Hypoparathyroidism News: Rare Disease Groups in US Join in Plea for Care Across State Lines (11/8) – This article highlights efforts by the Alliance for Connected Care, National Organization for Rare Disorders (NORD) and ALS Association to convene a letter urging governors to maintain and expand licensure flexibilities for the duration of the federal public health emergency. The letter, which was signed by over 230 organizations, encourages state governors to reinstate expired licensure flexibilities, or put in place new flexibilities to better meet patient needs throughout the pandemic. “State governors must act to ensure these flexibilities continue, and consider solutions to address the ongoing needs of patients both during the pandemic and in the future,” said Krista Drobac, Executive Director of the Alliance for Connected Care.
CMS: COVID-19 Medicaid and CHIP Data Snapshot through May 2021 (11/12) – CMS released a preliminary data snapshot of Medicaid and CHIP services from March 2020 through May 2021. Preliminary data suggest that services delivered via telehealth increased for beneficiaries of all age groups during the PHE, but were highest among the 19 to 64 age group. Service delivery via telehealth for children increased dramatically starting in April 2020 compared to prior years, with the highest average monthly rates in northeaster states. Comparing the PHE period March 2020 – May 2021 to the same period two years prior finds that 144,067,318 more services delivered through telehealth, an increase of 3,774%.
Federal Communications Commission (FCC): FCC Reaches $150M Benchmark for COVID-19 Telehealth Program Round 2 (11/9) – The FCC approved an additional 75 applications for funding for the COVID-19 Telehealth Program, bringing the total round 2 funding to over $165 million. As outlined in the Round 2 Report and Order, now that $150 million has been allotted, the FCC’s Wireline Competition Bureau issued a Public Notice announcing an opportunity for all remaining applicants to supplement their applications, as required by Congress. The FCC’s COVID-19 Telehealth Program supports health care providers by providing reimbursement for telecommunications services, information services, and connected devices. Round 2 is a $249.95 million federal initiative that builds on the $200 million program established as part of the CARES Act.
State Telehealth News and Activity
mHealth Intelligence: NJ Governor Shoots Down Telehealth Pay Parity Bill (11/10) – New Jersey Governor Phil Murphy rejected a bill from the State Senate that would require telehealth payment parity, stating that the cost to taxpayers could be “substantial” and would possibly limit opportunities for patients who prefer office visits. The bill was first introduced in June 2020 and would have required carriers that offer a health benefits plan in the state to pay for all forms of health care delivered through telehealth at the same rate as in-person care. The bill would have also banned payers from placing restrictions on locations from where services were provided, technological platform used, and from denying coverage for routine patient monitoring performed using telemedicine. Governor Murphy conditionally vetoed the bill, meaning it was sent back to the Senate for recommended amendments.
The Buckeye Institute: Making Telehealth Permanent Will Increase Access to Care (11/10) – The Buckeye Institute testified before the Ohio Senate Health Committee on House Bill 122, which would permanently expand access to telehealth in the state of Ohio. The testimony included assertions that making access to telehealth services permanent would “help Ohio citizens – especially those living in rural areas – access more health care services and specialists.” Ohio’s current emergency COVID-19 rules on telehealth access are set to expire on December 31, 2021, at which point many Ohioans risk losing access to these vital services unless the state legislature acts.
NASHP: How States Use ARPA Funds to Support Telehealth, Technology and Data Infrastructure (11/9) – The National Academy for State Health Policy (NASHP) created a new map showing how states are using one-time funds available through the American Rescue Plan Act (ARPA) to support telehealth service delivery, technology-based innovations, and data infrastructure. These investments will help states address longstanding technological challenges with Medicaid home and community-based services, among other areas. To explore the map, click here.
The Missouri Times: Missouri Schools, Libraries Awarded $57M in Federal Connectivity Funds (11/9) – The Federal Communications Commission (FCC) awarded more than $57 million for Missouri schools and libraries to expand internet access. The funds will help reimburse school district and libraries for broadband equipment and internet-connected devices to support virtual learning and telehealth. Missouri hospitals including SSM Health St. Louis, Health Care Collaborative of Rural Missouri, Swope Heath Services, and Mercy Health St. Louis were also awarded grants through the program over the last few months.
Telehealth Research, Reports and Surveys
Kaiser Family Foundation (KFF): 2021 Employer Health Benefits Survey (11/10) – The Kaiser Family Foundation released
the 2021 Employer Health Benefits Survey, finding that premiums on employer-sponsored plans rose 4% this year and found significant changes in the provision of telehealth and mental health services by employers.
Among firms with at least 50 workers that offer health benefits, almost four in 10 (39%) report making changes to their mental health and substance abuse benefits since the beginning of the pandemic. This includes 31% who increased the ways enrollees can access mental-health services, such as through telemedicine; and 16% who offered new mental health resources, such as an employee assistance program.
Nearly two thirds (65%) of offering firms with at least 50 workers say they made changes related to telemedicine due to the pandemic. Half (51%) did additional promotion of their telemedicine benefits to workers and 31% expanded coverage for additional modes of telemedicine. In addition, nearly a quarter expanded the places where telemedicine could be delivered (24%), expanded the number or types of telemedicine providers (23%), and expanded covered telemedicine services.
