The Alliance for Connected Care
is pleased to welcome the Cystic Fibrosis Foundation, the American College of Emergency Physicians, and the Haystack Project to the Alliance Advisory Board. The Alliance works with Advisory Board members on advocacy strategies related to the value of telehealth. With more than 40 patient and provider organizations active on the Alliance Advisory Board, the Alliance is growing its influence and expanding its reach.
Becker’s Hospital Review: Home-Based Care: How Removing Barriers Can Improve Access, Experience, Outcomes, and Health Equity (6/16) – During a featured session at Becker’s Hospital Review’s Shift to Digital Virtual Event, telehealth was highlighted as a valuable alternative model of care. Telehealth enables home-based care for patients of lower socioeconomic status, which can be empowering for patients who may feel intimidated navigating the health care system in person. “The power dynamic changes when someone is in their own home,” Krista Drobac, executive director of the Alliance for Connected Care said.
Senate Finance Committee: Medicaid Interstate Licensure Provision Included in the Youth Mental Health Discussion Draft (6/15) – Senate Finance Committee Chair Wyden (D-OR), Ranking Member Crapo (R-ID), Senator Carper (D-DE) and Senator Cassidy (R-LA) released the second draft section of the Committee’s mental health package. This portion focuses on youth mental health care policies as part of the Committee’s ongoing work to improve mental health. The draft includes language that would simplify the process for eligible out-of-state providers to enroll as a participating provider in state Medicaid or CHIP plans without additional screening requirements, among other provisions.
Inside Health Policy: Wyden: Build Mental Health Reform Foundation in Gun Safety Bill (6/14) – Senate Finance Committee Chair Wyden (D-OR) wants the mental health provisions in the bipartisan gun safety proposal currently being negotiated in the Senate to include some of the policies the Finance Committee is working on around mental health, like creating a telehealth bill of rights. Wyden told Inside Health Policy that he is working with bipartisan leadership to incorporate some of the suggestions from the Senate Finance Committee’s mental health workgroups in the final gun safety bill.
Senator Murphy (D-CT): Bipartisan Group of Senators Announce Agreement on the Gun Safety Proposal (6/12) – Senator Murphy (D-CT) and 19 bipartisan Senators announced the expected provisions of their gun safety proposal, which includes investments in programs that increase access to mental and behavioral health services for youth and families in crisis via telehealth. For additional coverage, see Fierce Healthcare, and Inside Telehealth.
Rep. Pappas (D-NH): Senate Passage of Honoring Our PACT Act Includes Pappas’s Legislation to Invest In and Expand VA Workforce – The Senate passed the Honoring our Promise to Address Comprehensive Toxics (PACT) Act (H.R. 3967), which addresses health care, presumption of service-connection, research, resources, and other matters related to veterans who were exposed to toxic substances during military services. The legislation incorporates the VA Workforce Investment and Expansion Act of 2022 (H.R. 8017), which was introduced by Reps. Pappas (D-NH) and Cline (R-VA) earlier this year. The bill includes a carve out for controlled substance prescribing via telemedicine.
Centers for Medicare and Medicaid Services: CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements Proposed Rule (6/17) – The Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2023 Home Health Prospective Payment System (HH PPS) Rate Update proposed rule, which would update Medicare payment policies and rates for home health agencies (HHAs). This proposed rule solicits comments on the collection of data on the use of such services furnished using telecommunications technology for home health claims (at the individual beneficiary level). For additional information, see the CMS Fact Sheet. Comments are due by August 16, 2022.
HRSA: Telehealth for LGBTQ+ Patients (6/14) – The Health Resources and Services Administration (HRSA) published a webpage outlining resources for health care professionals providing telehealth services for LGBTQ+ patients. Telehealth can be a safe, convenient way for LGBTQ+ patients to access health care, and a lifeline for some patients who do not have LGBTQ+ affirming health care available nearby. HRSA provides health care providers serving this community through telehealth with expert insights, best practices, and other resources.
Department of Health and Human Services: HHS Issues Guidance on HIPAA and Audio-Only Telehealth (6/13) – The Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued guidance on how covered health care providers and health plans can use remote communication technologies to provide audio-only telehealth services when such communications are conducted in a manner that is consistent with the applicable requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules. The guidance explains how the HIPAA rules can permit health care providers and plans to offer audio-only telehealth while protecting the privacy and security of individuals’ health information. For additional coverage, see HIPAA Journal, Inside Telehealth, and mHealth Intelligence.
Telehealth Research, Reports and Surveys
The Lancet: Mobile Health School Screening and Telemedicine Referral to Improve Access To Specialty Care In Rural Alaska: A Cluster- Randomized Controlled Trial (6/16) – A study by the University of Arkansas for Medical Sciences found that referring children to specialists via telemedicine provides significantly quicker access to follow-up care than referring them to primary care providers. The study found that 70 percent of children received follow-up care through a telehealth referral pathway, compared to 30 percent of children in a standard pathway. Additionally, children in the telemedicine specialty referral pathway received follow-up care 17.6 percent faster than those in the standard primary care referral pathway. The randomized controlled trial, conducted in rural Alaskan communities from 2017-2020, provides implications for rural areas for improving access to specialists for other preventable health conditions. For additional coverage, see a press release for the study here.
