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Connected Care Update

October 26, 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

More than 80 Organizations Call on DEA to Finalize Special Registration for Telemedicine: (10/26) – The Alliance worked to convene over 80 organizations in a letter to the Drug Enforcement Administration (DEA) calling on the DEA to finalize the special registration for telemedicine. The anticipated registration would enable a practitioner to deliver, distribute, dispense, or prescribe via telemedicine a controlled substance to a patient who has not been medically examined in-person by the prescribing practitioner. Special registration to prescribe controlled substances through telemedicine was originally called for in the Ryan Haight Act of 2008. View the letter.

    Federal Updates

    Department of Veterans Affairs: (10/20) – VA announced it is developing a National Women Veterans Oncology System of Excellence through research, partnerships precision oncology and teleoncology that will provide women Veteran oncology patients with cutting edge care and access to potentially lifesaving clinical trials. As part of this effort, VA is seeking to partner with more oncology medical and research organizations and universities. View the press release.

      Legislative Activity

      Home Health Emergency Access to Telehealth (HEAT) Act (S. 4854): (10/23) – Sens. Collins (R-ME) and Cardin (D-MD) introduced the Home Health Emergency Access to Telehealth (HEAT) Act (S. 4854), which would provide payments for home health services furnished via visual or audio telecommunication systems during an emergency period. Reps. Marshall (R-KS), Sewell (D-AL), Arrington (R-TX) and Thompson (D-CA) introduced companion legislation in the House (H.R. 8677). View the press release and bill text.

      Safe Testing at Residence Telehealth (START) Act (H.R. 8642): (10/20) – Reps. Schweikert (R-AZ), Rush (D-IL), and Kelly (R-PA) introduced the bipartisan Safe Testing at Residence Telehealth (START) Act (H.R. 8642), which would provide coverage and payment for certain tests and assistive telehealth consultations during the COVID-19 emergency period. View the press release and bill text.

      Ensuring Parity in Medicare Advantage for Audio-Only Telehealth Act of 2020 (S. 4840): (10/21) – Sens. Roberts (R-KS), Cortez Masto (D-NV), Scott (R-SC), and Casey (D-PA) introduced the bipartisan Ensuring Parity in Medicare Advantage for Audio-Only Telehealth Act of 2020 (S. 4840), companion legislation to the House version (H.R. 7659) introduced by Rep. Sewell (D-AL) and seven bipartisan cosponsors, which would require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans. View the press release.

      Legislative Update –

      Top telehealth bills continue to attract attention and additional cosponsors in Congress:

      • The CONNECT for Health Act (S. 2741/H.R. 4932) gained four bipartisan cosponsors in the Senate this week. While we still support the CONNECT for Health Act, we believe Congress needs to go further than this legislation in order to hold on to the access created during the public health emergency. View cosponsors and bill text here.

      State Telehealth News

      The National Law Review: (10/21) – Several states are moving to make certain flexibilities around telehealth usage during COVID-19 permanent. This article provides a brief highlight of what some states have done to ensure temporary measures around telehealth become permanently implemented moving forward.

      mHealth Intelligence: (10/23) – Michigan payer Priority Health became the first payer in the state to introduce a telehealth-only plan. The MyPriority Telehealth PCP plan will assign members a primary care provider through Doctor on Demand, with all visits happening virtually. The plan goes into effect at the beginning of 2021.

      Becker’s Hospital Review: (10/20) – Illinois Governor Pritzker announced the release of $50 million to support the second round of the Connect Illinois broadband internet expansion to new communities across the state. This initiative aims to increase broadband access for telehealth, among other areas, by 2024. (10/20) – Delaware Governor Carney and the Delaware Department of Health and Social Services announced the creation of the Health Care Relief Fund, which would support providers through the pandemic. The $100 million fund will support funding for resources including telehealth equipment.

      Papers, Surveys, and Studies

      Check out the Alliance for Connected Care studies and polling website for more resources.  

      Global Spine Journal: (10/22) – A study published in the Global Spine Journal reports that 87.7% of spinal patients were satisfied with telemedicine appointments during the pandemic. A total of 772 patients participated in the survey across two practices in the USA.

      The Headache & Migraine Policy Forum: (10/21) – The Headache and Migraine Policy Forum (HMPF), in partnership with Migraine Again, released a report from its survey of nearly 1,300 participants conducted mid-summer regarding COVID-19 impact and telemedicine use by the migraine community. The survey revealed the growing value of telemedicine in maintaining access to care, finding that 66 percent of respondents agreed telemedicine allowed them to keep a medical appointment they would have otherwise canceled because of COVID-19.

      CareJourney: (10/21) – CareJourney released a report on telehealth expansion in Medicare using national Medicare fee-for-service claims data provided by CMS. The report provides a breakdown of telehealth utilization at the state and county-levels, by age cohort, ACO assignment status, frailty segment and Medicare enrollment cohort, and by COVID mortality risk. For example, the report finds that nationwide, 30% of eligible Medicare beneficiaries had at least one telehealth visit in 2020 with significant variation existing at both the state and county levels, ACO assigned beneficiaries are receiving care via telehealth at a higher rate than those not assigned to an ACO, patients in the frail elderly and major complex chronic segments are the highest adopters of telehealth at 46% and 42% respectively, and 36% of dual-eligible beneficiaries had used telehealth as of September 2020.

