Politico Pro: Telehealth lobbyists fear abortion debate could erase wins (7/6) – In light of the recent Supreme Court decision to overturn Roe v. Wade, telehealth lobbyists have been pressed with questions around telehealth and abortion as states move to protect or ban the procedure — while simultaneously updating their telehealth laws. “This is not a debate about the merits of telehealth. Everyone recognizes that telehealth increases access to health care services, whether it’s chronic disease management, mental health, post-acute care, primary care, specialty consultations or other services,” said Krista Drobac, the executive director of the Alliance for Connected Care. “This is a debate about the enforcement of the standards of care set by the state. Medical providers have always, and will continue to be, required to abide by the laws and standards of care set by the state where the patient is located, regardless of where the provider is located.”
American Association of Nurse Practitioners: Poll Shows Patients Overwhelmingly Support Nurse Practitioners Working to the Full Extent of Their Education (7/6) – Alliance Advisory Board member American Association of Nurse Practitioners (AANP) applauds the results of a recent Alliance for Connected Care poll
that shows 82 percent of patients support allowing nurse practitioners (NPs) to practice to the full extent of their education and clinical training, including through telehealth. The poll covered a number of topics asking patients and practitioners about their telehealth usage and telehealth experiences, their use of care across state lines, and the workforce implications of these developments. The survey also found that 84 percent of recent telehealth patients say they have personally benefited from the option to receive care through telehealth, including telehealth visits with NPs. For additional coverage, see the Atlanta Journal-Constitution and Becker’s Hospital Review.
Inside Health Policy: Workforce, Integration Still On Congress’ Mental Health Reform List (7/5) – Advocates expect to see the next mental health reforms come out of the Senate Finance Committee, among other congressional panels. While several of the committee’s telehealth and pediatric care proposals passed in the gun safety bill, lawmakers in both chambers of Congress are still crafting or considering legislative packages that are expected to address workforce shortages, telehealth use and incorporating mental health providers into primary care offices.
Add some services to the Medicare Telehealth Services List on a Category 3 basis through the end of 2023, some of which had not been previously added to the Medicare Telehealth List during the COVID-19 public health emergency (PHE), but will be added on a subregulatory basis.
Medicare telehealth services furnished on or before the 151st day after the end of the PHE, in alignment with the extensions of telehealth-related flexibilities in the Consolidated Appropriations Act, 2022, will continue to be processed for payment as Medicare telehealth claims when accompanied with the modifier “95”.
Physicians and practitioners can continue to report the place of service code that would have been reported had the service been furnished in-person during the 151-day period after the end of the PHE, as finalized on an interim basis in the March 31 IFC (85 FR 19233).
The Alliance compiled a summary of the telehealth provisions included in the proposed rule, which can be found here. A fact sheet on the rule can be found here. For additional coverage, see Inside Telehealth.
Office of Management and Budget: Audio-Only Telemedicine for Buprenorphine Initiation for Treatment of Opioid Use Disorder (7/5) – The Office of Management and Budget received and began to review a proposed rule entitled, “Audio-Only Telemedicine for Buprenorphine Initiation for Treatment of Opioid Use Disorder”. This rule would clarify the rights and obligations for DATA-waived registrants when prescribing buprenorphine to patients with Opioid Use Disorder pursuant to a telemedicine encounter which utilizes audio-only telecommunication systems.
Telehealth Research, Reports and Surveys
mHealth Intelligence: COVID-19 Reappears on Top Five Telehealth Diagnoses List (7/7) – After two months of decline, the FAIR Health Monthly Regional Tracker reported that telehealth use grew in April, and COVID-19 appeared as one of the top five telehealth diagnoses nationally for the first time since January. Researchers surmised that this increase was primarily due to the prevalence of the Omicron variant at the time the data was collected. For additional coverage, see Inside Telehealth.
