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Connected Care Update

August 24, 2020

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 News

Taskforce on TelehealthThe Taskforce will release its report at an event on September 15. The Taskforce, a multi-stakeholder effort convened by the Alliance for Connected Care, NCQA and ATA will issue its final report during a webinar on Tuesday, September 15. A registration link will be emailed and posted here when it becomes available.

Executive Branch Telehealth Activity/Guidance

The Alliance for Connected Care continues to update a COVID-19 website tracking guidance.  We have also posted our summary of the CY2021 Physician Fee Schedule. 

White House Blog: (8/19) – The White House Office of Science and Technology Policy posted a blog affirming its commitment to telehealth innovation and describing highlights from a Roundtable Discussion on “Embracing Technology and Telehealth.” During the Roundtable, the White House launched the Pledge to Embrace Technology to Advance America’s Health to reassure patients, providers, and payers that telehealth is here to stay and will be covered over the long term. View the blog.

CMS Rural Crosswalk: (8/20) – CMS released a new resource that documents all current COVID-19-related waivers and flexibilities issued by CMS that impact Rural Health Clinics, Federally Qualified Health Centers, Critical Access Hospitals, rural hospitals generally, and long-term care facilities. The document is divided into six sections; one of which includes telehealth and other virtual services. View the Rural Crosswalk: CMS Flexibilities to Fight COVID-19.

Health Resources and Services Administration: (8/20) – HRSA awarded over $35 million to more than 50 rural organizations across 33 states to increase access to high-quality care in rural communities through investments in areas like telehealth, health workforce training, health research, technical assistance for vulnerable rural hospitals and HIV care and treatment. View the press release. The awards through HRSA’s Federal Office of Rural Health Policy (FORHP) specifically for telehealth include:

  • $8.8 million awarded to 30 organizations across 23 states as part of the Telehealth Network Grant Program (TNGP). Awardees will promote rural tele-emergency services by enhancing emergency care consults from health care providers via telehealth through increased access and training.
  • Nearly $2 million to support the Telehealth Focused Rural Health Research Center (TF RHRC) Program. TF RHRC awardees will carry out a comprehensive evaluation of nationwide telehealth investments in rural areas and populations, and conduct research to expand the evidence base for rural telehealth services.
  • Nearly $1 million to establish the new Rural Telementoring Training Center (RTTC). The RTTC will train academic medical centers and other centers of excellence to create technology-enabled telementoring learning programs to disseminate best-practice specialty care to primary care providers in rural and underserved areas.

Research and Reports

Patient-Centered Outcomes Research Institute (PCORI): (8/17) – PCORI approved $22.6 million in funding for seven COVID-19 research studies to assess various health care approaches to improve outcomes among people infected by the novel coronavirus, including several to evaluate whether telehealth approaches achieve comparable or better outcomes for patients. The newly approved telehealth studies include:

  • $3 million for a Joan and Sanford I. Weill Medical College of Cornell University study examining the comparative effectiveness of different approaches to providing primary care during the widespread transition from in-person to remote visits during the pandemic. The study examines how telemedicine is offered to and experienced by diverse populations as well as telemedicine’s effectiveness on outcomes and disparities among people with chronic conditions. The study uses PCORnet® to examine the impact of telemedicine on patient-centered outcomes and disparities in outcomes for patients with chronic disease at many clinics.
  • $2.5 million for a State University of New York study to compare a mindfulness-based stress reduction (MBSR) group intervention via teleconference with an MBSR mobile app in reducing worry and improving other mental health outcomes among adults living in low-income racial and ethnic minority neighborhoods who lack access to mental health care.

University of Michigan Institute for Healthcare Policy and Innovation: (8/17) – A new poll on telemedicine use by older adults in the period March to June 2020 finds adoption of telemedicine is higher compared to 2019, and previous concerns over privacy and telehealth capabilities are lower. One in four older Americans had a virtual medical visit in the first three months of the COVID-19 pandemic, compared to just 4% in 2019. Other findings include:

  • They feel very or somewhat comfortable with video conferencing technologies: 64%, up from 53% in 2019
  • At least one of their health providers offer telehealth visits: 62%, up from 14%
  • They are interested in using telehealth to connect with a provider they had seen before: 72%, up from 58%
  • They are interested in using telehealth for a one-time follow-up appointment after a procedure or operation: 63%, up from 55%
  • They have concerns about privacy during a telehealth visit: 24%, down from 49%
  • They are concerned they would have difficulty seeing or hearing the provider during a video visit: 25%, down from 39%

View the press release and survey data.

Progressive Policy Institute & Americans for Prosperity: (8/17) – The Progressive Policy Institute and Americans for Prosperity jointly issued a white paper on telehealth, which outlines recent federal, state, private payer and provider policy actions and lists policies Congress should make permanent. 

Telehealth News

STAT: (8/17) – An op-ed from Roy Schoenberg, president and CEO of Amwell, highlights the impact of COVID-19 on the transformation of virtual care. For continued adoption of telehealth, Dr. Schoenberg suggests the United State will need two things: the technology to shift a greater proportion of care to the home combined with more intense collaboration among all health care stakeholders, from health systems and health plans to patients, providers, innovators, and the government.

