The Alliance for Connected Care continues to track the end of the public health emergency (PHE), as well as the 151-day grace period once the PHE ends which would mark the expiration of current Medicare telehealth flexibilities. Both trackers can be found on our website.
According to recent reporting, the Biden Administration is expected to extend the PHE beyond the midterm elections in November and potentially into early 2023, following extensive deliberations among Biden Administration officials over the future of the emergency declaration. This could still change ahead of the August 15 deadline for deciding whether to let the declaration continue. See below for how many days there are left until the PHE is currently set to end:
Alliance for Connected Care: Alliance Submits Comments in Response to the HHS Request for Information on Strengthening Primary Health Care (8/1) – The Alliance submitted comments in response to an HHS request for information on its Initiative to Strengthen Primary Health Care, providing comments on the impact of telehealth and virtual care on primary care access. The Alliance believes telehealth and remote patient monitoring are a solution to improve primary care. Telehealth and cross-state care provide greater access to primary health care, are tools to address primary care access (and workforce shortages) in rural and medically underserved communities, and provide patients affordable ways to access primary care via telehealth. To read our comments, click here.
Department of Veterans Affairs Office of Inspector General: Digital Divide Consults and Devices for VA Video Connect Appointments (8/4) – The Department of Veterans Affairs (VA) Office of Inspector General (OIG) published an audit report which found that the Veterans Health Administration (VHA) distributed devices to about 41,000 patients during the first three quarters of 2021.More than 10,000 patients had a video appointment scheduled, but did not complete the visit for various reasons, such as technical issues or a cancellation, and never scheduled another virtual appointment. OIG recommended developing a mechanism to alert the clinics that a patient can be scheduled for a virtual appointment and enhancing tracking device packages to reduce delays to care. For additional coverage, see Federal News Network.
Federal News Network: TRICARE Recipients will Once Again Have to Pay for Telehealth Copays (8/3) – For the nearly 10 million people using TRICARE as their health care insurance provider, telehealth appointments have been free of copays, adding a layer of financial relief during a worldwide pandemic. However, that is now about to change as the United States rethinks the pandemic’s national emergency status. The Defense Health Agency says it will, once again, start charging copays for telehealth visits with medical professionals. The change marks the first time in more than two years that TRICARE recipients will have to pay upfront for remote care. For additional coverage, see Health Leaders Media.
Telehealth Research, Reports and Surveys
Healio: Orthopedic Telehealth Remains Popular Despite Reopening of Clinical Offices After COVID-19 (8/3) – Despite vaccine availability and the reopening of clinical offices after the onset of the COVID-19 pandemic, telehealth remains a popular choice for orthopedic patients. Using the terms “orthopedic,” “surgeon,” “doctor,” “injury,” “pain” and “telehealth,” researchers from Rothman Orthopaedic Institute performed a Google Trends search to assess interest in orthopedic telehealth from May 2016 to May 2021. Researchers concluded that interest in orthopedic telehealth was steadily growing prior to the onset of the COVID-19 pandemic and remains significantly elevated beyond pre-pandemic levels despite the reopening of clinical offices and the introduction of vaccine availability across the country.
JAMA Internal Medicine: Trends in Remote Patient Monitoring Use in Traditional Medicare (8/1) – A study published in JAMA Internal Medicine
found that during the COVID-19 pandemic, there was a 555 percent increase in the use of remote patient monitoring (RPM) among Medicare beneficiaries. Regarding specialties, researchers noted that primary care physicians were the most common provider of general RPM, offering 63.1 percent of the services, followed by cardiologists (19.7 percent) and pulmonologists (4.1 percent). Researchers believe that the study provides valuable information regarding the evolution and potential future of RPM among Medicare patients. For additional coverage, see mHealth Intelligence.
United Health Group: Telehealth Enabled a 26 Percent Increase in Outpatient Behavioral Health Visits Among Commercially Insured Individuals (8/1) – According to a report from UnitedHealth Group (UHG), telehealth flexibilities during the COVID-19 pandemic contributed to a 26 percent spike in overall utilization of in-network outpatient behavioral health. UHG used data from commercially-insured Optum Behavioral Health plan members to compare behavioral health care utilization from before the pandemic to utilization after the pandemic started. In 2019, 99 percent of outpatient behavioral health care was conducted in an office. However, by the second quarter of 2021, only 35 percent of all outpatient behavioral health care visits were in an office. The report concluded that improving access for individuals covered by Medicare and Medicaid, as well as some commercially insured individuals, would require efforts to address disparities in access to technology and broadband, improve digital literacy, and increase the supply of behavioral health providers. For additional coverage, see Health Payer Intelligence.
