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Connected Care Update

December 14, 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

Wide range of groups call for telehealth in end of year package:

  • Digital Health Groups Call on Congress to Extend Telehealth Access: (12/11) – The Alliance for Connected Care, American Telemedicine Association, College of Healthcare Information Management Executives, Connected Health Initiative, eHealth Initiative, Health Innovation Alliance, HIMSS and the PCHAlliance called on Congressional leaders to act to preserve access to telehealth as part of an end of year package

.“While we seek permanent reforms to enable Medicare beneficiaries to continue to access services via telehealth once the COVID-19 public health emergency (PHE) ends, we write today to express our support for provisions, proposed by a bipartisan group of Senators, that would extend temporary telehealth flexibilities until the end of 2021 in an end-of-year package to fund the federal government. We believe this extension is a reasonable policy that will help provide certainty for patients and providers as we work together on permanent reform in 2021.”

Read the Letter to Congressional Leaders on Extending Telehealth Flexibilities

  • Health Partners Letter to Congress on Telehealth Priorities: (12/9) – More than 25 leading health partners joined in sending a letter to House and Senate leadership making a push for the inclusion of robust telehealth provisions in legislative vehicles that may come up in the coming week or next Congress.

Inside Health Policy: (12/9) – Inside Health Policy Michelle M. Stein wrote an article on the latest PREP Act amendment which allows doctors to provide certain COVID-19 pandemic-related services via telehealth across state lines. Krista Drobac, Alliance for Connected Care executive director, said this is an effective use of the public health emergency law, the article states. The pandemic waivers provide a unique opportunity to show that allowing providers to practice across state lines can increase access to care, Drobac added.

POLITICO Future Pulse, Maintaining Telehealth’s Momentum: (12/7) – Politico noted the Alliance’s efforts to make recent telehealth policy permanent. The Alliance for Connected Care’s Krista Drobac, who joined the Milken Institute in a telehealth panel, said the pandemic presents an “unprecedented opportunity to change telehealth for the long term.” She expects to focus on expanding Medicare and commercial payers’ reimbursement, loosening licensing restrictions that make it harder to practice across state lines, removing federal barriers to prescribing behavioral health drugs to patients virtually, and building out better broadband, the article notes. “We’re going to continue rabble-rousing on the DEA regulations, and we are going to be making a big push this coming year in 2021 on cross-state licensing,” she told Politico.

Milken Institute 2020 Future of Health Summit, Realizing the Promise of Telehealth During the Pandemic and Beyond: (12/7) – Alliance Executive Director Krista Drobac joined the Milken Institute in a telehealth panel to discuss the rapid shift to telehealth during the COVID-19 pandemic and whether telehealth will allow us to spread access to health services and help foster health equity and narrow the disparities in health outcomes across underserved communities. A recording can be viewed here.

    Congressional Update

    Congressional Telehealth Caucus Planning for 2021

    The Alliance for Connected Care is working with the Senate Telehealth Working Group and House Telehealth Caucus to develop updated Medicare telehealth legislation to build on the CONNECT for Health Act in 2021. Please feel free to share input for our priorities with cadamec@connectwithcare.org by December 18.

    Legislative Activity 

    Comprehensive Addiction & Recovery Act (CARA) 2.0: Sens. Portman (R-OH), Whitehouse (D-RI), and Klobuchar (D-MN) introduced the Comprehensive Addiction and Recovery Act (CARA) 2.0 to increase the funding authorization levels for the Comprehensive Addiction & Recovery Act (CARA) programs enacted in 2016 and put in place additional policy reforms to help combat the opioid epidemic that has worsened during the coronavirus pandemic. Among other provisions, CARA 2.0:

    • Permanently allows providers to prescribe medication-assisted treatment and other necessary drugs without a prior in-person visit, and to bill Medicare for audio-only telehealth services.

    View the press release, bill text, section-by-section, and a summary.

    Bipartisan Emergency COVID Relief Act of 2020: (12/9) – While its outcome remains very much in doubt, the $908 Billion bipartisan compromise proposal put forward in the Senate includes notable telehealth provisions. 

    • Extension of telehealth flexibility through December 31, 2021
    • $475 million to FCC COVID-19 Telehealth Program to support efforts of healthcare providers to address coronavirus, including a 20% set aside for small, rural health providers
    • Limited extension of associated CMS and DEA telehealth waivers focused on to Medication-Assisted Treatment (MAT) and elimination of the requirement that practitioners to apply for a waiver through the DEA in order to prescribe buprenorphine for substance use disorder treatment to the end of the Public Health Emergency or to December 31, 2021, with appropriate state oversight and study to be conducted on buprenorphine diversion
    • $6.25 billion for State Broadband Deployment and Broadband Connectivity grants to bridge the digital divide and ensure affordable access to broadband during the COVID 19 pandemic.
    • $100 million to Department of Veterans Affairs for Telehealth and Connected Care Program to purchase, maintain, and refresh devices and services to veterans for provision of access to telehealth services

      State Telehealth News

      JD Supra: (12/10) – Manatt released a new report tracking telehealth changes made in each state in response to the COVID-19 pandemic. This tracker outlines both federal and state-level policy, regulatory, and legal changes made related to telehealth in 2020.

      mHealth Intelligence: (12/10) – Advocates have long argued that laws prohibiting cross-state licensure create one of the largest barriers to telehealth expansion. Recently, a Virginia-based psychologist sued the District of Columbia for the right to use telehealth to treat patients in D.C., arguing it is a freedom she has under the First Amendment to counsel patients in other states.