    WLFI: (8/17) – St. Louis County is leading the way in treating the uninsured with their Telehealth services. Because of the barriers of getting to see a doctor is tough, Telehealth can serve clients in the shelter without them having to leave. Primary care and mental health are among the various services offered.

    mHealthIntelligence: (8/17) – Soldier On, launched in 1994 in Pittsfield, MA, which now serves thousands of veterans in the Northeast, recently Partnered with Let’s Talk Interactive to leverage telemedicine kiosks and telehealth platforms in transitional and permanent housing and jail programs. The kiosks allow the organization’s 80 full-time caseworkers to conduct virtual visits with veterans who might otherwise ignore or skip appointments for care.

    Becker’s Hospital Review: (8/17) – Hometown Health Center in Dexter, Maine announced a clinical trial to determine whether telehealth services effectively treat rural opioid addiction patients.

    The Hill: (8/18) – A new op-ed from Sen. Cassidy (R-LA) and Dr. Adam Bruggeman discusses the way the healthcare system has innovated during COVID-19 with a special focus on telehealth. The op-ed also describes pre-pandemic barriers to telehealth access and calls for expanding telehealth access to all patients – regardless of their geographic location and in their home.

    Healthcare IT News: (8/18) – A new survey of more than 5,000 adults in June from CynergisTek found nearly three quarters said they will continue to use telehealth post-pandemic – however, nearly two-thirds of Baby Boomers and the Silent Generation would lose their enthusiasm if data breaches became common.

    Modern Healthcare: (8/18) – A new article from Modern Healthcare finds more healthcare providers are carving out telehealth leadership roles in their C-suites, a trend that will likely accelerate as a result of the COVID-19 pandemic, governance experts said. There was around a 40% increase in the number of telehealth leadership roles among health system C-suites from early 2019 to early 2020, according to data from SullivanCotter.

    Healthcare IT News: (8/19) – AccessHealth, which focuses on serving underserved patients has boosted mental health visits by 10% during the COVID-19 pandemic through the use of telemedicine visits.

    PRNewswire: (8/19) – Instacart, announced a new partnership with Doctor On Demand to offer free access to COVID-19 screenings and virtual medical consultations to the shopper community. As part of the program, any Instacart shopper experiencing symptoms of COVID-19 may schedule a free telemedicine appointment with Doctor on Demand to discuss whether they should get tested. Instacart will cover the cost of the visit and the shopper will be eligible to receive up to 14 days of extended pay.

    American Hospital Association Letter to President Trump: (8/19) – The American Hospital Association sent a letter to President Trump to make permanent the telehealth flexibilities provided during the COVID-19 pandemic. Specifically, HHS is urging HHS and CMS to permanently:

    • Expand the list of Medicare telehealth services to include services that were added during the COVID-19 pandemic and maintain the sub-regulatory process for adding additional services to the list;
    • Allow virtual check-ins and e-visits to be used for new and established patients;
    • Allow remote patient monitoring to be used for new and established patients, and for acute and chronic conditions;
    • Allow direct supervision to be provided using real-time, interactive audio and video technology.

    Healthcare IT News: (8/20) – Adventist Health announced a partnership with the AI-driven behavioral telehealth company Synchronous Health to develop behavioral health solutions to address community needs.

    mHealthIntelligence: (8/21) – EMS providers are partnering in mobile integrated health programs, reducing ER transports, and improving care outcomes. “First responders have a great opportunity to use telehealth in ways that we really haven’t seen before,” says Carl Marci, chief medical officer for Ready, a two-year-old provider of mobile healthcare services that has seen business skyrocket during the coronavirus.

    Notable Telehealth Commentary

    Senator Roger Wicker and Senator Brian Schatz applauded new white paper jointly issued by the Progressive Policy Institute and Americans for Prosperity.

    “It is refreshing to see two groups with such different perspectives come together to support greater access to telehealth. When Senator Schatz and I started our telehealth working group years ago, we chose to work on bipartisan policy that would improve access to health care and save lives. We will continue to work together to ensure Americans can enjoy the benefits of telehealth for years to come,” said Sen. Wicker (R-MS).

    “As this paper shows, telehealth is a rare area with strong bipartisan support and it’s here to stay. While we have made some progress in Congress on expanding access to telehealth during this pandemic, we have more work to do to make these changes permanent and allow more patients to continue receiving the critical health care they need wherever they are,” said Sen. Schatz (D-HI).

    Upcoming Events

    August 24 - AMA Webinar: "Where does telehealth go from here? 

    August 24 - AHIP/amwell Webinar: "How NYC's Metroplus Health Plan Engaged Members In Telehealth During The Covid-19 Pandemic"

    August 25 – CMS COVID-19 Office Hours Call. Office Hour calls provide an opportunity to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems. 

    • Increase Hospital Capacity – CMS Hospitals Without Walls;
    • Rapidly Expand the Healthcare Workforce;
    • Put Patients Over Paperwork; and
    • Further Promote Telehealth in Medicare

    August 26 - #TelemedNow Twitter chat at 8pm ET

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