holistic solution to the ever-present cost-of-care and network adequacy pressures on health systems and insurers, while also addressing physician burnout and the complexities of providing timely specialty care locally? All with built-in continuous improvement? The Modern-Day House Call. Duke City’s Medic Buddy: House Call/Telemed Hybrid August 24, 2022 Mark Maydew, CFO/COO and Kelly Spring, PA-C from Duke City Cares walk us through their Medic Buddy Mobile Medical Care service. Duke City Cares is not only making house calls but connecting patients when needed to physicians via telemedicine via this mobile service. Growing Peer Support in the Virtual World. How Presbyterian Healthcare Service’s Community Health Built a Virtual Peer Network March 17, 2022 Valerie V. Quintana, MA, PTP, and Donald M. Hume, CPSW with Presbyterian Health Services, Community Health. Presbyterian Healthcare Service's Community Health department stood up a virtual peer network. In this presentation, Valerie Quintana and Donald Hume describe what they built and bring us their experience - the challenges, the successes, and what they learned in creating this new network. BUSINESS OF TELEHEALTH Telehealth Needs & Opportunities: Emerging Findings from BH Providers December 08, 2021 Margy Wienbar, MS, and Renee G. Sussman, RN, MA, MSN. This presentation briefly reviews the findings of the report “Telehealth Needs & Opportunities: F indings from Nonprofit Behavioral Health Providers in Northern New Mexico” that was published by the New Mexico Telehealth Alliance and Anchorum St. Vincent in July of 2021. Participants will hear from three of the organizations that were interviewed and contributed to the report’s findings. Telemedicine Billing & Coding: What You Need to Know September 08, 2021 Steve DeSaulniers from Blue Cross Blue Shield of New Mexico, Jennifer Sandoval from Molina Healthcare, Julie Wohrlin from Western Sky Community Care, Dr. Denise Gonzales from Presbyterian Healthcare, Lorelei Kellogg, NM HSD, and Moderator: Stetson Berg, UNM Center for Telehealth This full panel of speakers present and answer questions from attendees. Delta Variant is on the Rise: Is Your Telemedicine Practice HIPAA Compliant? September 01, 2021 Michael Herrick, Founder & CEO Matterform. With the rise of the Delta Variant, you may be thinking that we will be relying on telehealth more this fall. Are you compliant? Do you have concerns about your platform? Have you been relying on tools that won't be compliant once the Public Emergency Health order ends? Collective Learning of the Telehealth Learning Community March 31, 2021 Kate Gibbons, LCSW, LISW, Ph.D., of Janus LLC. A summation and update on the learning and data collected during the first cohort of the Telehealth Learning Community (TLC) for behavioral health providers. Show Me the Data: How COVID-19 Impacted Telehealth Claims & What Happens Next March 17, 2021 Stefany Goradia, MSIE-VP Health Analytics, RS21 Health Lab. COVID-19 caused a spike in telehealth as new payment models were approved and the healthcare industry pivoted rapidly to continue providing care via telehealth at the March onset. Since that time, organizations have witnessed declines in overall telehealth utilization, with some services slowly dwindling and others converting entirely back to in-person visits. In this case study, we will review an anonymized payer’s telehealth claim trends, services and conditions that were identified to be the most widely-adopted for telehealth between March and December 2020, and considerations for an ongoing telehealth strategy going into 2021. New Mexico’s Telehealth Stature Simplified: What You Need To Know March 10, 2021 Beth Landon, MBA, MHA-NMTHA Chair, and Stetson Berg, MHA-NMTHA Vice Chair. New Mexico enjoys one of the nation’s most progressive telehealth laws. Full payment parity and zero geographic restrictions comprise just part of the law; we also suffer zero limitations on eligible providers and no lifetime limits. This presentation and ensuing discussion intends to demystify the law, answer your questions, and gain your ideas on how to further improve the statute in subsequent legislative sessions. Developing Telehealth Workflow for Best Possible Patient and Provider Experience February 10, 2021 Jen Gruger, PMI-PBA. Delivering a successful telehealth visit is as much about the step-by-step workflow and how each individual involved executes their portion, as it is about the technology used and the clinical outcome we desire. This session will cover three essential components of building (or repairing) an effective and efficient workflow for this type of visit regardless of the telehealth platform being used. Using Remote Monitoring Technology to Improve Patient Outcomes & Retain Staff January 20, 2021 Arlene Maxim, RN. This presentation focuses on technology to augment home health care, an extremely valuable tool when clinicians use it effectively. Agency owners and managers are beginning to see the critical role that telehealth and remote care monitoring can play in keeping patients at home and improving patient satisfaction. Telehealth and remote care monitoring can also improve clinician satisfaction. During this session we discuss what to look for in a telehealth/remote care monitoring provider and how to market technology’s ability to improve patient outcomes and staff satisfaction. FUNDING FCC Rural Health Care Program Funding Opportunities March 24, 2021 Steve Constantine, SVP/CIO, Prairie Health Ventures & COO, and Marci L. White, FCC Rural Health Care Program Funding Specialist. The FCC Rural Health Care Programs provide funding opportunities for eligible healthcare providers across the U.S. to develop and grow their telemedicine programs. The two programs fund telecommunications and broadband services necessary for the provision of health care. In addition, the Healthcare Connect Fund allows opportunities for some urban participation as well as funding for data centers, administrative offices and certain network equipment. NMTHA TOWN HALL Town Hall: The Future of Telehealth September 22, 2021 Dr. Ronald S. Weinstein, na tional telemedicine pioneer, and Russell Toal, New Mexico Superintendent of Ins urance and local community. This special 90-minute town hall explores the possibilities of where we go from here. The town hall features speakers from local and state leadership, healthcare and YOU. INTERVIEWS: TELEH EA LTH EXPERTS Elizabeth Krupinksi , PhD, Southwest Telehealth Resource Center Jen Gruger , PMI-PBA, EHR Sup port Dept., Gerald Champion Regional Medical Center Geof Empey , Progra m Operations Director, University of New Mexico Center for Telehealth Kelly Schlegel , Director of the New Mexico Office of Broadband Access and Expansion Clincal Innovation Business Funding NMTHA Town Hall Highlighted Videos Experts in TH Highlighted NMTHA Webinar Series 10-week Educational Series From our 2021 10-week educational series, webinars focused on data, broadband in New Mexico, client engagement, and more! These webinars were hosted by the New Mexico Telehealth Alliance and made possible through funding by Health Resources and Services Administration Office for the Advancement of Telehealth and the Southwest Telehealth Resource Center. View Webinar Fall 2021 Webinar Series Topics include the future of telehealth, billing, using telehealth for clinical specialties, and more. View Webinar Webinars

