PR Newswire: Protecting Patients and Telehealth Access: Over 230 National Organizations Urge Governors to Maintain and Expand Licensure Flexibilities throughout Federal Public Health Emergency: (11/1) – More than 230 organizations sent a letter to all 50 state governors urging them to maintain and expand licensure flexibilities enacted at the start of the pandemic for the duration of the federal public health emergency, to better address patient needs during the ongoing pandemic. The letter asks state governors to act now to ensure patients can access the care they need where they reside and when they need it, and outlines a set of principles to consider for licensure policies that should be in place right now to ensure patient access to care. The letter was convened by the Alliance for Connected Care, ALS Association, and National Organization for Rare Disorders (NORD), and includes a diverse mix of signers ranging from patient advocacy organizations, hospitals and health systems, academic medical centers, higher education, digital health companies, health information management associations, and many more. To read the letter, click here.
Healthcare IT News: ATA, businesses ask Congress to expand telehealth options for workers (11/2) – Several groups sent a letter to Congress requesting that they continue to allow telehealth and remote care services to be treated as an excepted benefit. The organizations who signed the letter, which included the Alliance for Connected Care, urged Congress to permanently add telehealth and remote care services as excepted benefits, as other benefits like disability insurance and workers’ compensation already are and as it would not affect an employer’s responsibility to offer minimum essential coverage to employees under the ACA. The letter, which included dozens of business groups and industry representatives, read “Without Congressional action, employers will be unable to offer basic virtual health services to millions of Americans in part-time and seasonal jobs or workers otherwise not participating in their employer’s full medical plan.”
Alliance for Connected Care: Telehealth Data Request
Building on our important work as part of the Taskforce on Telehealth, the Alliance for Connected Care continues to collect data necessary to make the case for permanent telehealth policies. We are seeking to understand what we have learned about telehealth utilization and its effect on prevention, urgent care, transportation, and etc. Our goal is to educate a conversation about what impact expanding telehealth access in Medicare will have on federal budgeting models.
In our efforts to gather data on cost, we are asking organizations, health systems, or providers to submit data on telehealth during COVID-19. Please view our collection page here.
Utilization data: to what extent is telehealth serving as a replacement for in-person care?
Demographics/Race/Ethnicity/Age distribution: To the extent you have such data, we want to show telehealth utilization broken down by various demographics including race/ethnicity, age, gender, income, education, etc.
No-show Rates: Were no-show rates reduced, and if so, by how much?
Post-discharge: Were post-discharge transition codes (99495 and 99496) billed at a higher rate?
SNF Transfers: Did telehealth resolve skilled nursing facility -resident issues without transfer, i.e. were transfers to hospitals lower without compromising patient care?
Imaging: What happened to orders for imaging for telehealth visits, were they higher or lower for commensurate in-person care?
CMS: CY2022 Medicare Physician Fee Schedule (11/2) – CMS released the final CY2022 Medicare Physician Fee Schedule, which makes payment and policy changes under Medicare Part B. The rule finalizes several telehealth policies including eliminating of geographic restrictions and includes the home as an eligible originating site when furnishing telehealth services for mental health services. CMS will also allow audio-only for telemental health services, but only when the beneficiary is not capable of using, or does not consent to using audio/video technology. In addition, CMS finalized several new policies with respect to the Medicare Diabetes Prevention Program (MDPP) in order to boost beneficiary access and supplier participation in the program. View the telehealth fact sheet, MDPP Fact sheet and final rule.
Expanded Telehealth Access Act: (11/4) – Senators Daines (R-MT), Smith (D-MN), Moran (R-KS) and Rosen (D-NV) introduced the Expanded Telehealth Access Act (S.3193), which would expand the scope of practitioners eligible for payment for telehealth services under the Medicare program. The “Expanded Telehealth Access Act” makes permanent the reimbursement eligibility for physical therapists, audiologists, occupational therapists, and speech language pathologists and permits the Secretary of Health and Human services to expand this list. The Alliance for Connected Care has endorsed this bill.
“Physical therapists, audiologists, occupational therapists, and speech language pathologists are critical providers for seniors, and an important part of whole-person care. Earlier this year, the Alliance co-led a lettersigned by more than 430 groups urging Congress to maintain and enhance the list of health care providers eligible to provide telehealth services. The Alliance strongly supports changes to distant site provider list restrictions to allow for all Medicare providers to deliver telehealth services, when clinically appropriate, to beneficiaries through telehealth,”said Krista Drobac, Executive Director of the Alliance for Connected Care
View additional coverage of the bill from The Hill.
Tele-MAT Bill: (11/3) – Representatives Curtis (R-UT) and Peters (D-CA) introduced a bill (H.R. 5837) that would expand access to telehealth services relating to substance use disorder treatment. The official press release and bill text have not yet been released.
State Telehealth News and Activity
Michigan State Medical Society: Interoperable Telehealth: Patient Safety Considerations (11/1) – Telehealth interoperability with EHR systems is key for delivering high quality care, according to guidance published by the Michigan State Medical Society. “During the pandemic, it rapidly became clear that a single-source solution for telehealth fully integrated with the electronic health record (EHR) is necessary to maintain telehealth visits on a large scale.”
