Last Week in Connected Care


	View in browser

Week Ending June 19, 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.

Subscribe to the newsletter and send any news or events to crystal.wallace@connectwithcare.org for inclusion.

- CALL TO ACTION -
Sign Letter to Congress on Medicare Telehealth

Please find linked a multi-stakeholder sign-on letter to Congressional leaders calling for a permanent end to location restrictions for telehealth in Medicare, continued FQHC telehealth payment, and continued telehealth waiver abilities for CMS.

Organizations (not individuals) may SIGN THE LETTER HERE by COB next Friday, June 26. and feel free to share with a wide range of organizations who may be interested in advocating for continued telehealth access in Medicare.

Alliance News

Launch of the Taskforce on Telehealth Policy: The Alliance for Connected Care, the National Committee for Quality Assurance (NCQA), and the American Telemedicine Association (ATA) convened twenty of the nation’s leading healthcare voices to form a Taskforce on Telehealth Policy. The group – representing a broad spectrum of plans, providers, consumer advocates and health quality experts from the public, private and non-profit sectors – will develop consensus recommendations for policymakers on how to maximize the benefits of telehealth services while maintaining high standards for patient safety and program integrity. Other priorities to be addressed include the integration of remote care into the healthcare ecosystem and ensuring the quality, accessibility, and efficacy of telehealth. The Taskforce was announced in many news outlets including: POLITICO, Inside Health Policy, Bloomberg, mHealthIntelligence, Managed Healthcare Executive, Becker’s Hospital Review, and others.

In the News: Executive Director Krista Drobac was featured in America's Health Insurance Plans' virtual annual conference and quoted in Healthcare Dive, "If one state opens their borders, another [state's doctors] could come in, but that state couldn't send their doctors out. Without that reciprocity, it's difficult to create continuous licensure across the states," Krista Drobac, executive director of the Alliance for Connected Care, said Tuesday.

Federal Agency Telehealth Activity / Guidance

The Alliance for Connected Care continues to update a COVID-19 website tracking guidance.

Food and Drug Administration (FDA): (6/15) – FDA permitted the marketing of the first game-based digital therapeutic device to improve attention function in children with attention deficit hyperactivity disorder (ADHD). The prescription-only game-based device, called EndeavorRx, is indicated for pediatric patients ages 8 to12 years old with primarily inattentive or combined-type ADHD who have demonstrated an attention issue.

Federal Communications Commission (FCC): (6/17) – FCC approved the eleventh set of COVID-19 Telehealth Program applications, funding an additional 62 health care providers. To date, FCC’s COVID-19 Telehealth Program has funded 367 health care providers in 45 states and D.C. for a total of $128.23 million in funding. List of awards.

Congressional Activity and Legislation

The Alliance for Connected Care continues to update a recent telehealth legislation page.

Senate Letter: (6/15) – Sens. Schatz (D-HI) and Wicker (R-MS) led 28 bipartisan Senators in a letter to Senate Majority Leader McConnell (R-KY) and Senate Minority Leader Schumer (D-NY) urging them to make permanent the provisions from CONNECT that were included in COVID-19 legislation – including to waive telehealth requirements under Section 1834(m) of the Social Security Act, allow FQHCs and RHCs to provide distant site telehealth services, and allow for the use of telehealth to conduct the face-to-face visit required to recertify a patient’s eligibility for hospice care. The Senators also called on the federal government to collect and analyze data on the impact of telehealth on utilization, quality, health outcomes, and spending during the COVID-19 pandemic. See press release.

Letter: (6/17) – Reps. Kustoff (R-TN) and Soto (D-FL) led 64 bipartisan members of Congress in a letter to Speaker of the House Pelosi (D-CA) and House Minority Leader McCarthy (R-CA) to extend the Centers for Medicare and Medicaid Services’ (CMS) emergency telehealth waivers, including those for behavioral health, for a period of 22 months or longer. See press release.

Senate HELP Committee Hearing on Telehealth: (6/17) – Senate HELP Committee Chair Alexander (R-TN) called for two important temporary telehealth changes in federal policy be made permanent. In opening remarks, Sen. Alexander said the federal government should 1) permanently extend policy changes that allowed physicians to be reimbursed for a telehealth appointment wherever the patient is located, including the patient’s home, and 2) permanently extend the policy change that nearly doubled the number of telehealth services that could be reimbursed by Medicare. He said there were 29 other temporary federal policy changes that could also be considered for being made permanent.

Enhancing Preparedness Through Telehealth Act: (6/17) – Sens. Cassidy (R-LA), Smith (D-MN), Jones (D-AL), and Sullivan (R-AK) introduced the Enhancing Preparedness Through Telehealth Act (S. 3988), which would amend the Public Health Service Act with respect to telehealth enhancements for emergency response. See press release.

Equal Access to Care Act: (6/17) – Sens. Cruz (R-TX) and Blackburn (R-TN) introduced the Equal Access to Care Act (S. 3993), which would permit a licensed health care provider to provide health care services to individuals in one or more States in which the provider is not licensed. See press release.

KEEP Telehealth Options Act: (6/18) – Reps. Balderson (R-OH), Axne (D-IA), Williams (R-TX) and Gibbs (R-OH) introduced the KEEP Telehealth Options Act (H.R. 7233), which would direct the Secretary of Health and Human Services and the Comptroller General of the United States to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency. See press release.