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

Elo and 19Labs Partner To Offer Next Generation Telehealth Kiosks PR Newswire and 19 Labs July 2021 The partnership allows pharmacies, schools, and rural communities to go beyond just video calls and deploy eClinics with smart diagnostic devices and remote monitoring. The hospital-at-home trend is rapidly changing the healthcare industry. COVID-19 has accelerated telehealth technology's rate of innovation, and the industry has advanced by more than five years in just five months. Healthcare companies are now moving quickly to provide care in new locations and serve new use cases, bringing healthcare access not just to the home but also to other places like rural communities, schools, and pharmacies. 19Labs and Elo are working together to bring eClinics to these new locations globally. 19Labs' GALE eClinics are next generation point-of-care platforms that seamlessly integrate leading mobile and healthcare technologies into cost-effective and smart solutions such as telehealth carts, healthcare kiosks, or portable telehealth kits. They are highly secure, easily deployable, and can be operated by anyone with minimal training. "19Labs' eClinics enable our customers to easily deploy enhanced telehealth using the world's most advanced diagnostic devices: from ultrasound, ECGs, and even blood pressure," said Dan Ludwick, Chief Product Officer, Elo. "The eClinics do more than just video calls. They bring together Zoom, Amwell, custom wellness applications, and remote patient monitoring into a solution that can be easily used by anyone, which can drastically reduce operating and deployment costs." "Elo has been a great partner," says Ram Fish, 19Labs CEO & Founder. "They are a dynamic, innovative company with global reach, and we are happy to work with them in making healthcare more accessible worldwide. Their Android-based touchscreen systems are beautiful, well-engineered, and provide a unique, affordable solution to deploying kiosks in different form factors within the healthcare industry. Elo's tablets are built-to-last and highly reliable. Their commercial-grade hardware is complemented by great Android implementation. These make Elo's solutions perfect for enhanced telehealth." In Oaxaca, Mexico, the state's health ministry has been rapidly deploying 19Labs' eClinics. Dr. Lorena Ocampo, Chief Coordinator of Telemedicine at Oaxaca's Ministry of Health, says the next generation healthcare kiosks will significantly increase healthcare accessibility and quality in the region. "It's been a pleasure working with 19Labs and Elo. The impact these units have on the healthcare conditions within the community, and the ability to easily access advanced medical care, radically improves the quality of service that we are able to provide." About Elo As a leading global supplier of interactive solutions, #EloIsEverywhere. To date, we have deployed more than 25 million installations in over 80 countries. A new Elo touchscreen is installed every 21 seconds, on average, somewhere in the world. Built on a unified architecture, Elo's broad portfolio allows our customers to easily Choose, Configure and Connect & Control to create a unique experience. Choose from all-in-one systems, open-frame monitors and touchscreen monitors ranging from 10 to 70 inches. Configure with our unique Elo Edge Connect peripherals that allow use-specific solutions. Connect & Control with EloView®, a secure cloud-based platform for Android-powered devices. EloView enables secure deployment and management of a large network of interactive systems designed to reduce operating costs while increasing up-time and security. Consumers can find Elo touchscreen solutions in self-service kiosks, point-of-sale terminals, interactive signage, gaming machines, hospitality systems, point-of-care displays and transportation applications—to name a few. Learn more at EloTouch.com. About 19Labs 19Labs is the creator of GALE, Next Generation Point-of-Care platform for pharmacies, schools, and rural communities. GALE brings together "best of breed" diagnostic technologies from industry leaders like Zoom, Elo, Amwell, Eko, Samsung Mobile, MIR, Omron, Viasat, and many others in one smart, efficient, and cost-effective platform. It was designed from the ground up to be operated by non-healthcare professionals, in locations with limited infrastructure and optimized for low bandwidth and intermittent connectivity. To learn more about GALE, please visit www.19labs.com/platform. < Previous News Next News >

Why is an Alliance needed? NMTHA assists with ensuring telehealth program dollars are applied effectively and efficiently through : Clinical coordination Technical coordination Health information technology Administrative Services Federal, State, and private funds are spent on telehealth programs with little or no attention to coordination with other programs, efficient reuse of existing resources, and delivering the best level of cost-effective services. Existing and proposed programs create a patchwork of telehealth solutions with overlaps, gaps, and little long-term accountability. No entity coordinates telehealth statewide and ensures that telehealth programs and dollars generate the best possible health benefits for New Mexicans. How can New Mexico ensure dollars spent on telehealth programs are applied effectively and efficiently? New Mexico needs an organization to provide the following telehealth-related services: Clinical Coordination: Identifying healthcare delivery needs, finding organizations to deliver healthcare services, monitoring the delivery, and ensuring improved health outcomes. Technical Coordination: Identifying the proper technical solution for healthcare service delivery including equipment evaluation, telecommunications connectivity, reuse of existing resources, scheduling, network management, support, and maintenance. Health Information Technology: Managing information exchange among healthcare providers and ensuring compliance with federal, state, and other standards. Administrative Services: Reimbursement issues, administrative policy and procedures, legislative issues, and general management of the telehealth process. Every dollar spent on coordination ensures that dollars spent on specific telehealth programs generate the greatest improvement in health across all programs and regions of the State. Be part of the solution! Join the New Mexico Telehealth Alliance JOIN NOW