University of Michigan: Disparities in Accessing Care Could Worsen if Audio Visits Aren’t Available as a Telehealth Option (8/1) – A study found that audio-only appointments made up nearly half of the Michigan Medicine Department of Urology’s telehealth visits during the first few months of the pandemic. Forty-four percent of patients who had a telehealth visit for a urological concern from April 1, 2020, to June 30, 2020 used audio but not video functions. The study found factors that affected whether patients preferred audio over video or did not have the technological capacity for video calls included older age, Black or American Indian/Alaska Native ethnicity, the need for an interpreter, living in a rural area with limited broadband access, or having Medicaid health insurance. The findings suggest that audio encounters may be an important medium for certain patient populations to connect with their physicians during the COVID-19 public health emergency and beyond.
JAMA Network Open: Association of Health Literacy and Area Deprivation With Initiation and Completion of Telehealth Visits in Adult Medicine Clinics Across a Large Health Care System (7/25) –Research shows that factors such as health literacy and area deprivation index (ADI) can influence whether video-based or audio-only telehealth is used. For this study, researchers included information on 18,130 telehealth visits. The study found that although telehealth can provide many benefits, there are also many accessibility factors associated with its use. Providers must consider that some patients may experience difficulties obtaining and using telehealth technology due to their level of health literacy and ADI. For additional coverage, see mHealth Intelligence.
Spotlight on Cross-State Licensure
Alliance for Connected Care: Updated COVID-19 State Telehealth and Licensure Waiver Dashboard – The Alliance for Connected Care has updated its tracker outlining which states have lifted their COVID-19 emergency waivers, and how this has impacted telehealth and licensing flexibilities in each state. As of August 3, only 11 states continue to have emergency declarations in place and only 14 states continue to have COVID-era licensure flexibilities in place. For more information, click here.
MedPage Today: Location Shouldn't Matter When It Comes to Health Care (8/1) – In this opinion piece, Dr. Fred Pelzman, an internist at Cornell Medicine, advocates for cross-state care. Specifically, he highlights the parallel of his driver’s license with his medical license. He also questions if medicine is so different from one state to the next that physicians can’t be trusted to practice medicine across state lines as long as they follow the other state’s laws.
Health Affairs: August 2022 Issue (8/1) – Interstate licensure is spotlighted in several articles included in this month’s issue of Health Affairs:
Interstate Licensure: Has The Time Come?: This perspective piece describes the impact of New Jersey’s efforts to rapidly expand the workforce in response to the pandemic by allowing for temporary reciprocity of out-of-state practitioners’ licenses.
Impact Of The New Jersey COVID-19 Temporary Emergency Reciprocity Licensure Program On Health Care Workforce Supply: During the pandemic, New Jersey’s COVID-19 Temporary Emergency Reciprocity Licensure Program provided temporary licenses to more than 31,000 out-of-state health care practitioners. A survey found that practitioners who used this temporary license originated from every state in the US, provided both COVID- and non-COVID-related care, served a combination of new and existing patients, conversed with patients in at least 36 languages, and primarily used telehealth. Findings suggest that such temporary licensure of out-of-state practitioners, along with telehealth waivers, may be a valuable solution to mitigating health care workforce shortages during public health emergencies.
For more information and advocacy related to this issue, visit our website here.
Telehealth News and Market Developments
Becker’s Hospital Review: Amwell announces CVS Health virtual care partnership: (8/5) – Alliance board member Amwell is working with Alliance board member CVS Health to roll out CVS Health’s new virtual primary care service. The offering gives consumers access to primary care, on-demand care, chronic condition management and mental health services and will be available to eligible Aetna and CVS Caremark members.
Broadband Breakfast: If You Can’t Give Away Free Internet, Consider Telehealth (8/4) –The Federal Communications Commission (FCC) met on Friday to authorize a $100-million grant program to help boost utilization of the Affordable Connectivity Program (ACP). However, ACP adoption has been difficult for community organizations due to poor funding support. In this opinion piece, Craig Settles, a telehealth analyst, recommends six tactics for communities to deploy telehealth and ACP adoption. Specifically, he recommends pushing telehealth services as the marketing message for ACP adoption.
Fierce Healthcare: MedArrive Teams Up with Brave Health to Integrate Virtual Mental Health into Home Care Visits (8/4) – Home-based health care technology company MedArrive is teaming up with Brave Health, a virtual-first behavioral health provider, to refer its customers who need behavioral health services to Brave Health. Through the partnership, MedArrive identifies an eligible health plan member in need of mental health support, and can immediately refer that member to Brave Health’s behavioral health providers in real time and schedule care within 72 hours.