Epic Research: Insurance Type is the Top Predictor of Telehealth Use as Adoption Levels Off Long-Term (6/16) – A recent study found that telehealth use remains higher than pre-pandemic levels for all insurers, suggesting continued insurance coverage for telehealth services is important for ongoing health care access. The study also found that rates of outpatient telehealth use in urban and rural areas vary only slightly despite documented barriers like broadband access and a higher proportion of elderly residents in rural areas. These findings suggest that efforts to support equitable access to telehealth may need to account for more than technology access, such as insurance coverage for care delivered via telehealth.
Second Opinion: Virtual Care Needs to be Integrated for Patient Needs (6/16) – A study from Omada Health, a digital health company that works across diabetes, hypertension, and more, found that the average patient had 28 percent of their services received via virtual first care. Virtual care should be integrated with in-person care based on the patient’s needs. Patients will value and optimize for convenience, providing an opportunity to deliver certain types of care in a more convenient, accessible, and equitable manner.
United Press International: Patients with Advanced Cancer May Benefit from Telemedicine (6/15) – A large percentage of cancer patients don’t always report negative symptoms to their providers. However, a recent study
found that digital health services had a high level of engagement from older cancer patients. The study’s monitoring program showed a 33 percent improvement in physical function for patients who used it, as well as 15 percent better control of symptoms, compared to those who were evaluated at in-person doctor visits. The researchers added that the program is unlikely to cost patients more money, and that overall, the tech will cost the health care industry less money because investing in preventive care will drive down expensive costs for emergency room visits and doctor consults in later stages of care.
Medscape: First Year of Pandemic Showed Telemedicine Benefited Less Urban Patients (6/15) – According to a study
published in the Journal of the American Board of Family Medicine, telemedicine was a more viable option for patients living in health professional shortage areas (HPSA) and those belonging to other underserved communities. Although White patients were 61 percent more likely to use telemedicine to see their provider as compared with Hispanic patients, Black patients were 37 percent more likely to receive care via telemedicine than Hispanic patients. Patients living in geographically underserved areas — those living 20 minutes or more from a clinic — were also more likely to schedule telemedicine appointments. The study suggests rural patients benefit from telehealth by reducing their commute time.
National Telehealth Technology and Assessment Center: 2022 TTAC National Telehealth Technology Survey (6/14) – The National Telehealth Technology Assessment Center (TTAC) released its 2022 Survey on telehealth technology used by organizations and individuals. The survey was funded by the Health Resources and Services Administration’s Office for the Advancement of Telehealth (OAT). The survey found an increased emphasis on solutions that provide care to the patient in their homes, particularly remote monitoring technologies. The survey also found that 72 percent of respondents plan to expand telemedicine in the next one to two years, highlighting the importance of making COVID-19 telehealth flexibilities permanent.
FAIR Health: The Evolution of Telehealth during the COVID-19 Pandemic
(6/14) – According to FAIR Health’s data brief, mental health conditions consistently appeared among the top telehealth diagnoses across the country during the COVID-19 pandemic. The report found a 4,347 percent increase in national telehealth claim lines between March 2019 and March 2020. Researchers also observed that COVID-19 did not occupy spots on regional telehealth diagnosis lists immediately starting in 2020. November 2020 was the first month COVID-19 appeared on a regional telehealth diagnosis list. This finding suggests that telehealth was used for conditions other than just COVID-19. For additional coverage, see mHealth Intelligence.
mHealth Intelligence: Telehealth Supports Type 1 Diabetes Management Among Pediatric Patients (6/13) – A study
published in BMC Pediatrics found that increases in the use of telehealth and continuous glucose monitors (CGMs) likely helped mitigate the impacts of the COVID-19 pandemic on hospitalization frequency, glycemic control, and depression incidence among pediatric type 1 diabetes patients. Researchers examined various factors, including patient characteristics, glycemic control, PHQ-9 depression screening, and CGM utilization, in around 1,600 pediatric type 1 diabetes patients in one-year periods before and after the COVID-19 pandemic. The study shows that there was no difference in these factors between the pre-and post-pandemic groups. The researchers surmised that the sharp increase in the use of telehealth may have helped keep these factors the same before and during the pandemic.
The Alliance has updated its COVID-19 State Telehealth and Licensure Expansion Dashboard, which tracks state-by-state developments on the status of COVID-19 emergency waivers and its impact on temporary telehealth and licensure policies. As of June 15, 39 states and D.C. have ended their emergency declarations, while 11 states continue to have them in place. Additionally, 13 states continue to have licensure flexibility waivers in place and allow providers to practice across state lines, under certain circumstances.
NBC News: State by state, some patients are losing telehealth access to doctors (6/19) - Telehealth access has been rolling back gradually and quietly over the past few months as pandemic-era emergency health orders have lapsed. "Some patients and their families now have to switch doctors or drive hours to different states when previously video calls from their homes would have been allowed under the looser regulations," said Dr. Brian Hasselfeld, Johns Hopkins Medicine's medical director for digital health and telemedicine.