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

HIMSSCast: How emerging tech is opening new avenues in telehealth, RPM Mike Miliard October 28, 2022 Virtual therapeutics, voice recognition and fast-evolving artificial intelligence tools are transforming home-based care, says Robin Farmanfarmaian, co-author of the new book How AI Can Democratize Healthcare. Remote patient monitoring and other forms of virtual care are fast finding footholds in healthcare as patients get acquainted with these new care modalities, and as health systems learn to appreciate the cost efficiencies they offer. But telehealth and RPM are still in their early days, and fast-changing as they're augmented with other new and emerging digital health and artificial intelligence technologies. Robin Farmanfarmaian, a longtime Silicon Valley entrepreneur and co-author of the new book, How AI Can Democratize Healthcare, joined us recently to discuss how the growing momentum toward home-based care is being impacted by leading-edge innovations such as natural language processing, digital therapeutics and more. leading-edge-technologies-are-transforming-telehealth-and-rpm (1).mp3 Talking points: Where remote patient monitoring is now, and where it's headed How AI is changing how virtual care is delivered New approaches to patient engagement and experience What's next for digital therapeutics and other app-based interventions Innovative use cases for NLP and machine learning models More about this episode: The intersection of remote patient monitoring and AI How remote patient monitoring is moving into the mainstream AI-powered telehealth improves PT care at Essen Health Care Mayo Clinic working with Memora Health on virtual postpartum care AI-powered RPM can help address the rural neonatal care crisis How remote patient monitoring improves care, saves money AI and IoT device connects with concierge platform for RPM Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Healthcare IT News is a HIMSS publication. See original podcast: https://www.healthcareitnews.com/news/himsscast-how-emerging-tech-opening-new-avenues-telehealth-rpm < Previous News Next News >

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

What an eventual end to the PHE would mean for telehealth Andrea Fox October 17, 2022 Among other impacts, ending the PHE would represent access challenges and a loss of Medicaid coverage for millions, and would end medication-assisted treatment for opioid use disorder without an in-person exam. Since the COVID-19 public health emergency was declared in 2020, the Department of Health and Human Services has renewed the legislation every 90 days. Close to the end of the most recent expiration date, October 13, HHS Secretary Xavier Becerra again signed a renewal determination and it was posted without announcement late in the day. There had been no official news, but a lot of hearsay that the PHE would be renewed once more, because the Biden Administration indicated it would give two months' notice before its expiration. There is also the matter that open enrollment begins on November 1, and without the relaxed enrollment provisions for Medicaid that the PHE provides, the national uninsured rate along with health premium costs would certainly rise. But by definition an "emergency" can't last forever. The inevitable end of the PHE could result in the loss of Medicaid to millions when states review enrollee eligibility and in other impacts to healthcare operations. Questions regarding what will happen to telehealth benefits and the continuum of care in the absence of the PHE loom large. There has been extensive support for making the changes that have launched telehealth and provided the opportunity to serve more patients, but some people want to halt the prescribing of controlled substances via telehealth for mental health and substance abuse disorders and see the Ryan Haight Act – the online pharmacy consumer protection act of 2008 – reinstated. What's at stake Despite the Consolidated Appropriations Act of 2022, which provides a 151-day extension on some flexibilities granted during the COVID-19 public health emergency once the PHE ends, providers and other healthcare professionals engaged in telehealth are eager to prepare for the expiration date. There has been mounting pressure from the Republican Party, including a September 19 letter from Sen. Richard Burr, R-N.C., with numerous questions about ending emergency powers after President Joe Biden remarked during his September 60 Minutes appearance that "the pandemic is over." "Without a clear plan to wind down pandemic-era policies, the deficit will continue to balloon and the effectiveness of public health measures will wane as the American people continue to be confused by mixed messages and distrust of federal officials," wrote Burr. Despite economic concerns, ending the legal waivers afforded under the PHE could ricochet, hammering against gains made in increased patient access. Dr. Adrienne Boissy, Qualtrics chief medical officer (and former Cleveland Clinic chief experience officer), notes that patients continue to rely on expanded digital access as mental health effects from the pandemic linger. She says that a reversal would limit digital health access, which an overly burdened and understaffed industry has come to rely on. "The ease and convenience telehealth provides are consistent sources of positive patient experiences, as well as decreased total costs of care and less time away from the workplace," she said in a statement to Healthcare IT News. "Comparing 2016 to 2022, clinicians also report better health outcomes for patients, efficiency and less stress/burnout as major drivers for adopting digital tools, including telehealth," she said. "With the PHE, we saw the industry put patients and their access to care first – no longer hindered by location or demographics. "To revert back to reimbursement models that only support in-person care unravels the gains of meeting people where they are – physically and emotionally," said Boissy. "We can’t turn back now," Boissy said. Brad Kittredge, CEO and cofounder of Brightside Health, adds that the country will be short of psychiatrists – by 14,280 to 31,109 – in just a few years. Ending the PHE presents a reduced ability to serve the growing number of patients in need of or seeking mental healthcare, he said. "While there’s no silver bullet solution, telehealth offers the best and most immediate solution to this growing challenge by increasing patient access to mental health specialists without being limited to geographic regions or facilities," Kittredge explained in a statement sent to HITN. "More significantly, telehealth enables us to use technology and data to help clinicians be more efficient and effective at treating their patients, maximizing the impact they can make," he said. Telehealth in legislative limbo During a recent American Telemedicine Association policy update, the ATA's federal and state-level telehealth policy experts described efforts to develop a consistent regulatory framework so telehealth can be deployed across states, be fully leveraged and address the patchwork of 50 different state requirements. Legislators have also proposed broadening access to telehealth through the Telehealth Benefit Expansion for Workers Act, the Telehealth Extension Act and the Advancing Telehealth Beyond COVID-19 Act of 2021, which was passed by the House of Representatives in July, received in the Senate and referred to the Committee on Finance, where it sits. Also at play are a number of loosened restrictions that opened the gateway to online treatment of certain conditions when uptake surged and access to in-person medical care was restricted. Healthcare organizations and retailers entering the space through mergers and acquisitions with healthcare providers have urged the U.S. Justice Department and the Drug Enforcement Agency to revise telehealth controlled substance rules. The bill H.R. 7666 – the Restoring Hope for Mental Health and Well-Being Act of 2022 – introduced by Rep. Frank Pallone Jr., D-N.J., which was passed in the House, aims to address this hot-button issue for mental telehealth providers. The bill would permanently eliminate the X waiver, currently not required under the PHE. To qualify for the waiver to dispense buprenorphine for maintenance or detoxification treatment, the practitioner must take an eight-hour training and may only treat up to 30 opioid use disorder patients. Dr. Kristin Mack, a physician in Ticonderoga, N.Y., told MedPage Today that she would like to see the X waiver eliminated permanently. According to the story, rural communities are some of the hardest hit by the opiate epidemic. "We work really hard with community resources to provide counseling and things like that. But if I were to tell somebody, 'Oh, you have to go an hour away to a city to get care for this,' and then they need to be seen monthly, it's just not an option," she said. The Restoring Hope for Mental Health and Well-Being Act of 2022 was received in the Senate and was referred to its Committee on Health, Education, Labor and Pensions at the time of reporting. Treating opioid use disorders via telehealth It has been more than 10 years since the Ryan Haight Act mandated that DEA establish a rule ensuring that healthcare providers can successfully prescribe controlled substances via telehealth, but there has been no rule set forward. The SUPPORT Act again mandated the DEA issue rulemaking by October 2019 and the fiscal year 2021 final appropriations report requested that the agency establish these rules, according to the website of Sen. Mark Warner, D-Va. This past year he urged the Biden Administration to finalize regulations that allow doctors to prescribe controlled substances through telehealth. "In practice, the DEA’s failure to address this issue means that a vast majority of healthcare 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. These restrictions have been temporarily waived during the COVID-19 public health emergency, and I welcome that, but patients and providers need a more permanent and long-term solution to this long-delayed rulemaking," Warner wrote in May 2021. Under the PHE, several virtual behavioral health startups focused on medication-assisted treatment for substance abuse disorder received investment rounds, according to Chris Larson at Behavioral Health Business. According to the story, Doug Nemecek, the chief medical officer of behavioral health for Evernorth, said that not enough people are accessing MAT, and that overdose rates have reached historic highs. "If regulations come back that prevent those companies from being able to deliver care in that way, we’re concerned that it’s going to have a negative impact on patients and our ability to make sure that people have access to the MAT that we want them to have access to," Nemecek said. Evernorth, part of Cigna Corp., is connected to digital MAT companies like Quit Genius. The cofounder of Quit Genius, Dr. Maroof Ahmed, explained in an email to Healthcare IT News that telehealth has filled a void that existed before the PHE. "Telehealth flexibilities and ePrescribing waivers have been crucial in enabling providers to care for patients during the pandemic and have greatly expanded access to care in situations where patients were unable or unwilling to travel to a physical location," he insists. Reinstating Ryan Haight Act requirements also has support Amending the Ryan Haight Act law is an effort largely supported in the healthcare and mental health space. However, Dr. Mimi Winsberg, CMO and the other cofounder of Brightside Health, shared another point of view regarding the dubious practice of prescribing controlled substances without an initial in-person visit. "To count on a public health emergency temporary lifting of laws in order to stimulate growth of your business is perhaps a questionable practice," she told Healthcare IT News, noting that Brightside adhered to not prescribing controlled substances over telemedicine despite the legal waivers. "While a lot of medical visits moved to tele during this sort of difficult part of the pandemic, that now in most specialties, they have gone back to in-person, but what we are seeing in mental health is about 80% have stayed remote," she added. "And so patients are continuing to get their mental healthcare largely through telemedicine." Winsberg entertained the question out loud: "Will they be resistant to in-person appointments if they need certain kinds of prescriptions?" "I don't think they will because we have seen that they're willing to go back to the doctor for other reasons," she added. The net growth of prescription drugs issued – stimulants and other controlled substances – grew during the pandemic, and she says she questions if the growth was largely driven by online practices "that were taking advantage of the lifting of the Ryan Haight Act." Winsberg did acknowledge, however, that an inability to prescribe buprenorphine via telehealth for substance abuse disorder, "is potentially an issue," she said. "These laws exist for a reason, and what we have to balance in medicine is the willingness to help people with the do no harm principle." Establishing systematic monitoring of controlled-substance prescribing via telehealth could be achievable, Winsberg said. "But, we'd like to move towards appropriate prescriptions of controlled substances, and if we can find a way to meaningfully regulate that online, then great," she concluded. Equal treatment for mental health disorders In January, Dr. Robert Field and doctoral candidate Kimberly Williams at Drexel University published a commentary on the National Academy of Medicine website on the long overdue policy update needed to prescribe buprenorphine via telehealth. The authors say that those who need treatment for opioid use disorder should have the same level of telehealth access as others who receive treatment for other medical concerns. They also noted that the DEA has not created a registration process through the online pharmacy consumer protection act, despite Congressional requests and statutory actions. "Doing so would not only ensure increased access to treatment but also set the stage for systematic monitoring of telemedicine and telephone services to confirm they meet the same rigorous standards of care as in-person services. "Such quality assurance efforts could promote the development of best practice guidelines and reduce variations in care as usage of these modalities increases," they argue. For the mental telehealth provider community wondering if the ability to prescribe buprenorphine via telehealth fades away in five months – if the Biden Administration does not intervene and extend the PHE, Congress does not pass legislation and the DEA does not create a registration process for prescribing controlled substances for opioid use disorder via telehealth – the U.S. may face even higher overdose rates. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication. See original article: https://www.healthcareitnews.com/news/what-eventual-end-phe-would-mean-telehealth < Previous News Next News >