      Becker’s Hospital Review: (12/10) – UW Medicine in Seattle launched a new on-demand virtual care program in partnership with telehealth provider 98point6. The program will allow patients to receive on-demand medical care via text message consults with physicians, with information from the visit sent to the patient’s electronic medical record after the visit.

      JD Supra: (12/9) – Tennessee Governor Bill Lee issued a new Executive Order to provide the tools to increase health care resources and capacity in the state. One provision in the Order includes allowing pre-license, graduate, or doctoral level audiology and speech language pathology professionals to provide telehealth services. The order would also encourage the expansion of hospital-level care in home programs and telemedicine access.

      mHealth Intelligence: (12/8) – The city of Schenectady in New York is leveraging its fire department to launch a mobile integrated telehealth program to reduce emergency department (ED) traffic and improve time to treatment. The program uses a connected health platform to connect EMS providers with ED physicians employed by United Concierge Medicine during emergency calls. The program saw 71 percent of 41 telehealth calls successfully treated at home in its first month.

      Papers, Surveys, and Studies

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

      Center for Connected Health Policy: (12/8) – The Center for Connected Health Policy released its 2020 roundup of state-approved telehealth legislation. While the number of bills passed remained relatively consistent from 2019 to 2020, the types of bills varied as a result of the need for more expansive telehealth policies on a large scale due to the pandemic. This resource contains a detailed listing of all bills by topic area and state.

      Medicare Advantage Plans: (12/8) – A new Medicare Advantage study found that for 2021, consumers are choosing MA not only for the telehealth benefits, but for COVID-19 supplemental benefits offered by the private plans. Of those who decided on an MA plan because of supplemental benefits, 35% cited COVID-19 supplemental benefits specifically, while 27% cited telehealth benefits, the report said.

      Milken Institute: (12/7) – The Milken Institute released an issue brief on Recommendations to Advance Telehealth during and after the COVID-19 Pandemic. To encourage progress in telehealth, the Milken Institute recommends the following:

      1. Permanently lift Medicare location restrictions on telehealth to ensure that older adults can receive a variety of services in their homes and communities, regardless of where they live.
      2. Meet the growing need for behavioral health care by addressing barriers to remote care and expanding the availability of telebehavioral health services.
      3. Increase equitable access to telehealth services through digital technology, literacy programs, and broadband coverage.
      4. Support development and implementation of innovative telehealth and mobile health technology for prevention, well-being, clinical care, and research.
      5. Develop and document clear data sharing standards to support transitions of care across acute, post-acute, and long-term care settings, including care provided in the home and in residential care facilities.

      … Although recent telehealth adoption was “driven by necessity, emerging data indicate high patient satisfaction with telehealth services and a willingness to engage remotely in the future,” authors wrote.

      Telehealth News and Market Developments

      Washington Post: (12/10) – Johns Hopkins Medicine CEO Dr. Paul Rothman and Kevin Sowers, President of the Johns Hopkins Health System issued an op ed in the Washington Post urging Congress to take swift action on the TREAT Act. As a reminder, the TREAT Act (H.R. 8283/S. 4421) would provide temporary licensing reciprocity for telehealth and interstate health care treatment. View the press release and bill text.

      Patient Engagement HIT: (12/10) – Cerner Corporation announced it’s building on the recent collaboration with Xealth to offer health systems new centralized digital ordering and monitoring for clients. These capabilities are designed to help health systems choose, manage, and deploy digital tools and applications while offering clinicians access to remote monitoring and more direct engagement with patients.

      Health Affairs: (12/7) – A blog in health affairs notes the need for modernizing the patient experience measurement in light of a rise in telehealth rise and value-based care.

      Ongoing Alliance Efforts

      PLEASE SIGN-ON to Consensus Principles on Telehealth Across State Lines

      The Alliance for Connected Care seeks your support on an open letter to U.S. State and Federal Policymakers calling for care across state lines to support patients and empower healthcare professionals.

      This high-level statement is intended to call attention to the need for telehealth care across state lines, through solutions that allow for mutual recognition of health professional licensure. Please sign here. Please also feel free to share this opportunity with others.

      Read more about this statement featured in mHealthIntelligence.

        Upcoming Events

        December 17, Project ECHO, “Telemedicine to Combat Fatigue and Burnout: COVID-19 & Telemedicine – A Project ECHO Event.”

        December 17, AHIP, “From Barrier to Bridge: Interoperability’s Role in Value-Based Care.”

        January 15, 2021, Center for Connected Health Policy, “Telehealth & Medicaid: Waivers and State Plan Amendments to Address COVID-19.”

        January 22, 2021, Center for Connected Health Policy, “Telehealth & Medicaid: Provider Engagement and Education.

        January 29, 2021, Center for Connected Health Policy, “Telehealth & Medicaid: Patient Engagement and Education.”

        Past Events

        Milken Institute 2020 Future of Health Summit, "Realizing the Promise of Telehealth During the Pandemic and Beyond." Alliance Executive Director Krista Drobac joined the Milken Institute in a telehealth panel to discuss the rapid shift to telehealth during the COVID-19 pandemic and whether telehealth will allow us to spread access to health services and help foster health equity and narrow the disparities in health outcomes across underserved communities.

        REACH Healthcare Foundation, “Telehealth: In Response to COVID and Beyond.” The REACH Healthcare Foundation, in conjunction with the KU Center for Telemedicine and Telehealth (KUCTT), hosted a webinar to review COVID-19 telehealth policy updates and the landscape of telehealth policy after the public health emergency.

        Please subscribe to this newsletter and send any news or events to crystal.wallace@connectwithcare.org for inclusion.

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