Urology Times: Study shows how Medicare patients are using interstate telehealth visits (7/7) – A study
published last month by the University of Michigan shows that most out-of-state telehealth in Medicare is used for continuity of care, not acquiring new patients. The findings contradict the notion that extending pandemic-related flexibilities that allow for interstate telehealth would result in out-of-state doctors poaching patients from their current physicians. The study found that about two-thirds of out-of-state telehealth visits among Medicare beneficiaries were with a physician in a bordering state, and that a higher percentage of rural patients used both out-of-state in-person and telehealth services compared to patients in non-rural areas.
mHealth Intelligence: Half of Americans likely to use telehealth post-pandemic (7/6) – According to a survey
conducted by the Associated Press-NORC Center for Public Affairs Research and The SCAN Foundation, many Americans would like to have continued access to virtual options like telehealth post-pandemic. Nearly half of respondents (48 percent) said that telehealth should continue after the pandemic is over. Though telehealth may provide various benefits to adults over 50, only 16 percent of people in this age group said they were extremely or very likely to continue using the care modality after the pandemic. In contrast, 26 percent of adults between the ages of 18 and 49 said they were extremely or very likely to continue using telehealth post-pandemic.
JAMA Network Open: Association of Remote Technology Use and Other Decentralization Tools with Patient Likelihood to Enroll in Cancer Clinical Trials (7/5) – A study by the American Cancer Society Cancer Action Network found that cancer clinical trials leveraging remote technology and decentralization tools to reduce patient time and travel burden associated with participation may increase the patient consent and participation rate. Conducted between July 6 and September 8, 2021, a 41-question, cross-sectional, internet-based survey was administered to cancer patients and survivors in the US who had been diagnosed with or treated for cancer in the past seven years. The study found that self-reported patient disposition toward enrollment in cancer clinical trials increased for modifications using remote technology and other decentralization tools. These findings suggest that greater adoption of practices that reduce patient time and travel burden associated with clinical trial participation could improve enrollment in cancer trials.
DovePress: Telehealth Encourages Patients with Diabetes in Racial and Ethnic Minority Groups to Return for in-Person Ophthalmic Care During the COVID-19 Pandemic (7/4) – This study evaluates the role telehealth visits played in helping patients with diabetes mellitus (DM) return for subsequent, in-person eye examinations after the outbreak of COVID-19. The study found that patients from racial and/or ethnic minority groups completed fewer in-person eye examinations compared with White patients. However, both groups accessed telehealth services at a similar rate during this period. Patients who received telehealth services returned for subsequent, in-person eye examinations at substantially higher rates, regardless of race. The findings suggest that telehealth initiatives benefited patients from racial and/or ethnic minority groups by reducing disparities in access to eye care during the COVID-19 pandemic.
State Telehealth News and Activity
The Baltimore Sun: Gov. Hogan announces $127 million in funding aimed at expanding broadband access in Maryland (7/8) - In an effort to expand broadband access in Maryland, Governor Hogan announced that $127.6 million in grants will be awarded to internet service providers, education and community organizations and local jurisdictions across the state. As part of the state’s Connect Maryland initiative, the funding will provide broadband service to an additional 15,000 households that are currently unserved or underserved. Governor Hogan noted that high-speed internet access has been a lifeline during the pandemic, whether for telehealth or other matters.
Business Insurance: California comp regulators to extend emergency telehealth rules (7/8) – The California Division of Workers’ Compensation issued a notice of intent to readopt its emergency regulation to extend indefinitely the state’s temporary telemedicine rules beyond the current expiration date of July 18. The Division said the regulation addresses the ongoing need for telehealth medical-legal evaluations and office location flexibility, put in place in 2020 as the state grappled with safety measures related to the COVID-19 pandemic.
KSNT: Kansas debuts new “ATLAS” telehealth pod for veterans (7/7) – The first Accessing Telehealth Through Local Area Stations (ATLAS) Telehealth pod in Kansas officially opened this week, which is geared toward connecting veterans with health providers, especially those that may have limited broadband access in rural areas. ATLAS offers services that do not require hands-on exams, such as primary care, mental health care, and other specialty services. The pilot program will serve more than nine million veterans who receive care through the VA.