Effects on Patient Access to Telehealth as Some State Emergencies End Center for Connected Health Policy July 2021 With state of emergency declarations expiring or being lifted in states, there is growing concern patients are being left with reduced access if no permanent telehealth policy changes have been enacted. With state of emergency declarations expiring or being lifted in states, there is growing concern patients are being left with reduced access if no permanent telehealth policy changes have been enacted. According to the National Academy for State Health Policy (NASHP), nearly 20 states no longer are under emergency orders, with many soon to follow. Many states attached telehealth flexibilities to the federal public health emergency (PHE) while others made them contingent on state emergency declarations. Some states have successfully passed legislation to extend certain telehealth flexibilities in advance of state of emergency expirations, such as Connecticut and Delaware. The federal government Emergency Preparedness and Response for Home and Community Based (HCBS) 1915(c) Waivers were often originally tied to state emergencies, but appear to now extend 6 months after the federal PHE ends. Alaska is one of the states no longer under a state of emergency. During the pandemic a local outlet reported thousands of patients were being referred to out-of-state providers, especially in Washington, via telehealth for a variety of reasons including lack of specialty care and long wait times. Once the emergency licensing waivers expired, however, Seattle hospitals were sent rushing to reschedule Alaska patients and resume the more stringent process of becoming licensed in Alaska. According to recent local reports, Florida’s emergency expiration also took away audio-only and the ability to use telehealth to prescribe controlled substances and recertify medical cannabis patients. The Florida Medical Association told the local news outlet they will continue the push to make telehealth changes permanent in the next state legislative session, especially those requiring insurer reimbursement and payment parity, without which they say telehealth will simply no longer be made available to patients. For more information on the status of the emergency orders in each state visit the NASHP website - https://www.nashp.org/governors-prioritize-health-for-all/. < Previous News Next News >