Comments are due through this online form by 11:59 pm ET on Friday, December 10th.
American Medical Association (AMA): The AMA is engaging physicians in a grassroots effort to define and measure virtual care as Congress considers future coverage and payment policies. The AMA's "Return on Health" framework is a holistic value framework designed to guide clinicians, virtual care leaders, payers and other health care stakeholders in assessing value created for patients and for themselves.
JAMA: Analysis of Clinician and Patient Factors and Completion of Telemedicine Appointments Using Video (11/4) – A new research article published by JAMA Network Open, examines the results of a quality improvement study of more than 130,000 scheduled video visits at an academic health system between March 1 and Dec. 31, 2020. Patient characteristics including older age and ethnicity are associated
with the successful completion of video telemedicine visits, a new research article says.
The study generated several key data points.
90% of video visits were successful and 10% were converted to telephone visits
Lower clinician comfort with technology was associated with conversion to telephone visits (odds ratio 0.15)
Advanced patient age (66 to 80 years old) was associated with conversion to telephone visits (odds ratio 0.28)
Lower patient socioeconomic status including low access to high-speed Internet was associated with conversion to telephone visits (odds ratio 0.85)
Patient ethnic and racial minority status was associated with conversion to telephone visits (for Black and African American patients, the odds ratio was 0.75)
Relatively high patient income ($75,001 to $213,000) was associated with successful video visits (odds ratio 1.18)
Patient use of a tablet or laptop was associated with successful video visits (odds ratio 1.41)
Morning Consult: On-Demand Telehealth Is Booming Even as a Fierce Competitor Remains: the Doctor’s Office (11/3) – A new Morning Consult polling indicates that for now, most adults who use telehealth are sticking with virtual care from their doctors over on-demand services. “People are using their own doctors, and there aren’t these fly-by-night operations setting up to just bill Medicare for these services,” said Krista Drobac, executive director of the Alliance for Connected Care.
72% of U.S. adults who have used telehealth said they’ve accessed virtual care through their regular provider or health plan, while another 17% have gotten care through a direct-to-consumer platform and 11% have used both types of services.
53% of U.S. adults said they’d rather use in-person health care than telehealth moving forward, but that share fell to 45% among those who have used telehealth in the past.
Virtual care’s biggest growing pains: cost and coverage. Among the challenges for on-demand telehealth is getting coverage for the services, as traditional payers and providers roll out their own virtual care options.
FAIR Health: Telehealth Utilization in South Rose Nearly 13 Percent in August 2021 Compared to Prior Month (11/2) – Telehealth utilization in the South, measured as a percentage of all medical claim lines in that region, rose
12.9 percent from July to August 2021, increasing from 3.1 percent of medical claim lines in July to 3.5 percent in August. Telehealth utilization in August rose nationally (by 2.4 percent) and in all US census regions except the Midwest, but the growth in the South surpassed that in all other geographical areas. Reported by FAIR Health's Monthly Telehealth Regional Tracker, the data represent the privately insured population, including Medicare Advantage and excluding Medicare Fee-for-Service and Medicaid.
American College of Rheumatology: Race, Age, Sex and Language Affected Telemedicine Use by Rheumatology Clinic Patients During COVID-19 Pandemic (11/2) – New research
presented at ACR Convergence, the American College of Rheumatology’s annual meeting, shows a significant lack of fairness among telemedicine and electronic patient portals used by rheumatology clinic patients based on their race, age, sex and English language proficiency. During the pandemic, factors associated with telemedicine use were younger age, living farther from the hospital, female sex, English language preference, white race identity and having commercial insurance.
Researchers found that patients who identified as white were more than two times as likely as Black or American Indian/Alaska Native patients to use telemedicine.
Patients who preferred to speak English were more than three times as likely to use telemedicine than those who preferred to speak Spanish or other non-English languages.
Telehealth News and Market Developments
Modern Healthcare: Op-ed: We're running out of time to protect telehealth access (11/5) – Dr. Ken Davis, CEO and Dr. Rob Fields, executive vice president and chief population health officer, of Mount Sinai Health System in New York remarked on the need for permanent policy changes in order to protect patients who have come to depend on telehealth as a reliable and convenient option to health care services. Among the many flexibilities the authors highlight, they also call for the “federal government to work with state licensing boards to permanently expand the privileges established during the pandemic that make telehealth more flexible.”
Digital Therapeutics Alliance: The Digital Therapeutics Alliance Welcomes Decision by the CPT® Editorial Panel to Clarify Reporting of Remote Cognitive Behavioral Therapy Monitoring Services (11/4) –The Digital Therapeutics Alliance (DTA) - in a press release - praised the AMA's Current Procedural Terminology (CPT®) Editorial Panel’s recent decision to clarify reporting of remote cognitive-behavioral therapy (CBT) monitoring services. "The changes to the CPT code set reflect the growing recognition that digital therapeutics (DTx) are an effective treatment for patients with mental health conditions and physicians should ultimately be reimbursed for their time spent prescribing, monitoring, and supplying online CBT technologies," DTA said in a press release.