Health Tech: How Does Telehealth Expand Health Care Access for LGBTQ+ Patients? (8/4) – In this interview, the co-founder and chief medical officer of Plume, a virtual care service that offers gender-affirming hormone therapy, highlights the importance of telehealth for the LGBTQ community. Telehealth increases access to care for those who may be unable to access safe and affirming care locally. Plume can source providers from all over the country. If a physician anywhere in the US has the appropriate medical license for the state where the patient is located, and follows the relevant laws, that physician can provide care no matter where they live.
mHealth Intelligence: Hybrid Care Provider, Payer Team Up to Expand Care Access in Rural Michigan (8/4) – Homeward, a hybrid care provider focusing on rural health care, has partnered with Priority Health, a nonprofit health insurer, to expand access to its services in Michigan. Through the partnership, Priority Health Medicare Advantage plan members will be able to access Homeward's suite of virtual and in-person care options.
Healthcare IT News: Stony Brook Medicine Crafts A Telehealth Strategic Plan That Bears Fruit (8/2) – The Stony Brook Medicine health system uses telemedicine that ranges from outpatient to inpatient and remote patient monitoring via iPhones. Healthcare IT News interviewed Dr. Gerald J. Kelly, CIO at Stony Brook Medicine, who shares the opportunity telehealth provides.
State Telehealth News and Activity
Washington State Department of Health: New Telehealth Option Launched to Expand COVID-19 Treatment Access (8/4) – To increase access to potentially life-saving medication to treat COVID-19, the Washington State Department of Health (DOH) and its partners have launched a new telehealth option for patients. The new option expands the Federal government’s Test to Treat initiative and gives people at risk of severe disease another way to quickly access free treatment for COVID-19. For additional coverage, see Washington State Hospital Association.
Becker’s Hospital Review: Los Angeles Hospitals Launch Telestroke Program (8/3) – Los Angeles-based hospital CHA Hollywood Presbyterian Medical Center has launched a telestroke program in collaboration with the University of Southern California's Keck Medicine. The program allows clinicians at CHA Hollywood Presbyterian Medical Center to consult remotely with stroke specialists and neurologists at USC's Keck Medicine. The telehealth platform will be available for clinicians 24 hours a day, seven days a week.
Desert News: Opinion: Can’t Find a Therapist? Step One for Utah is Expanding Telehealth Access (8/3) – The COVID-19 pandemic fueled rapid regulatory and legislative changes, broadening Utahns’ access to a vast range of telemedicine services. Such policy changes, included temporarily waiving occupational licensing requirements and regulations that would have blocked access to large scale telehealth services. However, Utah will need to do more to address mental health issues. Scope of practice laws are regulations put into place by Utah’s lawmakers that dictate what activities various professionals are allowed to perform. The consequences of present scope of practice restrictions include workforce shortages, decreased access to care, poor health outcomes and increased cost.
Michigan State Medical Society: As Telemedicine Best Practices Emerge, Assess Your Practice (8/3) – In this article, the Michigan State Medical Society provides best practices for certain specialties, including obstetrics, otolaryngology and surgery. The article also notes that patient safety researchers promote reimbursement for providers who offer the substantial technology education and orientation some patients need to function as activated patients within the telemedicine landscape.
Boise State Public Radio News: Idaho Extends Telehealth Rules for Out-Of-State Therapists (8/2) – State officials in Idaho waived state licensing requirements during the COVID-19 pandemic to address mental health issues that have skyrocketed across the country. The waiver had been set to expire July 1, with some worried a sudden disruption could lead to a lapse in coverage for patients. Out-of-state mental health therapists will be able to continue practicing in Idaho via telehealth without a local license through the end of the year.
DC Health: DC Health Announces Telehealth Antiviral Treatment Program for COVID-19 (8/1) – DC Health announced a new partnership with Color Health to offer a free COVID-19 treatment access program via telehealth in D.C. This partnership will provide an additional resource to accessing Paxlovid to D.C. residents. To determine eligibility, residents will need to request a telehealth consultation through Color Health by completing a short questionnaire, which determines eligibility for a telehealth visit and connection with a provider.
Buffalo Business First, “The Future of Health Care: Roundtable.” Eight health care professionals recently gathered for a roundtable event to discuss their experiences and what the future of health care looks like. Panelists identified the biggest imprint from the pandemic on their organizations is the dramatic shift to telehealth services. While telehealth has become popular for its convenience, it has posed some difficulty at Evergreen, a public hospital in Washington, and its mission to serve the safety-net population. Poor access to technology and the Internet created a barrier for some and limited the organization’s ability to use it fully. Outside of the barriers, patients and staff are willing to use telehealth.
ICYMI: Office for the Advancement of Telehealth, “National Telehealth Conference.” The 2022 HRSA National Telehealth Conference brought together telehealth experts, providers, and policymakers to discuss the evolution of telehealth and expectations for the future.