Board of Directors BOARD A message from the Chair: Stetson Berg Thanks to our work at the Alliance and a terrific Legislature, New Mexico enjoys one of the most progressive telehealth statutes in the country. That doesn’t mean our work is done. The New Mexico Telehealth Alliance exists to support New Mexico telehealth capabilities by continuing to advocate for needed policy changes, providing useful resources in a variety of formats, and creating mechanisms for convening and sharing. We offer educational webinars, online forums, links to resources, and networking opportunities. Connect with us and participate in strengthening New Mexico's access and capacity to provide care across our vast State by bringing a telehealth-related problem you need help solving, joining a committee, participating in our webinars, or sharing your expertise as a speaker. Stetson Berg, MHA UNITED HEALTHCARE COMMUNITY AND STATE Chair Executive Committee Member Alex Carter, DMS, PA-C OCHSNER HEALTH Vice Chair Executive Committee Member Jennifer Sandoval, MHA MOLINA HEALTHCARE NEW MEXICO Secretary Executive Committee Member Maggie McCowen, LISW, MBA BEHAVIORAL HEALTH PROVIDERS ASSOCIATION OF NEW MEXICO Treasurer Executive Committee Member Jerry Harrison, PhD NEW MEXICO HEALTH RESOURCES Executive Committee Member Beth Landon, MBA, MHA LANDON & ASSOCIATES Immediate Past Chair Executive Committee Member Robert Longstreet NEW MEXICO PRIMARY CARE ASSOCIATION Executive Committee Member Richard Draper, JD COMAGINE HEALTH Advisory Council Chair Dale Alverson, MD UNM, PROFESSOR EMERITUS TOUCH-TSC, LLC Gisela Bartolome, MBA SYNCRONYS Kate Berg, RN UNM PROJECT ACCESS Christine David, MBA PRESBYTERIAN HEALTHCARE SERVICES Anneke Frankel, MPH UNITED HEALTHCARE COMMUNITY AND STATE Maggie Gunter, PhD SYNCRONYS TOUCH-TSC, LLC Annie Jung, MD NEW MEXICO MEDICAL SOCIETY Monica Marthell, DHA BLUE CROSS / BLUE SHIELD OF NEW MEXICO Niles McCall, MLS, CHCP NEW MEXICO MEDICAL SOCIETY Joy Thompson ALLIANCE FOR NAVAJO BROADBAND SPECTRUM SOLUTIONS, LLC

AHA Requests Information on Telehealth Prescriptions for Controlled Substances Mark Melchionna December 05, 2022 The American Hospital Association has asked the Drug Enforcement Administration to release information regarding future telehealth regulations for prescribing controlled substances. Representing nearly 5,000 member hospitals, health systems, and other healthcare organizations, a letter from the American Hospital Association (AHA) asked that the Drug Enforcement Administration (DEA) clarify future telehealth regulations for prescribing controlled substances and provide recommendations for an interim plan. Before the COVID-19 pandemic, some policies prohibited the use of telehealth for certain medical activities. For example, the Ryan Haight Act of 2008 amended the Controlled Substance Act to eliminate providers' ability to prescribe controlled substances through telehealth with no in-person visit beforehand. The act detailed the need for initial in-person evaluations before virtual prescribing controlled substances. However, exceptions to the in-person visit requirement can be enacted during public health emergencies (PHEs). This led the DEA to temporarily lift the in-person visit requirement during the COVID-19 pandemic, allowing patients to continue receiving controlled substance medications. Through the pandemic, the flexibilities helped support patients in various ways, including enabling prescriptions of controlled substances to be delivered via telehealth and allowing providers to use telephone evaluations to initiate buprenorphine prescribing, the AHA noted. The AHA sent the letter to the DEA to obtain further information regarding the future of these telehealth flexibilities. About 14 years ago, the Ryan Haight Act established the requirement that agencies issue a regulation that outlines the special registration process for telemedicine to waive the in-person requirement. Three years ago, the SUPPORT Act reinforced this policy. However, providers are continuing to wait for guidance with the concern that the expiration of the COVID-19 PHE will put them in a position where they cannot provide treatment. "With the expiration of the COVID-19 PHE currently scheduled for next year, this situation could come to pass as early as mid-January," the AHA wrote. Thus, the AHA has asked the DEA to provide proposed rules for the special registration for telemedicine process, noting that issues such as staffing shortages, provider burnout, and financial constraints would benefit from more time to reallocate resources to operationalize new regulation requirements. The letter also included a request for the DEA to provide an interim plan to support the continuity of care between the expiration of the COVID-19 PHE and the implementation of the special registration for telemedicine final rules. According to the AHA, the interim plan should include waiving the in-person requirement for prescribing buprenorphine. Further, the waiver should be transitioned and incorporated under the Opioid Epidemic PHE, according to the association. The letter also recommends that the DEA provide patients engaged in an episode of care that began virtually before the end of the COVID-19 PHE with a solution and support those who initiated an episode of care between the end of the COVID-19 PHE and the establishment of the final rules for special registration for telemedicine. The AHA letter comes as healthcare stakeholders urge Congress to solidify various telehealth flexibilities enacted during the pandemic. In December, a letter composed by the Connected Health Initiative (CHI) to the leaders of the US Senate and House Representatives asked that Congress continue the safe harbor for telehealth coverage by high-deductible health plans (HDHPs). In this letter, CHI noted its support for removing restrictions to telehealth access facing Medicare beneficiaries; however, it also asked that Congress separately extend the safe harbor for HDHPs to cover telehealth with first-dollar coverage. See original article: https://mhealthintelligence.com/news/aha-requests-information-on-telehealth-prescriptions-for-controlled-substances < 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 >

