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Connected Care Update

November 2, 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

Alliance DEA Letter in the News: On October 26, more than 80 organizations called on the Drug Enforcement Administration (DEA) to finalize the special registration to prescribe controlled substances through telemedicine, originally called for in the Ryan Haight Act of 2008. The letter, convened by the Alliance, has been featured in several news outlets including Healthcare IT News, GlobeNewswire, Yahoo Finance, mHealthIntelligence

View the letter and more information here.

    Federal Updates

    CDC: (10/30) – CDC released a report on trends in the use of telehealth during the COVID-19 pandemic, noting that telehealth could have multiple benefits during the pandemic by expanding access to care, reducing disease exposure for staff and patients, preserving scarce supplies of personal protective equipment, and reducing patient demand on facilities.

    CMS: (10/29) – CMS issued the final CY21 Payment and Policy Changes for Home Health Agencies rule that, among other things, allows providers to use telehealth for related skilled services if they are outlined in a patient's care plan. It also requires provides to describe how telehealth would improve treatment in a patient's medical record. finalizes a 5 percent cap on wage index decreases in CY 2021. The rule also finalizes Medicare enrollment policies for qualified home infusion therapy suppliers, updates the home infusion therapy services payment rates for CY 2021, finalizes a policy excluding home infusion therapy services from home health services, and finalizes policies under the Home Health Value Based Purchasing Model published in the May 8, 2020 interim final rule. View the fact sheet and additional information from Modern Healthcare.

      Legislative Activity

      Op-ed – 

      The Hill – By Sen. Smith (D-MN): (10/26) – On October 26, Sen. Smith (D-MN) issued an op-ed in The Hill on the importance of additional FCC COVID-19 Telehealth funding. Sens. Smith (D-MN) and Rounds (R-SD) introduced the COVID-19 Telehealth Program Extension Act (S. 4794), companion legislation to the Alliance-endorsed text introduced by Rep. Spanberger (D-VA) and six bipartisan cosponsors which would provide an additional $200 million for the Federal Communications Commission’s (FCC) COVID-19 Telehealth Program. Sen. Smith notes that, “As a member of the Senate Health Committee, I’ve championed telehealth because it’s proving to be an important tool in closing some of the most significant gaps in patients’ access to health care services. And it can continue to serve as a lifeline and address social determinants of health, not only during this pandemic, but into the future.”

      Legislative Update –

      Top telehealth bills continue to attract attention and additional cosponsors in Congress. We are tracking these and other bills on the Alliance website.

      • The CONNECT for Health Act (S. 2741/H.R. 4932) gained four bipartisan cosponsors in the Senate and four bipartisan cosponsors in the House this week. While we still support the CONNECT for Health Act, we believe Congress needs to go further than this legislation in order to hold on to the access created during the public health emergency. View cosponsors and bill text here and here.
      • The Protecting Access to Post-COVID-19 Telehealth Act of 2020 (H.R. 7663) gained four bipartisan cosponsors this week for a total of 40 cosponsors. The Alliance worked to convene over 200 organizations in a letter to House Telehealth Caucus Representatives Thompson, Welch, Matsui, Schweikert, and Johnson endorsing the Protecting Access to Post-COVID-19 Telehealth Act of 2020 (HR 7663). View the letter and cosponsors and bill text here.

      State Telehealth News

      The National Law Review: (10/30) – The COVID-19 pandemic has overhauled how health care providers practice in North Carolina, with many offices switching to virtual exams to help stop the spread of the virus. This article outlines steps the state has taken to make this transition to ensure patient access to care.

      mHealth Intelligence: (10/30) – The University of Arkansas for Medical Sciences received a grant of nearly $1 million from the USDA to set up digital health training services at telehealth training centers in the Arkansas Delta region. This effort aims to address challenges in connected health adoption.

      Center for Connected Health Policy (10/29) – CCHP released its Fall 2020 State Telehealth Laws & Reimbursement Policies Report and interactive policy map. The report breaks down telehealth and remote patient monitoring reimbursement practices and policies by state and includes any policies put in place during COVID-19 that have been permanently adopted.

      National Conference of State Legislatures (10/29) – Since March, 36 states, D.C. and Puerto Rico have enacted over 79 bills changing telehealth policies to meet the demands of the COVID-19 pandemic. States are using telehealth to address coverage for private insurance and Medicaid, bolster provider access to patients, and address additional barriers patients face when seeking services via telehealth.

      JD Supra: (10/26) – The Joint Committee on Agency Rule Review permanently implemented the temporary expansion of telemedicine scope of services enacted in the Ohio Medicaid program during the pandemic. This decision will ensure patients have access to care even with limits on in-person contact.

      The Maryland State Medical Society: (10/26) – MedChi has entered into a collaboration with Enable Healthcare (EHI) which will give Maryland physicians access to Remote Patient Monitoring as well as other value-based care solutions.

