Please find below updates on how the health care system is leveraging telehealth and remote patient monitoring - including research, data, and polling on its current use in response to COVID-19.
Alliance for Connected Care, “Telehealth Summit for Health Systems”: (4/22-4/23) – The Alliance for Connected Care held its virtual Telehealth Summit for Health Systems April 22 & 23. Participants heard from federal policymakers and executives at several health systems on a variety of issues related to virtual care, including improving access across the digital and social divide, consumer engagement in virtual care, post-pandemic licensure portability, and hardwiring virtual care transformation. Slides from the opening presentation, entitled “A Pivotal Moment for Telehealth & RPM Policy: A Look Ahead to 2021,” are now available on the website, and a recording of the opening sessions with our guest speakers from the White House and Congress will be available soon.
Politico: “How to get your telehealth data to policymakers”: (4/23) – Politico reporter Mohana Ravindranath covered our Telehealth Summit this week! Alliance Executive Director Krista Drobac asked White House Domestic Policy Council's deputy director for health and veterans affairs, Christen Linke Young how advocates can share data gathered during the pandemic. Christen Linke Young said that data on virtual care and its costs could be valuable in shaping post-pandemic telehealth policy — even if it's informal. "Not everything has to be a peer reviewed study to matter to policymakers, and sharing those key lessons informally can be really helpful,” Young said. Those with a subscription can read full coverage here.
Northwest Regional Telehealth Resource Center: (4/22) – The Alliance for Connected Care's Chris Adamec spoke to participants at the NRTRC Annual Conference “Telehealth’s Big Bang: From Challenge to Opportunity.” The Alliance spoke on “Strategies for Maintaining Regulatory Flexibilities” alongside the Oregon Office of Rural Health, the Center for Connected Health Policy, and the Wyoming Department of Health.
Alliance Support Letter for Missouri SB 193: (4/21) – The Alliance submitted a letter of support to Senator Bob Onder, Chair of the Missouri Senate Committee on Health and Pensions, for Senate Bill 193. The bill would allow APRNs providing nursing services under a collaborative practice agreement to provide such services outside the geographic proximity requirement if utilizing telehealth in the care of the patient and if the services are provided in a rural area located in a health professional shortage area. The Alliance believes eliminating geographic proximity requirements for telehealth services will improve access to care, especially in rural and underserved areas.
Alliance Support Letter for Missouri SB 584: (4/21) – The Alliance submitted a letter of support to Senator Jeanie Riddle, Chair of the Missouri Senate Committee on Professional Regulation, for Senate Bill 584. This bill would repeal the requirement that an APRN can only provide telehealth services in rural areas of need in order to practice telehealth services outside the geographic proximity requirements of a collaborative practice agreement. The Alliance believes eliminating geographic proximity requirements, especially for telehealth services, will improve access to care, especially in rural areas with provider shortages.
Health Resources and Services Administration (HRSA): (4/20) – HRSA awarded more than $12.7 million in funding to 61 public, private and non-profit entities across 35 states to serve rural communities and address rural health disparities as part of its community-based Rural Health Care Services Outreach Program (Outreach Program). Services will focus on social determinants of health, chronic disease management and prevention, care coordination, telehealth, dental care, and behavioral health, among other areas.
House Ways & Means Committee, Health Subcommittee: (4/28) – The House Ways & Means Committee, Health Subcommittee announced a hearing on Wednesday, April 28 on, “Charting the Path Forward for Telehealth.” The hearing will explore with key witnesses how current pandemic-induced telehealth flexibilities have impacted care delivery, utilization, and the impact on health care spending. It will also explore the impact of telehealth on reducing barriers to health care access for individuals in rural and underserved communities and ongoing challenges to ensure telehealth services are delivered equitably and in the correct clinical settings. Finally, the hearing will explore the implications of various proposals to permanently expand telehealth payments in the Medicare program. Stay tuned for witnesses, testimony and live coverage beginning at 2:00pm ET.
PREVENT Diabetes Act: (4/22) – Reps. Rice (R-SC), DeGette (D-CO), Reed (R-NY) and Butterfield (D-NC) introduced The Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-Based Strategies (PREVENT DIABETES) Act (H.R.2807), which would permit Centers for Disease Control and Prevention-recognized virtual diabetes prevention program suppliers to be included in the Medicare Diabetes Prevention Program Expanded Model conducted by the Center for Medicare and Medicaid Innovation under section 1115A of the Social Security Act (42 U.S.C. 1315a). The Alliance signed a group letter earlier this month asking HHS Secretary Becerra to allow virtual providers to deliver Medicare diabetes prevention program services. The Alliance and more than a dozen others endorse this legislation. Read the bill text and press release.
New Democrat Coalition Health Care Priorities: (4/21) – The New Democrat Coalition (NDC) comprised of 94 Democrats in the U.S. House of Representatives and chaired by Rep. Schrier (D-WA) and Sewell (D-AL) sent a letter to President Biden outlining health care priorities which include “embracing expanded telehealth and home care under the CARES Act and the American Rescue Plan.”
State Telehealth Legislation –
Carolina Journal: (4/23) – Lawmakers in North Carolina are considering telehealth reforms given its increased popularity during the COVID-19 pandemic. Under current law in the state, out of state providers would need to be licensed in North Carolina to provide care via telehealth to patients, a requirement experts urge should be waived for providers in good standing in other states. Other areas for improvement in the state would be to expand the type of providers who are able to practice telehealth and to eliminate the in-person visit requirement prior to utilizing telehealth services.
