The Centers for Medicare and Medicaid Services (CMS) allows practitioners to render telehealth services from their home without reporting their home address on their Medicare enrollment or billing paperwork. This will end on December 31, 2023. The current location-based enrollment structure is outdated and does not support providers new operational and privacy concerns faced in a digital age. For additional coverage, see Inside Telehealth.
We invite organizations to sign this letter by Tuesday, October 17.
Alliance for Connected Care: Alliance Submits Comments to House Ways & Means Committee RFI (10/5) - The Alliance submitted comments to the House Ways & Means RFI on ways to incentivize access to care in rural America. The Alliance highlights how telehealth and remote patient monitoring (RPM) connect rural patients to timely specialty care; low Medicare payment to rural practices disincentivize investment to telehealth and RPM; and how telehealth can expand access to the health care workforce.
Drug Enforcement Administration (DEA): Second Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications (10/11) - On October 6, the DEA released a second temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications. The second temporary rule extends these flexibilities to December 31, 2024. Note that this change will align DEA telemedicine flexibility with broader statutory telehealth restrictions, with most restrictions now set for December 2024. The DEA notes that the extension will allow it to thoroughly consider presentations made during the Telemedicine Listening Session, which the Alliance for Connected Careand other stakeholders participated in. Additional coverage can be found on The Hill, Healthcare Dive, Behavioral Health Business, and others.
House Energy & Commerce Committee: Chairs Rodgers and Guthrie Announce Health Legislative Hearing on Strengthening Patient Access to Care in Medicare (10/19) - The House Energy & Commerce Committee, Subcommittee on Health announced a legislative hearing on October 19. The Telehealth Privacy Act, which would would maintain certain telehealth flexibilities relating to provider privacy under the Medicare program, will be discussed. The bill was introduced by Reps. Balderson (R-OH), Dunn (R-FL), and Schweikert (R-AZ). For additional coverage about the bill, see Inside Telehealth.
Sen. Sinema (I-AZ): Introduction of the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act (10/4) - Sens. Sinema (I-AZ), Blackburn (R-TN), and Klobuchar (D-MN) introduced the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act (S.3021), which would permanently restore Medicare patients’ ability to receive cardiac and pulmonary rehabilitation services at home through telehealth. During the COVID-19 Public Health Emergency, the Centers for Medicare and Medicaid Services temporarily allowed certain cardiac and pulmonary rehabilitation programs to be reimbursed under Medicare when provided or supervised virtually in a patient’s home. This flexibility ensured patients were able to continue cardiac rehabilitation even when hospitals and outpatient centers were closed, and expanded access to telehealth services for rural communities who typically must travel far to receive care.
The Alliance for Connected Care maintains a tracker on legislation with significant telehealth or remote patient monitoring provisions.
Telehealth Research, Reports and Surveys
Psychiatric Services: Psychotherapy Disruption Before and After the Transition to Virtual Mental Health Care Induced by the COVID-19 Pandemic (10/11) - According to research published in Psychiatric Services, journal of the American Psychiatric Association (APA), the rapid transition to virtual care that occurred with the onset of the COVID-19 pandemic resulted in better continuity of psychotherapy visits compared to prior to the pandemic when almost all visits were in-person. Individuals with mental health conditions often miss health care appointments, and lapses in treatment can hinder overall improvement in mental health symptoms. Efforts to improve engagement in care are essential to promoting overall wellness among those receiving care. Results support the continued availability of virtual psychotherapy when appropriate infrastructure is in place. See the APA press release here.
Epilepsia: Telemedicine as a Path to Bridging Inequities in Patients with Epilepsy (10/9) - Access to epilepsy specialist care is not uniform in the US with prominent gaps in rural areas. In this retrospective study, social determinants of health were collected for all adult patients scheduled in epilepsy clinic, either as an in-person or telemedicine appointment at University of Kentucky between July 2021 till December 2022. The no-show rate was significantly higher for in-person visits (32 percent) compared with telemedicine visits (20 percent). Telemedicine was effective at improving attendance, overcoming socioeconomic hurdles, and widening access to epilepsy care, particularly among under-served population. Access to telehealth depended on insurance coverage and emphasized the need to include telemedicine in insurance plans to ensure uniform access to high-quality epilepsy care, irrespective of socioeconomic status.