Mississippi Public Broadcasting: Health care experts work to expand telehealth in Mississippi (6/13) – Mississippi recently expanded telemedicine access in the state to allow patients to have continued access to their providers over the phone or internet. The University of Mississippi Medical Center began its telemedicine program in 2003, with a team of physicians training nurse practitioners to work in rural hospitals. During the pandemic, emergency declarations eliminated many of the barriers to telehealth, allowing physicians to connect remotely with patients. And this year, Mississippi passed a law making that expansion permanent.
Telehealth News and Market Developments
Politico: Untreated’: Patients with opioid addiction could soon lose access to virtual care (6/20) - Federal regulations that have allowed practitioners the flexibility to prescribe buprenorphine virtually — and to patients outside their state — are due to expire along with the Covid-19 public health emergency. Find more background on this policy issue on the Alliance for Connected Care website.
Inside Telehealth: Cardiology, Family Physician Leaders: Continue Audio-Only Telehealth, Care Across State Lines (6/16) – During a recent FiscalNote webinar, leaders at the American College of Cardiology, and Alliance Advisory Board Member American Academy of Family Physicians (AAFP), expressed support for the federal government and states making pandemic-era allowances for telehealth across state lines and audio-only services permanent beyond the COVID-19 public health emergency. Members of the American College of Cardiology are invested in making sure patients with chronic heart conditions can see their regular provider via telehealth while traveling or spending part of their time in another state. AAFP saw the percentage of their members who have used telehealth increase from 13 percent before the pandemic to 94 percent. Telehealth can help doctors more efficiently see patients and respond to their individual needs. The federal government and states should begin to modernize the regulatory infrastructure around telehealth.
Forbes: Telehealth Platform is Filling the Health Care Gap for Women with PCOS (6/15) – Allara, a new chronic care platform for women with polycystic ovarian syndrome (PCOS), launched in June of last year. Over 50 percent of women with PCOS remain undiagnosed because it affects so many bodily systems. The platform reduces the difficult path to diagnosis from years to days, with their diagnostic tool testing a wide range of hormonal and metabolic markers.
Healthcare Innovation: PCORI to Fund Research on Maternal Health Inequities and Telehealth (6/15) – The Patient-Centered Outcomes Research Institute (PCORI) will provide funding of up to $50 million for research on using telehealth to improve management of multiple chronic conditions. This research will generate evidence to help the health care community better understand how to leverage the use of telehealth to improve care for individuals with complex chronic needs, particularly those in vulnerable populations. The funding announcement is expected to open on September 7, 2022, according to a PCORI press release.
PR Newswire: Amid Baby Formula Shortage, Immediate Emergency Relief Provided by Lactation Telehealth Pioneers Nest Collaborative (6/14) – Nest Collaborative, a virtual lactation consultation platform, announced it is seeing the highest demand for daily consultations with its national network of lactation consultants since the infant formula shortage began in May. Because visits are covered by most insurers, Nest Collaborative has increased access to this support.
Healio: AMA seeks to expand telehealth, reform payment system and prior authorization
(6/14) – During his presidential address at the American Medical Association (AMA) House of Delegates meeting, Gerald E. Harmon, MD outlined five actions that policymakers must take to better support physicians. One such action included to expand telehealth. To ensure the changes made during the pandemic continue after the public health emergency is lifted, Harmon said the AMA is “fighting to update our laws and regulations” to ensure telehealth can be used for chronic disease management, care coordination, tele-psychiatry, and more.
Healthcare IT News: The Challenges of Telemental Health, and How They Can Be Overcome (6/14) – In this article, the chief medical officer and cofounder of Redirect Health, a telehealth technology and services company, provides insight on how to increase telehealth accessibility. Key points include expanding access to the internet, proper telehealth training for health professionals, and adding support or modifications to better support patients with disabilities.
Forbes: Clinical Visits and Telehealth: Not Either, Or, But Both (6/14) –Rather than viewing the future of behavioral health as a choice between mental telehealth and clinical care, the focus should be on integrating the two. Telehealth can play a valuable role in providing foundational access for everyone who needs care. It’s the doctor’s office that never closes, providing informed, evidence-based advice from qualified medical professionals like nurses, physician assistants and trained therapists. An integrated model combining telehealth and clinically necessary in-person care can provide the best of both worlds.
Washington Examiner: Telehealth is Critical to Our Healthier Future (6/13) – Earlier this month, a group of 17 House Republicans released several ideas for modernizing the health care system, improving access to care, and lowering costs. One of the proposals includes safeguarding expanded access to telehealth. Making the COVID-19 telehealth flexibilities permanent after the end of the public health emergency can help eliminate onerous barriers to virtual care.
PYMTS: New Reimbursement Rules Would Spur Telehealth Innovations (6/13) – Remote patient monitoring can work with digital therapeutics to track disease states and use that patient data to fine-tune treatment. Earlier this year, CMS issued a Telehealth Update on the Medicare Physician Fee Schedule, which expanded the originating sites to include the patient’s home, among others. TheAlliance for Connected Care has continued to advocate
for the removal of the outdated originating site provision for telehealth.