The National Law Review: (4/21) – States across the country have introduced hundreds of bills to update and/or improve telemedicine laws. Most bills have increased the flexibility in provisions to provide care via telehealth and the types of services that can be provided, while other bills address reimbursement parity or other areas. This article provides an overview of actions state governors took to expand access to telehealth during the pandemic and how such flexibilities have catalyzed telehealth reform in the current legislative session.
EIN Presswire: (4/20) – Montana Governor Greg Gianforte signed House Bill 43 into law, which would permanently eliminate some telehealth regulations waived during the pandemic to better expand access to care. This bill will eliminate geographic and site restrictions and the requirement that patients and providers establish a relationship prior to leveraging telehealth services under certain circumstances.
Real Clear Policy: (4/20) – Arizona is considering a massive telehealth bill that could set a powerful precedent for states across the country. House Bill 2454 would allow registered health care providers who are in good standing in other states to provide services to Arizonans via telehealth through a registration process. This bill would also address other areas of telehealth such as reimbursement policies and would help expand access to care to individuals living in rural parts of the state facing provider shortages or long travel times to see a doctor.
mHealth Intelligence: (4/20) – New Jersey Governor Phil Murphy conditionally vetoed a telehealth bill on the grounds that it does not go far enough. The bill (SB 619/A 1635) would have allowed providers to use connected health channels to prescribe medical marijuana and allow such prescriptions for individuals who face barriers to in-person care. The bill would otherwise require an in-person exam for most others and would not take effect until 270 days after enactment, something the governor said would disrupt ongoing care for those currently using telehealth services to access care during the pandemic.
The National Law Review: (4/19) – The state of New Jersey has renewed its focus on telehealth this legislative session, with several bills and regulations introduced to address various aspects of telehealth policy. The state legislature is considering a bill (S. 2559) to expand reimbursement for covered services provided via telehealth and allow for new flexibilities such as reimbursement parity and audio-only telehealth. This bill, which passed out of the Budget and Appropriations Committee in March, would be an amendment to the telehealth law passed in 2017.
Telehealth Research, Reports and Surveys
American Institutes for Research (AIR): (4/22) – AIR released an issue brief titled, “Fraud and Abuse in Telehealth Is Not as Prevalent or as Significant as Some May Think.” The brief reviewed findings from federal investigations of telehealth utilization and insights from health systems providing telehealth services during the COVID-19 pandemic and found that telehealth can be used to deliver timely, person-centered care; generate cost savings; enhance care coordination; and be effectively employed to improve algorithms to detect fraud and ensure program integrity.
Becker’s Hospital Review: The Harris Poll released a survey last month finding that 35 percent of patients would consider leaving their primary provider for telehealth visits. Further, roughly half of older adults aged 65+ said they will likely use telehealth after the pandemic.
Telehealth News and Market Developments
Kaiser Health News: (4/23) – St. Louis-based Catholic health system Mercy became a pioneer in telehealth in 2015 when it opened a virtual care center in Chesterfield, Missouri. Having the virtual center gave Mercy a head start when the pandemic forced doctors and hospitals across the nation to turn to telehealth. “There is no evidence to support that doctors are going to start calling patients willy-nilly to get telehealth visits on the books. First off, they don’t have time for it. Secondly, if it’s not clinically appropriate, they can’t,” said Sarah-Lloyd Stevenson, a policy adviser for the U.S. Department of Health and Human Services during the Trump administration.
STAT News: (4/21) – An op-ed in STAT News calls for continued reimbursement of phone-only telehealth visits. “Meaningfully addressing the digital divide will require targeted patient outreach and education efforts, in addition to addressing technology access,” the authors note. “Eliminating coverage for telephone-only telehealth visits would disproportionately affect underserved communities that face barriers to accessing video technology.”
mHealth Intelligence: (4/21) – South Shore Health is adding remote patient monitoring capabilities to its Mobile Integrated Health program. The health system recently partnered with Current Health to create a “SNF at Home” program, which provides in-person and virtual care at home for patients who might otherwise be housed in skilled nursing facilities. The in-person care is handled by specially trained paramedics who are employed by the health system.
Health Affairs Blog: A blog published in Health Affairs discusses challenges to equitable engagement with telemedicine services and identifies opportunities to improve access for the most vulnerable and disenfranchised patients.
mHealth Intelligence: (4/20) – Emory Healthcare’s new ER-TEMS program gives rural EMS providers a telehealth link to ER doctors and specialists. The program is funded by a four-year $1.2 million grant from HRSA. ER-TEMS pairs telemedicine and EMS services to provide care to people in emergencies or who frequently use the 911 system to access care. The program is designed to give first responders virtual access to Emory providers to help assess and treat patients at the scene.
Alliance for Connected Care, “Telehealth Summit for Health Systems.” The Alliance for Connected Care held its virtual Telehealth Summit for Health Systems April 22 & 23. Participants heard from federal policymakers and executives at several health systems on a variety of issues related to virtual care, including improving access across the digital and social divide, consumer engagement in virtual care, post-pandemic licensure portability, and hardwiring virtual care transformation. Slides from the opening presentation, entitled “A Pivotal Moment for Telehealth & RPM Policy: A Look Ahead to 2021,” are now available on the website, and a recording of the opening sessions with our guest speakers from the White House and Congress will be available soon.