      Center for Connected Medicine, KLAS Research: (10/20) - According to a joint KLAS Research and Center for Connected Medicine survey of 117 health system execs, only 20% of US health systems said they'd continue offering telehealth if reimbursement rates reverted to pre-pandemic levels.

      Avalere: (10/19) - An analysis by Avalere revealed that one in three Medicare Advantage plans will offer new COVID-related supplemental benefits in 2021, such as COVID-19 care packages that include things like masks and hand sanitizer or no cost-sharing for testing. The analysis also found that 94% of MA plans will offer telehealth benefits for Medicare Part B covered services.

      American Journal of Managed Care: (10/16) – According to a study published in AJMC, clinicians with access to a share inpatient-outpatient EHR were more likely to schedule a telehealth follow-up appointment or conduct laboratory monitoring rather than an in-person visit. Additionally, the study finds that enhanced interoperability and patient data exchange can boost follow-up care efficiency. Additional reporting from EHR Intelligence.

      BMJ Open Diabetes Research & Care: (10/14) – A recent study launched by Kaiser Permanente found that daily foot temperature monitoring via a remote telehealth platform on patients at home helped eliminate major amputations and halve hospital admissions. Additional reporting from mHealthIntelligence.

      Telehealth News and Market Developments

      Modern Healthcare: (10/24) – Alliance Board Member Intermountain Healthcare president and CEO Dr. Marc Harrison issued an op-ed in Modern Healthcare discussed Intermountain’s experience with telehealth during COVID-19 and notes the need for permanent reimbursement.

      Modern Healthcare: (10/24) – Some experts and policymakers say it’s time to start thinking about reforming licensure at the federal level. “We should not allow … state licensing requirements to prevent telehealth from occurring. We should be putting our patients first, and if a patient wants to see a (practitioner) who’s licensed in another state, there shouldn’t be huge barriers in the way of that happening,” Sen. Chris Murphy (D-Conn.) said. Some experts said it could make sense to move away from state-based medical licensure now that medical standards are evidence-based and national organizations set medical training guidelines.

      Healthcare Finance News: (10/23) – In an interview with Alliance Board Member CVS Health, CEO Larry Merlo noted that the transformation to telehealth and remote monitoring during COVID-19 has, “[created] what we believe to be a more seamless experience in making healthcare more accessible and more affordable," he said.

      S&P Global Market Intelligence: (10/22) – IPO activity in the healthcare industry crossed the $10 billion mark for the second time in a row this year after companies attracted $13.44 billion in investment during the third quarter of 2020, data from S&P Global Market Intelligence showed. Third-quarter IPO activity was dominated by U.S. telehealth companies GoodRx Holdings Inc. and Amwell, which raised about $944.3 million and $853.3 million, respectively. GoodRx is the sixth digital health company to go public so far in 2020.

      Business Wire: (10/21) – Community Wellness, a digital health company dedicated to empowering people to achieve better health outcomes launched in California to bring its Remote Patient Monitoring (RPM) service to older adults living with cardiovascular disease and related comorbidities.

      Business Wire: (10/21) – Cloudbreak Health, a leading unified telemedicine and video medical interpretation solutions provider, announced a partnership with Oneview Healthcare, a healthcare technology company bringing digital services to the point of care. The partnership enables Martti, Cloudbreak’s video remote interpretation (VRI) services, within Oneview’s virtual care platform to offer patients and providers an integrated solution for overcoming language barriers in healthcare.

      Mobihealthnews: (10/20) - eVisit, an Arizona-based SaaS telehealth company, just landed $14 million in Series A funding. The company provides a telehealth platform that includes several facets, including a scheduling, intake, waiting room management and discharge function. Its main customers are hospitals and health systems.

      Upcoming Events

      October 27 – McDermott Will & Emery, “Provider Panel: Lessons Learned from Deploying Telehealth Strategies in COVID-19.”

      October 27 – STAT News, “A Conversation with Amwell.”

      October 29 – URAC, “The Future Of Telehealth.”

      October 30 – Medicaid and CHIP Payment and Access Commission (MACPAC), “Comment on Secretary's Report to Congress on Reducing Barriers to Substance Use Disorder Services Using Telehealth for Pediatric Populations under Medicaid.” Additional Information

      November 19 – Southwest Telehealth Resource Center, Arizona Telemedicine Program, “2020 Mid-Year Rural Health Policy Roundup.”

      Past Events

      Recording of an interview by Tradeoffs, a national health policy podcast with Chad Ellimoottil, MD. Dr. Ellimoottil references the University of Michigan’s Institute for Healthcare Policy & Innovation’s Telehealth Research Incubator and talked about: Current trends; Concerns about the impact of telehealth on healthcare spending; Return of copays; and Advantages and disadvantages of reimbursing phone calls.

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