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

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

Audio-Only Telemedicine In Primary Care: Embraced In The NHS, Second Rate In The US Rebecca Fisher, Urmimala Sarkar, Julia Adler-Milstein December 5, 2022 Use of telemedicine in primary care soared in the first wave of the COVID-19 pandemic and remains well above pre-pandemic levels. In the US, a major enabler of this shift is equal reimbursement across video, audio, and in-person visits. Policy makers must now choose whether to extend these COVID-19-era telemedicine policies. A key decision is whether audio-only telemedicine should be covered and if so, whether it should retain parity with video-based telemedicine. The dominance of video over audio in the US suggests that an appropriate policy strategy would be to not reimburse for audio-only telemedicine or reimburse at markedly lower levels. However, US policy makers would be wise to look internationally first—where experience suggests that audio-only can be an effective and more equitable means of delivering primary care. In the National Health Service (NHS) in England, almost one in three consultations in general practice is audio-only; a figure that has been stable since October 2021. This represents a major rise; pre-pandemic around 10 percent of consults were by phone. Despite efforts from UK policy makers such as fast-tracking funding for online consultation tools, the number of video consults remains stubbornly low, at just 0.4 percent of appointments. This is despite the fact that most NHS primary care practices are video-equipped, and the US and UK populations do not differ significantly in their digital literacy. What Explains The Higher Levels Of Audio-Only Telemedicine In The UK Versus US? There is no evidence that directly answers this important question. We therefore leverage circumstantial considerations to develop three possible explanations. National Policy Given the active efforts of policy makers at the start of the pandemic to expand availability of telemedicine, an initial explanation is that the countries implemented different policies regarding telemedicine provision—with the US pursuing policies that favored video while the UK pursued policies that favored audio. However, we are not aware of any such policy differences. In both countries, policy makers acted swiftly to make it easier for providers to consult using either modality. National guidance issued to practices in England encouraged use of phone and video encounters “tailored to the person, the circumstance and their needs,” but there was no directive to prioritize audio-only above video consulting. In the US, emergency legislation removed barriers to telemedicine consulting, including giving parity of reimbursement across audio and video encounters (theoretically an incentive to drive up audio-only rates). Both countries reduced regulatory barriers to video consultation, allowing providers to use non-medical video call applications such as Skype and Facetime. But neither country mandated—or strongly incentivized—provision of one telemedicine modality over the other. Path Dependence A second explanation is one of path dependence. The idea that faced with the need to act fast and little central planning or coordination, health care delivery organizations disproportionately scaled-up the form of telemedicine that made sense given prior circumstances before the pandemic. In the NHS, the use of audio-only for triage and traditional encounters in general practice was common pre-pandemic. In 2019, 10 percent of encounters in English general practice were by phone, compared to fewer than 1 percent across both telemedicine modalities in the US. The public was also used to receiving health advice by phone—the NHS 111 service is a free phoneline to help people in England access non-emergency medical advice and to link them to local NHS services. Thus, when the pandemic hit, it was easier to act quickly to scale the more familiar modality of audio. In contrast, the US did very little of either modality pre-pandemic, and in an effort to more closely replicate face-to-face care at the start of the pandemic when in-person care was not an option, US practices chose to ramp up video-based telemedicine. Provider Perceptions Of Quality While path dependence emphasizes the concept of choice driven by ease, a third potential explanation is that, instead of prior familiarity driving decisions about modality offerings, these decisions were driven by different perceptions of the strengths and limitations of each modality. In the UK, analysis of why general practitioners hadn’t used video consultations found that despite improvements in functionality and reliability of video consultation tools, practitioners viewed video encounters as logistically more challenging and more cognitively demanding than either face-to-face or telephone consulting. Physicians felt that many presenting problems could be sorted safely by telephone, with in-person assessment required for the remainder. Where problems required visual assessment, physicians preferred a combination of photograph plus telephone consultation (SMS technology is widely embedded in general practice [GP] electronic health records). Consensus from UK physicians seems to be that video provides little benefit over audio-only. Differential uptake of video over audio-consulting suggests that US physicians feel differently; surveys of US physicians have highlighted concerns about the diagnostic accuracy of telephone visits, and their suitability for new patients. The acceptability of different telemedicine modalities to patients is another dimension of quality that could have driven what health care delivery organizations offered. Evidence from the UK suggests that telephone appointments are a popular appointment modality in general practice. Indeed, analysis of 7.5 million patient-initiated requests for care across 146 primary care providers found that telephone consultation was the most popular patient preference, requested by 55 percent of people seeking care, with fewer than 1 percent of requests seeking a video consult. In the US, one trial reports similar patient satisfaction with audio and video consults, but it is possible that US physicians felt that patients expected video consultations and made efforts to oblige. Based on circumstantial evidence, we suspect that path dependence and perceptions of quality worked together to push the countries in different directions. While more conclusive evidence is needed, explanation three raises the more critical question of how to move from perceptions of quality differences to robust evidence that can inform choice of modality. What Is Currently Known About Which Modality Is Better From A Quality Perspective? The clearest evidence on differences between modalities is about access, where audio-only has clear advantages over video consults in promoting equity. People with the greatest need for health care may be least enabled to access it digitally—termed the “digital inverse care law.” In both the US and the UK, digital exclusion is socially patterned. Older people, those in lower-income groups, people with disabilities, or who do not have English as a first language are more likely to be digitally excluded. In the telemedicine context, video visits require digital literacy and access to technology and broadband/data that are not ubiquitous. On the health system side, providing video visits requires health centers and staff to overcome barriers including cost, training, and technology. These barriers may be more likely to occur in safety-net settings. In the US, video visits are more common in people earning above $100,000, White people, younger people, and people with private health insurance. In contrast, users of audio-only telemedicine are more likely to be Black people, older adults, and on Medicaid. With telephony already embedded in health centers and 97 percent of Americans owning cell phones, audio-only telemedicine represents an important means of accessing care for underserved populations. Beyond equitable access, we lack evidence on differences in other dimensions of quality between the two consultation modes, either overall or in specific clinical scenarios. Unfortunately, there is a major obstacle to such evidence generation: In the US, we do not routinely capture the specific telemedicine modality in use and therefore cannot readily compare audio-only to video encounters. Ruth Hailu and colleagues describe the range of interventions—including simplifying coding and adapting electronic health records—required to generate data that would support comparative analysis. However, even with such data available, the choice of modality is non-random, and individuals are likely to receive a blended mix of consultation types during episodes of care. Disentangling the impact of each encounter modality on a range of clinical and patient-reported outcomes would be a substantial research undertaking. Large, diverse population observational studies may be required, alongside a range of qualitative studies of patient and physician experience. Some of this evidence will take years to gather, and decisions on extending coverage beyond the pandemic emergency will likely be required before a full picture is clear. Neither health system can claim an “evidence-based” strategy—and it likely that neither the US nor the NHS has it right yet. So Where Does This Leave Policy Makers? In the UK, there is no urgent policy decision to be made around reimbursement, since all forms of telemedicine are covered by the capitated payment system for general practice. Instead, debate has focused on whether access to in-person appointments is now too limited. This is framed by decreasing public satisfaction with access to general practice, in the context of ongoing and severe shortages of primary care physicians. Despite nudges from policy makers, the pandemic has barely shifted the number of video consultations in general practice, and use of telephone consulting has expanded instead. Ongoing studies will monitor outcomes of this change and may require expansion to help the NHS identify an optimal blend of consulting modes. With UK general practitioners unconvinced of quality benefits of video consultations, it is likely that compelling evidence of their benefit would be required for use to increase. US policy makers face more difficult choices about ongoing reimbursement for audio-only telemedicine. The Consolidated Appropriations Act of 2022 extends certain telehealth coverages for 151 days after the official end of the federal public health emergency, thus going some way to preventing a “telehealth cliff.” But with the World Health Organization recently discussing for the first time the possibility of ending their emergency declaration on COVID-19, decisions about funding for audio-only and/or video will need to be made relatively soon. In the absence of robust evidence, decisions are likely to hinge on perceptions of the quality of different consultation modes. Arguments against payment parity between audio-only and video telehealth are likely to focus on early perceptions that audio is a lower-quality modality or prone to overuse. These arguments and their rebuttals have been clearly described already. However, given the clear evidence of the meaningful benefits for reaching underserved people, the US should extend coverage of audio-only telemedicine for a minimum of five years. During this time, perceptions of quality can be informed by empirical evidence, such that we can either phase out audio-only in an equitable way or give providers more flexibility to combine use of modalities. Even with reimbursement parity, policy makers will need to invest in complementary enablers of equitable telemedicine access through state-level action. As Elaine Khoong writes, avoiding a two-tier system where video encounters are disproportionately available to the wealthy requires policy makers to expand video-visit capacity in the safety net, alongside community-based strategies to improve digital literacy. Given that telehealth does not necessitate the same geographical constraints as in-person care—for example, with respect to physician licensing or online prescribing—amending policies to streamline provision across states is also vital. A Role For Payment Reform? The past two years have shown that telephone and video consultation can be combined to deliver high-quality and efficient care. Going forward, patients are likely to receive a blended mix of appointments across modalities, tailored to clinical need and individual circumstance. In the NHS, capitated payments give clinicians and managers the flexibility to offer a mix of appointment modalities, based on the clinical situation without the need to consider differential reimbursement or administrative burden. In fee-for-service models, differentiating payment levels across telemedicine modalities is likely to increase bureaucracy and risks decreasing efficiency and quality. In the longer run, experience from both systems suggests that we should move away from modality-based reimbursement. In recent testimony to the US Senate’s Committee on Finance, Robert Berenson suggested that fee-for-service is a particularly flawed payment model for telemedicine, and that the Centers for Medicare and Medicaid Services should consider paying for telehealth services in a similar model to the UK: via monthly capitated payments for primary care physicians as part of a hybrid payment model. Capitated payment systems enable physicians to use the encounter modality considered most appropriate for the situation without worrying about how they will be paid (or the patient billed). Berenson’s proposal would allow physicians and patients to tailor the type of telemedicine encounter more precisely to individual patient need and might reduce bureaucracy associated with billing, in turn increasing efficiency. As evidence on the benefits and risks of each modality emerges, such a payment model also allows rapid translation of evidence into practice. Authors’ Note Professor Sarkar holds current research funding from the National Cancer Institute, California Healthcare Foundation, the Food and Drug Administration, HopeLab, and the Commonwealth Fund. She has received prior grant funding from the Gordon and Betty Moore Foundation, the Blue Shield of California Foundation, and the Agency for Healthcare Research and Quality. She received gift funding from The Doctors Company Foundation. She holds contract funding from AppliedVR, InquisitHealth, Somnology, and RecoverX. Professor Sarkar serves as a scientific/expert adviser for nonprofit organizations HealthTech 4 Medicaid (volunteer) and for HopeLab (volunteer). She is a member of the American Medical Association’s Equity and Innovation Advisory Group (honoraria). She is an adviser for Waymark (shares) and for Ceteri Capital I GP, LLC (shares). She has been a clinical adviser for Omada Health (honoraria), and an advisory board member for Doximity (honoraria). See original article: https://www.healthaffairs.org/content/forefront/audio-only-telemedicine-primary-care-embraced-nhs-second-rate-us#.Y45MpkrZubQ.twitter < Previous News Next News >