JAMA Network Open: Utilization and Spending on Mental Health Services Among Children and Youths With Commercial Insurance (10/3) - Pediatric telehealth for mental health needs filled a critical deficit in the immediate period following the emergence of COVID-19, and continues to account for a substantial portion of pediatric mental health service utilization. Supported by evidence that telehealth can effectively deliver mental health treatment for children and youths, these findings have important implications for telehealth sustainability beyond the effects of COVID-19. For additional coverage, see Healthcare Finance.
PR Newswire: Utilization of Audio-Only Telehealth Remains Steady Nationally (10/3) - In July 2023, utilization of audio-only telehealth services remained steady at the national level in urban areas (4.8 percent) and increased slightly in rural areas (rising from 4.5 percent in June to 4.6 percent in July). The biggest change was seen in the rural South, where utilization decreased from 5.1 percent in June to 4.9 percent in July, while urban areas in that region remained steady at 9.1 percent. As in June, both nationally and in the South, urban areas showed higher utilization than rural areas, while in the Midwest, West and Northeast, utilization was higher in rural areas than urban areas.
JD Power: Telehealth Mobile Apps: Preferred Channel for Virtual Care Delivery (9/28) - Telehealth continues to enjoy elevated popularity thanks to the COVID-19 pandemic. Telehealth received higher marks for satisfaction with the clinicians patients interact with and for patients feeling their needs are met during a visit. The study found that ease of access is the primary reason people use telehealth rather than visit a doctor in-person. Twenty-eight percent of patients said they choose telehealth visits for convenience, and 17 percent said it was for the ability to receive care quickly.
Peterson-KFF: Private Insurer Payments for Telehealth and In-Person During the Pandemic (9/26) - Telehealth use surged with the COVID-19 pandemic as patients sought access to services while providers implemented social distancing protocols. Early in the pandemic, many payers eased restrictions on the use of telehealth and increased reimbursement rates to encourage its use. Among providers who offered both telehealth and in-person care, the vast majority of providers received similar payments regardless of whether the service was provided in-person or over telehealth. The researchers noted that the future of telehealth will be shaped by its effect on total health spending, federal and state regulations relating to scope of practice and reimbursement, and payer coverage and reimbursement policies.
Telehealth News and Market Developments
Health Affairs: Special Registration For Telemedicine Prescribing Of Buprenorphine Is Likely To Do More Harm Than Good (10/12) - Brian Hurley, president of the American Society of Addiction Medicine (ASAM) shared in this op-ed that ASAM does not support a special registration process for telemedicine prescribing of buprenorphine for OUD is unnecessary now as it has the potential to cause harm. Hurley recounts experiences from the X-waiver, which Congress posed as a needless barrier to treatment and recently repealed it. ASAM recommends, iIn lieu of a special registration process, the DEA and HHS should, in a final rule, establish a bona fide exam requirement that strikes the appropriate balance between public health and safety and effective controls against diversion for buprenorphine for OUD.
Modern Healthcare: Cigna Buys Digital Health Provider Bright.MD (10/10) - Cigna’s Evernorth Health Services unit will integrate Bright.md’s asynchronous digital services into MDLive, a telehealth platform that covers 60 million commercial, Medicaid and Medicare enrollees. MDLive supports about 2 million virtual urgent care, behavioral health, tele-dermatology and primary care visits annually. Beginning in 2024, more than 20 million commercial members will be able to correspond with Bright.md providers through MDLive for virtual urgent care services. Bright.md will convert their responses into chart notes that physicians can review and use to develop appropriate care plans, prescribe medications and schedule follow-up appointments.
