Notable Telehealth Commentary
On Monday, November 9, the Medicare Payment Advisory Commission (MedPAC) discussed whether and how to permanently expand telehealth in fee-for-service Medicare.
"Decisions made now might be inappropriate for telehealth of several years from now" because technology is changing so fast, said Bruce Pyenson, a MedPAC commissioner and consulting actuary at Milliman in New York City. MedPAC executive Jim Mathews welcomed the idea of commissioners suggesting that some limits might be set. “It might be helpful for groups like us to say, 'These expansions seem to make sense; these maybe not so much and should be pulled back,' against strong pressure to make everything permanent," he said. Opinions were divided on whether Medicare should continue reimbursing doctors for telehealth visits performed via telephone.
Commissioner Lawrence Casalino, MD, PhD, was opposed to getting rid of payments for telephone visits, "both for equity and efficiency reasons," he said. Brian DeBusk, PhD, also spoke in favor of audio-only visits. "I see audio as a secure, safe medium for some less sophisticated, lower socioeconomic status beneficiaries," said DeBusk, who is CEO of DeRoyal Industries, a medical equipment manufacturer in Powell, Tennessee.
Commissioner Pat Wang, president and CEO of Healthfirst, a health plan in New York City, said the potential for fraud with audio-only visits is immense. Commissioner Wayne Riley, MD, president of the State University of New York (SUNY) Downstate Health Sciences University, disagreed. While safeguards against fraud may be needed, "I would not want to totally discontinue telephonic access, particularly for vulnerable communities.”
Also, this week, the Bipartisan Policy Center held an event on “What's Next for Telehealth: Sustaining and Expanding Access After COVID-19.” Sen. Angus King (I-ME), Maine health care providers, and BPC experts discussed the benefits of telehealth during the pandemic and what things look like for the future of telehealth throughout the country. “One of the few silver linings of this pandemic has been the incredible acceleration of the adoption and expansion of the ability of telehealth, particularly in rural areas," King said. "I don’t think it can be stressed enough what an important development this is.”
Finally, Sen. Tina Smith (D-MN) said at an Axios event that the expansion in telehealth services to address the coronavirus pandemic needs to continue. Patients and providers have described telehealth as a lifeline, Smith said, especially in the need for mental health care, which has exploded during the pandemic.