Inside Health Policy: IRS Pressed to Waive Enforcement Until Congress Extends HSA Telehealth Policy (12/22) – Several stakeholders have asked the IRS to waive enforcement of the CARES Act provision that enabled employers and health plans to provide pre-deductible coverage of telehealth services to individuals with high-deductible health plans coupled with a health savings account (HDHP-HSAs) before it expired on December 31. A letter from the Alliance to Fight for Health Care urged the IRS to hold on enforcement until Congress is able to act in 2022, given it was not included in the Medicare extenders bill enacted in December. The Alliance for Connected Care has also been active on advocating around this issue, with Executive Director Krista Drobac stating “We are hopeful that the IRS will recognize congressional intent to continue telehealth flexibilities and provide a temporary delay in enforcement of HSA policy.”
Federal Communications Commission (FCC): FCC Announces Fifth Set of Awards for COVID-19 Telehealth Round 2 (12/21) – The FCC approved an additional 68 applications for funding commitments, totaling $42,702,383 for Round 2 of its COVID-19 Telehealth Program. This is the FCC’s fifth funding announcement of approved Round 2 applications, bringing the total to over $208 million awarded to health care providers in each state, territory, and the District of Columbia. Round 2 is a $249.95 million federal initiative that builds on the $200 million program established as part of the CARES Act.
HHS: HHS Announces PandemicX Accelerator with Health IT Cohort to Address COVID-19 Health Disparities (12/20) – HHS announced that 15 digital health startups are joining the 2022 PandemicX Accelerator cohort, specifically to address health inequities, create a culture for success, and deploy resources to mitigate the effects of the COVID-19 pandemic. PandemicX, co-led by the Office of the Assistant Secretary for Health and the Office of the National Coordinator for Health IT, involves using digital tools and publicly accessible data to eliminate disparities and tackle drivers of inequity exacerbated by COVID-19.
Congress: Letter to Treasury on the HDHP-HSA Telehealth Safe Harbor (12/22) – Senators Cortez Masto (D-NV) and Daines (R-MT) and Representatives Steel (R-CA) and Lee (D-NV), the co-sponsors of the Telehealth Expansion Act in the Senate and House, sent a letter
to the US Department of the Treasury on an IRS non-enforcement strategy for the CARES Act provision that enabled employers and insurers to provide pre-deductible coverage of telehealth services for individuals with HDHP-HSAs. This provision expired on December 31, 2021. The letter was sent to Secretary Yellen, as well as to the White House and HHS, urging the Treasury to issue guidance ensuring that Americans with an HDHP-HSA will not be faced with unexpected out-of-pocket costs for telehealth services after this provision expired to allow Congress the chance to act on this provision early in 2022. To date, Congress has not yet heard back from the Treasury on this outreach.
Telehealth Research, Reports and Surveys
Forbes: As Telehealth Rises Due To Covid-19, Doctors’ Influence Wanes, New Survey Shows (12/28) – According to a survey
conducted by Oliver Wyman, telehealth is now a common feature of many Americans’ health care experience. More than one-third of survey respondents said they’d had a video visit with a health care provider at some point during the pandemic—triple the percentage in a 2018 version of this survey. For the vast majority (85 percent), it was the first time they’d tried it. Among those who have used telehealth, most were happy with it. More than one-quarter (29 percent) said their video visit was much better than a traditional office visit and 38 percent said it was about the same.
mHealth Intelligence: How Telehealth Will Continue its Evolution Beyond Pandemic Response (12/27) – A survey
conducted by the College of Healthcare Information Management Executives (CHiME) found about 26 percent of organizations, including acute, ambulatory and post-acute care facilities, reported that more than a quarter of their patients had used telehealth as compared with the 32 percent of organizations that reported the same in 2020. This indicates that though telehealth will remain a key part of the care continuum, providers are still in the process of figuring out how best to integrate it with other types of care delivery.
NIH National Library of Medicine: Telehealth adaptation of perinatal mental health mother-infant group programming for the COVID-19 pandemic (12/25)
– The COVID-19 pandemic and ensuing isolation stressed pregnant and postpartum women and their families pervasively. A new study, that compares 2019 in-person and 2020 telehealth services during the period from mid-March through mid-December in each year, found that the Maternal Postpartum Peer Support Group participation increased with the transition to telehealth, with 27 individuals with over 100 group-based visits in 2020. Twenty-five mother–infant postpartum pairs initially enrolled in the 12-week multicomponent Mother–Infant Therapy Group (M-ITG) during 2019 in-person services, and 16 completed the program (36 percent non-completion rate). The authors highlighted the importance of increased coverage of telehealth even after the pandemic ends, since telehealth may be one option to increase access to populations who have public insurance and offer earlier intervention, which is critical during the first year of life.