Walmart: Walmart Expands Virtual Health Care Benefits, Increasing Access for Associates to Quality Providers Across the Country (10/10) - Walmart announced a partnership with Included Health to launch a virtual primary care option for employees in select states, including a $0 copayment for virtual care visits. In 2020, Walmart launched a virtual primary care pilot, which saw huge improvements to employees' health. Walmart saw a 26 percent reduction in hospital readmissions among people who used the virtual primary care platform as well as a 38 percent reduction in inpatient hospital costs on a cohort basis. Beginning January 1, 2024, Walmart employees can access these virtual health services.
Modern Healthcare: Walgreens to Launch On-Demand Virtual Care Services (10/10) - Walgreens announced at HLTH that they will launch an on-demand virtual care service later this month. The company will offer dermatology, primary care, urgent care, women’s health and men’s health services. Patients can set up video visits with providers, attend virtual consultations with a doctor or nurse practitioner and have prescriptions shipped to their home. The virtual care offering will give Walgreens more access to underserved communities and build consumer trust.
Modern Healthcare: How Employers Are Adding Virtual Cancer Care to Their Benefit Plans (10/10) - As the disease hits more working-age people, virtual cancer care is growing as a covered medical benefit in employer-sponsored plans. Large employers’ benefits packages often include medical and dental coverage, a 401(k) match and increasingly, virtual cancer care. Employers are investing in solutions to help people get diagnosed earlier, better navigate the complexities of cancer care and connect with leading cancer care centers. Fifty three percent of employers are planning to offer a cancer-focused center of excellence approach in their benefit plans in 2024.
Healthcare Dive: Amwell and Nestle Partner on Digital Nutrition Programs (10/5) - Telehealth firm Amwell is partnering with Nestlé Health Science to create digital health programs focused on nutrition. The partners’ first offering, the Advanced Surgical Nutrition Automated Care Program, pairs Amwell’s virtual companion service with Nestlé’s Impact Advanced Recovery drink and is available for patients undergoing major elective surgery in the U.S. Enrolled patients receive the drink while the digital program offers patient education and guidance, evaluates progress and adherence and can prompt clinicians to assist if necessary. The program could “help strengthen patients’ pre-operative journeys and foster better care plan compliance,” according to an Amwell spokesperson. The companies didn’t disclose financial terms behind the deal, but said they will work on other initiatives that aim to improve outcomes and lower costs for health systems.
Healthcare IT News: Telehealth Helps Address Many Key Chronic Care Management Challenges (10/3) - Telemedicine and remote patient monitoring are essential tools to help manage patients with chronic diseases, workforce shortage, and an aging population. Brian Esterly, CEO of TimeDoc Health, a vendor of virtual care management, shares how telehealth and RPM can help with chronic care management – especially as the number of people with chronic diseases grows, the population ages, and the shortage of health care workers worsens.
MedStar Health: Telehealth and Beyond: Innovative Digital Health Services Improve Patient Care (9/20) - Before COVID-19, accessing health care services almost always involved a trip to the doctor’s office or hospital: Taking time off work, arranging for a ride, getting someone to watch the kids. Less than half of U.S. health centers had telehealth then, but during the pandemic, 95 percent of U.S. health centers adopted it to maintain continuity of care for patients. In this blog post, MedStar Health highlights the benefits of digital health solutions.
American Medical Association, "Pay schedule contains AMA advocacy wins on telehealth, diabetes." CMS has proposed maintaining the waiver of geographic and originating site restrictions through Dec. 31, 2024. AMA Executive Vice President and CEO James Madara shares that the importance of these flexibilities in enhancing patient access to care has been made abundantly clear.
AMA, "Telepsychiatry Keeps Delivering High-Quality Care to More Patients." Like physicians across the country, those at Virginia Commonwealth University (VCU) Health were thrust into the world of telehealth thanks to the COVID-19 pandemic. VCU Health psychiatry chair Robert Findling, MD, detailed how the telepsychiatry program has evolved and the challenges and benefits of delivering care this way.