      Papers, Surveys, and Studies

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

      FAIR Health: (10/29) – FAIR Health issued its latest monthly data report on telehealth utilization. FAIR Health notes that the staying power of telehealth during the COVID-19 pandemic was evident in August 2020, according to results of FAIR Health’s Monthly Telehealth Regional Tracker: Telehealth claim lines increased 3,552% nationally from 8/2019 to 8/2020. View the press release and data here.

      ACHP Report and Proposed Framework on Medicare Telehealth Reimbursement Models: (10/27) – ACHP released a white paper proposing two reimbursement models that provide a path forward to develop a sustainable payment system for telehealth. The Support and Reform approach proposes Medicare offer full payment parity for telehealth for five years post-public health emergency. The Prove and Grow approach would allow for incremental growth of telehealth through the reinvestment of capital and support to specific areas of lower-capitalized types of care, including primary care. ACHP seeks input and insight from industry partners, consumer advocates and others on these models. ACHP will convene a stakeholder discussion this December in order to move these ideas forward. View the White Paper, blog post and slide deck

      Deloitte Analysis on Medicare Advantage: (10/27) – Fierce Healthcare released an article summarizing a recent survey from Deloitte on executives at MA plans and digital health companies, finding that through April 2020 more MA members used telehealth than did so in all of 2019. As open enrollment for Medicare continues, insurers that are embracing digital are getting a leg up on the competition, the analysis found.

      Altarum Report on PACE: (10/22) – According to a report last week on the Program for All-inclusive Care for the Elderly (PACE) program, many PACE programs faced a crisis earlier this year when the pandemic curbed in-person care, and many used telehealth to keep the program going. View the press release and additional information from mHealthIntelligence.

      Telehealth News and Market Developments

      mHealthIntelligence: (10/28) – The Indiana University School of Medicine and Regenstrief Institute are launching a telehealth project aimed at helping primary care providers treat patients dealing with both substance abuse issues and depression. The project aims to determine whether primary care providers who use a telehealth platform can combine substance abuse treatment – including medication-assisted treatment (MAT) therapy – and behavioral health treatment to improve health outcomes.

      Mobihealthnews: (10/27) – CVS launched a new telemedicine service that lets patients take a digital eye exam and get their prescription renewed by an eye doctor.

      Healthcare IT News: (10/27) – Universal Community Health Center in Los Angeles invested in virtual care workstations during COVID-19, with various scopes that allow physicians to remotely guide patients through near-complete examinations.

      Intermountain Healthcare: (10/26) – Alliance member Intermountain Healthcare and Sanford Health have signed a letter of intent to develop a strategic partnership.

      Becker’s Hospital Review: (10/26) – Ten healthcare CIOs weigh in on whether telehealth growth will outlast the pandemic. As they similarly noted, the fate of telehealth rests on several factors, including CMS and commercial payers permanently extending payment benefits for telehealth and virtual care services.

      Notable Telehealth Commentary

      The Hill – By Sen. Smith (D-MN): (10/26) – “As a member of the Senate Health Committee, I’ve championed telehealth because it’s proving to be an important tool in closing some of the most significant gaps in patients’ access to health care services. And it can continue to serve as a lifeline and address social determinants of health, not only during this pandemic, but into the future.” Sen. Smith (D-MN) commented.

      Upcoming Events

      November 9 – 11 – Fierce Health IT Virtual Series, “Telehealth’s Takeover.”

      November 10 – National Consortium of Telehealth Resource Centers, “NCTRC Telehealth Hack – Licensure and Patient-Provider Relationships.

      November 11 – AHIP, “Virtual Primary Care and Its Role in Keeping Care In-Network.”

      November 18 – National Consortium of Telehealth Resource Centers, “NCTRC Telehealth Hack – Privacy and Liability.

      November 19 – National Consortium of Telehealth Resource Centers, “Leveraging Telehealth to Address Social Determinants.”

      November 19 – Southwest Telehealth Resource Center, Arizona Telemedicine Program, “2020 Mid-Year Rural Health Policy Roundup.”

      November 20 – AHIP, “Innovations to Virtualize Healthy Living Across Care Settings.”

      Past Events

      HIMSS TV, “For behavioral health patients, telehealth helps bridge the gap.” Telehealth Connection TV: Dr. Danielle Hairston, psychiatry residency training director at Howard University College of Medicine, says virtual care isn't perfect, but its accessibility is an advantage.

      Xtelligent Healthcare Media’s Healthcare Strategies podcast series, “Striking the Right Balance Between In-Person Care and Telehealth Services.” With the recent surge in telehealth services utilization, Chris Waugh, chief innovation officer at Sutter Health, has been facing a question that many leading health professionals are asking: how can providers strike a balance between telehealth and in-person care? Waugh offers his perspective on this and how to appropriately and innovatively leverage telehealth, data analytics, and remote monitoring to prioritize the best patient outcomes.

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