Doc Wire News: The Opportunities and Challenges of Telemedicine during COVID-19 Pandemic (12/23) – A new study found that telemedicine provides safe, affordable, and convenient medical and education assistance. Throughout the pandemic, telemedicine provided an alternative platform to medical care and eliminated direct contact of medical workers with patients. The authors found that new laws and regulations are needed to regulate responsibility in the field of remote treatment, as well as guidelines regarding the use of crowdsourced disease monitoring in addition to traditional epidemiological surveillance systems.
Rheumatology and Therapy Journal: Patient-Reported Nausea and Fatigue Related to Methotrexate: A Prospective, Self-Controlled Study in the ArthritisPower® Registry (12/20) – A new study found that the use of digital technology helps assess medication-related symptoms. Researchers found that nearly two-thirds of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients experience methotrexate side effects (including fatigue and nausea) and that for many, the experience of such symptoms is much more intense in the one to two days after each weekly dose is taken. The authors concluded that digital remote patient monitoring presents an opportunity to detect and address medication tolerability in real time.
Arkansas Center for Health Improvement: Report: Telemedicine Utilization Increased 30-Fold During First 12 Months of COVID-19 Pandemic (12/20) – The Arkansas Center for Health Improvement (ACHI) assessed telemedicine trends from March 2020 through April 2021 for Arkansas, with trends reflecting findings similar to the CMS Medicare Telemedicine Snapshot report during the pandemic. April 2020 represented the month with the highest utilization of telemedicine services, with slightly reduced but still high utilization through the summer months into early fall 2020. Despite a reduction in telemedicine claims utilization from November 2020 through April 2021, telehealth claims were still up 67 percent in April 2021 compared to March 2020. Given the increased utilization of telemedicine services, both the state and federal government have made permanent some of the telemedicine rule changes instituted in response to the pandemic.
mHealth Intelligence: Outcomes for Virtual Prenatal, Postpartum Care Similar to In-Person Visits (12/14) – According to a Health Science Reports study, rapid telehealth implementation during the COVID-19 pandemic was proven to be feasible for underserved populations at a clinic in Massachusetts, in particular for prenatal and postpartum care services. For prenatal care, telehealth accounted for 57 percent of all visits of patients who were between 22 and 25 weeks along. Around half of the postpartum patients had at least one telehealth visit, with 52 percent of patients attending a virtual visit for both the two-week and six-week postpartum checkups. The researchers also stressed the importance of audio-only telehealth for underserved populations who may not have access to adequate internet or devices with camera capabilities.
NCBI: Real-World Outcomes in Cystic Fibrosis Telemedicine Clinical Care in a Time of a Global Pandemic (12/10) – A new study found that telemedicine increases access to care for adults with cystic fibrosis living in regions remote to a cystic fibrosis specialty center, with 95 percent of patients with cystic fibrosis having access to telemedicine. Telemedicine accounted for 64 percent of encounters, hybrid visits accounted for 28 percent of encounters and in-person visits accounted for seven percent of encounters.
State Telehealth News and Activity
Office of Governor Doug Ducey: 2021 Year in Review: Arizona at the National Forefront of Telehealth (12/29) – This blog post recaps actions taken by the State of Arizona to expand access to medical services via telehealth. The post highlights the landmark telehealth legislation signed by Governor Ducey, which ensured providers receive equal compensation from insurance companies for telehealth services, allowed out-of-state health care providers to practice telemedicine in the state, and much more. A video of the Governor’s remarks can be found here.
mHealth Intelligence: Ohio, New Jersey Governors Sign Telehealth Bills IntoLaw (12/23) – Ohio Governor Mike DeWine and New Jersey Governor Phil Murphy both signed telehealth bills into law in December that would expand access to telehealth in both states. In Ohio, the Telemedicine Expansion Act will widen access to telehealth services in many ways, including by allowing a wider variety of health care professionals to conduct telehealth visits and increasing the type of provider sites that can submit claims to Medicaid for telehealth services. In New Jersey, Governor Murphy signed a bill (S. 2559) that requires payers to reimburse providers for all forms of health care delivered via telehealth at the same rate as in-person care for two years, and bans restrictions on locations from where the services are provided. It also requires a study on telehealth use and its effects on patient outcomes, quality, satisfaction, and access to care.
Tennessean: Tennessee can push the envelope in mental health services by using eConsults (12/23) – In this op-ed, Dr. Edward Cladera of AristaMD discusses how, despite increases in access to mental health services in Tennessee in recent years, more can be done to increase such services via telehealth and eConsults. Dr. Cladera highlights the three common barriers in improving mental health access and management as diagnostic resources, provider support, and continuity of care, all of which have been addressed directly by telehealth during the pandemic and can continue to be addressed using such services moving forward.