Making Telemedicine Feasible for Everyone – Especially Those With Physical Challenges Elizabeth A. Krupinski, Southwest Telehealth Resource Center August 2021 In the context of healthcare, nondiscrimination on the basis of disability means equal access to available health care services, whether those services are provided in-person or via telehealth. Telemedicine has for years been touted as providing access to healthcare for everyone, anywhere, anytime and it has been quite successful in doing so in many respects but disparities still exist among a number of patient populations. In particular, those who traditionally have challenges accessing healthcare due to physical challenges often experience similar or even greater challenges with telemedicine. Think about for a minute. Telemedicine is predominantly provided using audio and/or video-based telecommunications technologies. This fundamental fact of how telemedicine visits occur can actually exacerbate digital disparities. According to the Americans with Disabilities Act (ADA), an individual with a disability is defined as: 1. a person who has a physical or mental impairment that substantially limits one or more major activities; or 2. a person who has a history or record of such an impairment; or 3. a person who is perceived by others as having such an impairment Under Section 504 of the 1973 Rehabilitation Act, no qualified individual with a disability shall, by reason of his or her disability, be excluded from the participation in, denied the benefits of, or subjected to discrimination under any services, programs, or activities of the covered entity (e.g., healthcare providers). In the context of healthcare, nondiscrimination on the basis of disability means equal access to available health care services, whether those services are provided in-person or via telehealth. Some basic facts highlight the problem. About 15% of American adults (37.5 million) over 18 report some trouble hearing, 2 to 3 per 1,000 US children are born with detectable hearing loss in one or both ears and overall 1 in 8 people (13%) 12 years or older has hearing loss in both ears. Interestingly, non-Hispanic white adults are more likely than other racial/ethnic groups to have hearing loss and non-Hispanic black adults have the lowest prevalence among adults aged 20-69. Rates increase with age. The statistics for vision impairments are equally high. About 12 million people over 40 years have a vision impairment, with 1 million who are blind and 6.8% of children younger than 18 have a diagnosed eye and vision condition. The annual economic impact of major vision problems for those over 40 is over $145 billion! For blindness, access to healthcare is especially critical as 90% of blindness caused by diabetes is preventable and early detection and treatment of conditions such as diabetic retinopathy is efficacious and cost effective. So what can we do in the telemedicine community to help ameliorate these disparities? The National Consortium of Telehealth Resource Centers has developed a fact sheet to help providers. Some of the key recommendations are actually fairly easy to carry out. Inventory products, services, and factors required to provide effective telehealth services to patients and ensure they meet basic accessibility requirements for people with disabilities. Consider compatibility of assistive technology (e.g., alternative keyboards) and whether they can work effectively with your chosen telehealth modality. Learn about and incorporate accessibility features (e.g., close-captioning) of software programs you use. Be sure to include the patient’s caregiver, family member, or home health aide during telehealth visits. Increase your knowledge and awareness on cultural competency and linguistic sensitivity. The easiest thing to do ask patients with disabilities about their accessibility requirements! Some additional aids to consider may take a little more effort but are worth it. For those with hearing loss consider: qualified sign language interpreter, qualified cued-speech interpreter, qualified tactile interpreter, real-time captioning or communication access real-time translation (CART), video remote interpreting (VRI), use written materials, ensure the patient has access to headphones or a headset, confirm participants are wearing their hearing aids or amplification device, and use video whenever possible to allow lip reading and provide visual clues like gestures. For those with vision loss consider: a qualified reader, information in large print, Braille, or electronically for use with a computer screen-reading program, have an audio recording of printed information, be aware of your background - there needs to be contrast between you and your background and blurring the background may make it challenging for the patient, ensure lighting is bright enough for patients to clearly see your face, use simplified and enlarged text, ensure patients have a computer-screen reading program for transmission of electronic information and try providing an audio recording of printed information provided during the appointment. Additional ideas and tips can be found on the Health & Human Services (HHS) website There is also good news in terms of funding. The Federal Communications Commission (FCC) recently announced that under the National Deaf-Blind Equipment Distribution Program (NDBEDP), also called “iCanConnect,” may provide up to $10 million annually from the interstate telecommunications relay service fund (TRS Fund) to support local programs that distribute equipment to eligible low-income individuals who are deafblind to access telecommunications service, Internet access service, and advanced communications services. This is clearly a boon for telemedicine applications. The announcement includes a state-by-state list of the initial allocations for the 56 covered jurisdictions. Hearing and vision loss are just two common challenges deal with. Other physical, mental and behavioral challenges are very common as well, and many of the tips above can be adapted to these patients as well, especially simply reaching out and asking them what their needs are and how you can help meet them as well as involving the patient’s caregiver, family member, or home health aide during telehealth visits. Basically telemedicine must be available to any patient and programs should make it a priority to develop strategies and tools to empower all patients no matter what their resources and capabilities to access safe, effective and efficient care. < 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 >