New York State Department of Health: Telehealth Consumer Survey Deadline Extended (7/5) – The New York State Department of Health extended the Telehealth Consumer Survey to learn more about how it can improve upon telehealth services in New York. The survey will help the Department to understand how this modality of care is performing in light of its expansion during the pandemic. The survey will close on August 1, 2022.
Telehealth News and Market Developments
Yahoo News: Racial Trauma Is A US Mental Health Epidemic, And Telehealth Is Needed To Address It (7/7) – Race-based traumatic stress results in generations of mental health challenges. The disproportionate impact of COVID-19 on the Black community both in lives lost and the emotional trauma of grief can add to such challenges for this population. The shortage of mental health providers is also magnified in predominantly Black neighborhoods. Telehealth can be part of the solution, and can help boost appointment completion rates for Black patients from 52 percent to 70 percent according to research from five hospitals in Philadelphia. Telehealth connects patients to culturally competent care that is trauma- and race-informed, which can improve outcomes and increase trust in the health care system.
Psychiatric Times: Telehealth’s Calming Effect on Autism (7/7) – Since the COVID-19 pandemic, telehealth has been used as a successful way to meet and treat patients where they are. For individuals living with autism spectrum disorder (ASD), telehealth can help reach more patients. One of telehealth’s biggest benefits is its ability to give patients more control over their treatment environment. Patients can avoid jarring transitions into medical settings and remain in spaces that are more natural to them, such as their homes. Many patients also appreciate having the freedom to switch off the video if face-to-face interactions become too intense. Providing these options can go a long way in establishing trust and connection between ASD patients and clinicians.
Health Affairs: To Integrate Virtual Care, Start By Redefining The ‘Visit’ (7/6) – As ambulatory care managers and new digital entrants alike move from a crisis mindset to a mindset of planful redesign, they will find the optimal balance between virtual and in-person care. The key to this process will be to redefine what constitutes a “visit.” To build the care delivery system of the future, which will focus on value and outcomes, the billing system and reimbursement models need to be shifted away from the idea of synchronous interactions in specific “places of service.”
Teladoc Health: Teladoc Redoubles Focus on Convenient Care, Smarter Virtual Visits with Primary360 (7/6) –Teladoc Health announced it is adding new capabilities to its platform to strengthen virtual and in-home offerings across a spectrum of virtual health services. Members of Primary360, Teladoc’s whole-person virtual care concept, will now receive health plan in-network referrals and care coordination support; free, same-day medication delivery from Capsule, a national digital pharmacy; and in-home, on-demand phlebotomy with Scarlet Health.
Modern Healthcare: Oncologists turn to telehealth for an extra layer of patient care (7/5) – Some health systems have found an enduring use case for virtual care: oncology. Although telehealth appointments aren’t a replacement for in-person therapies, oncologists say scheduling regular remote check-ins and constantly monitoring symptoms have helped them stay on top of their patients’ health, especially amid COVID-19-related delays in cancer treatments. Despite limits on efficacy data, organizations point to expanded access and reduced emergency department visits as early signs of success.
Fierce Healthcare: With Cerebral in the spotlight, DOJ, regulators to ramp up scrutiny of telehealth startups (7/5) – The Department of Justice recently launched an investigation into mental health startup Cerebral and is said to be ramping up its focus on telehealth companies and prescribing practices for controlled substances. With the rise in telehealth over the past two years, the DOJ has stepped up enforcement of telehealth services and whether they are being billed properly.
Health Podyssey, “Podcast: Juan Andino Breaks Down Interstate Telehealth Waivers.” Juan Andino from the University of Michigan joins A Health Podyssey to discuss how interstate telehealth use changed in the face of COVID-19. Andino and colleagues published a paper in the June 2022 issue of Health Affairs assessing the effect of waivers on interstate telehealth use among Medicare beneficiaries during the COVID-19 pandemic.
HIMSSCast, “Next Steps for Telehealth Optimization.” Courtney Stevens at Detroit's Henry Ford Health System discusses optimizing telehealth integration into care pathways, conducting comprehensive exams via video and improving telehealth literacy.