National Association of Community Health Centers: Health Centers Benefit from Pandemic-Era Medicaid Flexibilities (11/10) – As part of the Families First Coronavirus Response Act passed last March, states began receiving a 6.2% bump to the federal Medicaid match rate. In exchange for the higher federal funding, states are not allowed to disenroll any beneficiaries from Medicaid during the PHE. The NACHC surveyed federally qualified health centers, federally funded nonprofit provider clinics, in September to determine how losing the Medicaid flexibilities will affect their operations and their patients' health. The group argues that, along with codifying telehealth flexibilities, Congress should take a number of actions to protect Medicaid coverage — many of which it's already considering.
Progressive Policy Institute and Americans for Prosperity: Telehealth Saves Money And Lives: Lessons From The Covid-19 Pandemic (11/10) – Using aggregated, de-identified data from FAIR Health, the organizations’ study found that while telehealth patients’ costs started higher than in-person patients’ costs, the average telehealth patients’ health care costs fell 61%, from $1,099 per month to $425 per month between January 2020 and February 2021. Additionally, people who used telehealth had lower overall health care utilization compared with people who used only in-person care, except during the early months of the pandemic, March to May 2020. The “study confirms a promising trend toward cost savings for patients who use a combination of in-person and telehealth services,” the authors note. Furthermore, the authors state that “These results should give lawmakers confidence to extend the telehealth provisions of the public health emergency rather than letting them expire.”
R Street Institute: An Analysis of State and Federal Telehealth Reforms During and Beyond Covid-19 (11/8) – R Street Institute, a nonprofit, nonpartisan, public policy research organization issued a report of the changing trends in telehealth policies during the pandemic and recommends solidifying flexibilities related to audio-only telemedicine services, store-and-forward data services and medical licensure. This report echoes suggestions made by the Alliance for Connected Care and over 230 other groups in a recent letter sent to governors urging them to maintain and expand licensure flexibilities through the end of the federal public health emergency. The report makes the following recommendations:
Consider audio-only telehealth expansions. Audio-only telehealth became accessible in all 50 states and Washington, D.C. during the pandemic. Now, as evidence emerges on where audio-only telehealth is most useful–particularly for rural and low-income areas without broadband access–policymakers should consider which pandemic-era audio-only policies helped these communities the most, and ensure state regulations allow for them.
Make specific allowances for store-and-forward telehealth to take better advantage of its full potential. Especially in states with rural and remote communities, store-and-forward telehealth can greatly complement synchronous telehealth and traditional in-person care. For urban areas, store-and-forward telehealth provides greater convenience and flexibility for patients and physicians alike and eases the need of taking time for appointments. Thus, more states should move towards legislation that reimburses store-and-forward telehealth. To do this, patients, physicians and legislators must be assured that asynchronous telehealth is a safe modality that can protect a patient’s personal information, and is a sufficient means through which a patient-physician relationship can be established.
Enhance flexibility for patients and providers located in different states. Telehealth facilitates the connection between patients and providers regardless of the geographic distance, but states are slow to adopt permanent cross-state licensing reforms with the same regularity as audio-only methods. Policymakers looking to expand telehealth should consider state restrictions on medical licenses, and look to join licensure compacts or eliminate in-state license requirements.
Telehealth News and Market Developments
Fierce Healthcare: Blue Cross NC teams with Teladoc for expanded telehealth services (11/11) – Blue Cross and Blue Shield of North Carolina will offer Teladoc's virtual care services to select employers and members, the insurer announced this week. Members in most Blue Cross NC's individual and fully insured group plans will be able to access Teladoc Health's virtual platform for acute care and behavioral healthcare needs, the company said.
Health Leaders: Virtual Care Expanding from Pandemic Necessity to Delivery System Innovation (11/11) – A growing number of regional and national payers are putting telehealth at the center of their care delivery, benefit, and plan designs. CareFirst has introduced CloseKnit, a "virtual primary care" [model that] … will offer a wide variety of care services, including preventive and urgent care, behavioral and mental health, care coordination, insurance navigation and more." Aetna, Cigna, and UnitedHealth are three national providers announcing their telehealth developments as part of a broader, virtual care strategy.
Inside Health Policy: States Ask HHS, Congress for More Certainty on PHE’s End Date (11/11) – The National Association of Medicaid Directors, ADvancing States, the National Association of State Directors of Developmental Disabilities Services and the National Association of State Mental Health Program Directors sent letters to HHS Secretary Becerra and Congressional leaders seeking additional certainty around the anticipated duration of the COVID-19 Public Health Emergency, “[By committing to states that the PHE will not end before July 1, 2022, the PHE will end on the first day of a quarter, and 90 days advance notice will be given, HHS can ensure that states are well-prepared to resume normal Medicaid operations at the end of the PHE.”] Read the letter to HHS here and the letter to Congressional leaders here.
The Hill: Telehealth was a godsend during the pandemic; Congress should keep the innovation going (11/10) – An op-ed from Americans for Prosperity and the Progressive Policy Institute urges Congress to make permanent the many telehealth flexibilities enacted during the pandemic. “Telehealth has proven a godsend for millions of Americans. It helped us navigate the treacherous months of the pandemic, and brought millions safety and security.” The op-ed cites a recent report from the organizations to show concerns about higher costs and overutilization are largely unfounded.
Fierce Biotech: Cue Health to kick off direct-to-consumer COVID test launch with new telehealth platform (11/9) – After being tapped by sports stadiums and professional athletes, Cue Health is now planning to kick off a nationwide, direct-to-consumer launch of its cartridge-based COVID self-test this month, alongside a virtual health platform that will provide access to electronic prescription services and digital results that can help clear the user for travel, according to a statement.
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?