Connecticut State Department of Public Health: DPH Temporarily Suspends Requirements for Licensed Health Care Professionals From Other States (12/22) – The Connecticut Department of Public Health temporarily waived
the state’s license requirements for certain out-of-state health care professionals looking to practice in Connecticut. This order waives the requirement of licensure, certification or registration for health care professionals licensed and in good standing in another state or territory of the United States and D.C. for 60 days, through February 15, 2022. This order applies to both in-person practice and telehealth services. Additional information
JD Supra: Washington Medical Commission Issues New Guidance for Telehealth Providers (12/21) – The Washington Medical Commission issued a new policy governing the practice of telemedicine by allopathic physicians and physician assistants in Washington State. The Commission is using the policy as a way to clarify when a Washington medical license is required for a practitioner to practice telehealth in the state, as well as to clarify the state’s definition of telemedicine. The policy also offers detailed guidance to physicians providing medical services via telemedicine technologies on appropriate standards of care and professional ethics when providing such services.
Telehealth News and Market Developments
mHealth Intelligence: NC Health System Launches New Digital Care Access Tools (12/30) – Novant Health, a North Carolina-based health system, launched two new digital tools to help patients access care and make informed decisions. Novant Health Now will provide users with real-time health information and clinical support, where patients can use voice or text to get answers in real time via a virtual assistant. A physician matcher tool also helps patients find the right expert for their care needs.
Fierce Healthcare: 2022 forecast: Competition in retail healthcare will heat up. Here’s what to expect from Amazon, CVS and Walgreens (12/22) – The biggest U.S. retailers are placing huge bets on health care. As patients increasingly demand lower costs and convenient care delivery, retailers like Walmart, Amazon, CVS and Walgreens have stepped in to meet their needs where traditional providers lack the resources to do the same. All four companies have accelerated their investments in health care this year, stepping into new areas from primary care to telehealth.
Healthcare IT: Amwell CEO on what 2022 may hold for RPM and telehealth reimbursement (12/21) – In this article, Amwell CEO and Alliance Board Member Roy Schoenberg discusses the future of remote patient monitoring, reimbursement regulation and technological advancements for telehealth in 2022.
Forbes: Improving the Continuum of Patient Care Through Technology (12/21) – In past years, governments and health systems have explored ways to address population health management and chronic disease challenges. Specifically, there has been discussion around restructuring health care teams and technology to improve the patient experience, accelerate care delivery and lower health care costs. While many would argue that the value of remote patient monitoring (RPM) is no longer in dispute, the lack of visibility and coordination across clinical specialties, together with the pace of regulatory and payment models, could be a barrier toward increased tech penetration. Tech leaders who are able to connect patient complexities with physician specialties and provide effective, billable remote or digital management tools to physicians and their teams will likely succeed in facilitating a greater continuum of care.
Healthcare IT News: Advances in telemedicine are on the way in 2022 (12/20) – In an interview with Dr. Ian Tong, chief medical officer at Included Health, a telehealth technology and services company, Healthcare IT News asks about telemedicine reimbursement, potential passage of a virtual-case legislation, and the future of remote patient monitoring. They also discuss Dr. Tong’s predictions for telehealth in 2022 and beyond.
HealthTech: How Health Tech Help to Improve Patient Care (12/20) – With the start of the pandemic, health care providers have been under growing pressure to ensure the delivery of quality care services. In addition, the coronavirus has moved other diseases to the back burner with no diagnosis or treatment. Another challenge the health care sector faces is the global ageing population. Older people are prone to chronic conditions that should be addressed through a continuum of care. Health care providers had to develop a more resilient system that would meet all their and their patients’ needs. Many companies have opted to adopt cutting-edge technologies to continue operations and satisfy consumer demands. Innovations offer the possibility to automate particular tasks, enforce remote treatments, obtain data-driven results and more.
Forbes, “Meet the Texas Startup Powering Telehealth.” When COVID hit, the health care industry found itself turning to telemedicine to meet patient needs. Every digital health company, hospital and insurer faced the same two obstacles: a need for more doctors and better technological infrastructure. At Austin, Texas-based Wheel, cofounder and CEO Michelle Davey had already been building this back-end infrastructure for years - both the technology end and the doctor and nurse network. “The vision of Wheel is really about expanding access,” says Davey. “It's about connecting patients to the right care for them, when they need it most.”
HIMSS TV, “Making the telehealth patient experience seamless.” In this episode of HIMSS TV, Robert Murphy, Revation Systems' VP of marketing, discusses creating a secure “digital office” telehealth experience for patients and providers that complements office visits.
HIMSSCast, “2021: A Year in Review & Look Ahead to 2022.” In this episode of HIMSSCast, host Jonah Comstock is joined by editors from all three HIMSS Media brands – Kat Jercich, senior editor at Healthcare IT News; Susan Morse, executive editor at Healthcare Finance News, and Laura Lovett, executive editor at MobiHealthNews – to look back at the biggest health tech and finance trends of the past year and chat about what to expect in 2022.