US Reps Push for Extension of Telehealth Flexibilities for HDHP Members Mark Melchionna December 15, 2022 Three US Representatives led a bipartisan group of lawmakers in submitting a request to Congress to extend telehealth flexibilities for some high-deductible health plan members. In anticipation of critical telehealth flexibilities expiring on Dec. 31, US Representatives Michelle Steel (CA-48), Brad Schneider (IL-10), and Susie Lee (NV-3), along with a bipartisan group of 30 Congress members, sent a letter requesting that House leadership include two pieces of legislation that extend some flexibilities in a year-end package. When the COVID-19 pandemic began, patients and providers turned to telehealth in droves to maintain care. According to the Centers for Disease Control and Prevention (CDC), there was a 154 percent increase in telehealth visits when comparing data from the last week of March 2020 with that of March 2019. This uptake of telehealth was likely associated with the withdrawal of regulatory restrictions in response to the limitations placed on in-person care during the public health emergency. As part of the CARES Act of 2020, Congress passed reforms that expanded access to telehealth services. For instance, prior to the CARES Act, Americans with high-deductible health plans (HDHPs) coupled with health savings accounts (HSAs) had to reach the minimum deductible before they qualified for telehealth coverage. However, Section 3701 of the CARES Act eliminated this requirement initially through Dec. 31, 2021. The provision was later extended through the Consolidated Appropriations Act, 2022. This led to wider coverage of telehealth services as health plans and employers were able to expand access to virtual care services for individuals with HDHP-HSAs pre-deductible. According to the representatives, increased access has led to many benefits for patients, particularly those without access to transportation services and those who reside far away from clinical locations. “Access to telehealth has also provided a significant portion of the U.S. workforce relief at a time when household costs are rising. Telehealth has allowed families to avoid taking time off from work to travel to and from appointments, and timely care has helped prevent costly visits to urgent care or the emergency room. Unfortunately, those with a high deductible may decide to skip critical preventative services – including primary care and behavioral health services – if the deductible is not waived, often leading to poor health outcomes and more costly care down the line,” the letter states. Due to the increasingly apparent benefits of telehealth, the US representatives are requesting that House leadership include the Primary and Virtual Care Affordability Act and the Telehealth Expansion Act in the end-of-the-year package. The Telehealth Expansion Act would make the telehealth flexibility permanent for people with HDHP-HSAs. The Primary and Virtual Care Affordability Act would both extend the flexibility and allow insurance providers to cover primary care services pre-deductible. This letter is part of a larger effort among healthcare stakeholders to ensure that expanded access to telehealth is solidified. Another letter written by the Connected Health Initiative (CHI) requested that Congress extend the safe harbor for telehealth coverage by HDHPs. In the letter, CHI noted its support for removing restrictions impeding telehealth access among Medicare beneficiaries. It also emphasized the upcoming telehealth deadline Americans with HDHPs will face at the end of 2022. Due to this, CHI requested that Congress extend the safe harbor for HDHPs to cover telehealth with first-dollar coverage. This would also allow them to maintain HDHP status. See original article: https://mhealthintelligence.com/news/us-reps-push-for-extension-of-telehealth-flexibilities-for-hdhp-members < Previous News Next News >