Telehealth for Underserved Communities Act: (6/18) – Sens. Hyde-Smith (R-MS) and King (I-ME) introduced the Improving Telehealth for Underserved Communities Act (S. 3998), which would simplify payments for telehealth services furnished by Federally qualified health centers or rural health clinics under the Medicare program. See press release.

S.3999: (6/18) – Sens. King (I-ME) and Young (R-IN) introduced S. 3999, which would ensure access to mental health and behavioral health services furnished through telehealth under the Medicare program. Bill text and press release have not yet been posted.

Legislative Framework on Broadband: (6/18) – House Energy & Commerce Committee Ranking Member Walden (R-OR) and Senate Commerce, Science, and Transportation Committee Chair Wicker (R-MS) released principles for a legislative framework to expand broadband access and close the digital divide. The framework would, among other things, expand broadband access and digital opportunity and ensure that the FCC’s Telehealth Program has the necessary resources to make sure health care facilities have the appropriate technologies to treat patients remotely.

News and Reports

Healio News: (6/14) – The Advanced Comprehensive Diabetes Care (ACDC), a 6-month telehealth intervention utilized by the VA that combines telemonitoring with module-based self-management support and medication management significantly reduced HbA1c levels that were sustained for 18 months among rural adults with type 2 diabetes.

College of Healthcare Information Management Executives (CHIME): (6/15) – CHIME released findings from a survey of nearly 200 digital healthcare executives, finding that post-COVID-19, 84% of organizations were conducting more than 50 visits per day and a full one-third of those were scheduling over 250 visits per day. Even organizations that already had been seeing high volumes of patients virtually prior to COVID-19 experienced a 366% increase in the number of virtual visits. Organizations also reported increases in the use of remote patient monitoring.

National Journal: (6/15) – Substance-use-disorder experts are hoping to keep some changes, such as allowing prescribing for controlled substances via telehealth beyond the pandemic. “Having the ability to do video conferencing and phone conferencing, including the use of landlines, has been tremendously helpful in creating opportunities for people to connect to care,” said Criss, Ohio Department of Mental Health and Addiction Services Director, who added that a large part of Ohio does not have broadband access readily available in households.

PR Newswire: (6/16) – Doctor.com released a study on "Telemedicine Adoption in the Age of COVID-19 and Beyond," based on the results of a nationwide survey of more than 1,800 adults. The majority of patients (83%) say they will likely use telemedicine even after the pandemic ends. 55% of patients are willing to use telemedicine to see new doctors, and 69% convey that "easy-to-use technology" would help them decide to make a telemedicine appointment.

Becker’s Hospital Review: (6/16) – FDA expanded the use of noninvasive patient-monitoring technologies during the pandemic, allowing clinicians to use the Apple Watch as a remote monitoring ECG device.

Healthcare Dive: (6/17) – According to pre-COVID-19 research published in JAMA on 1.1 million patients with primary care appointments through Kaiser Permanente Northern California's online patient portal between January 2016 and May 2018, female patients and younger adults were more likely to choose a telemedicine visit. In addition, people with greater access to technology and those facing transportation or logistical barriers to care were more likely to select a virtual visit, and patients were more likely to choose a telemedicine visit if it was with their personal primary care clinician, opposed to a new doctor.

Modern Healthcare: (6/18) – The rapid and widespread adoption of telehealth has prompted the need for data on outcomes including quality, value, and cost-effectiveness. Telehealth leaders at Geisinger Health in Danville, Pa., would like to better understand what conditions work best for telehealth. UCSF Health in California is currently analyzing the demographics of those who have had virtual visits, looking at age, race, illness, and ZIP code.

Notable Telehealth Commentary

“I can’t imagine going back,” Seema Verma, CMS Administrator, told STAT during a live virtual event. “People recognize the value of this, so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits.” Verma also said telemedicine visits jumped to more than 1 million a week, compared to about 12,000 before March.

“Even with an event as significant as COVID-19, memories fade and attention moves quickly to the next crisis, so it is important for Congress to act on legislation this year. Because of this 10 years of telehealth experience crammed into 3 months—patients, doctors, nurses, therapists, and caregivers can write some new rules of the road, and we should do so while the experiences still are fresh on our minds,” - Senate HELP Committee Chair Alexander (R-TN) in his opening remarks during a full Senate HELP Committee hearing this week on telehealth.

All witnesses testifying at Wednesday's Senate HELP Committee hearing gave their support for making pandemic telehealth policy permanent - UVA's Karen Rheuban, American Telemedicine Association President Joseph Kvedar, Project ECHO's Sanjeev Arora, and BlueCross BlueShield of Tennessee's Andrea Willis

Upcoming Events –

June 23 – House Veterans’ Affairs Committee, Technology Modernization Subcommittee and Health Subcommittee, “VA Telehealth During the COVID-19 Pandemic: Expansion and Impact.” Virtual hearing

July 9 – Health IT Leadership Roundtable, “Virtual Care as the New Normal.” Webinar

July 29 – STAT, “Inside the virtual care boom: What happens when the point of care becomes anywhere?” Webinar

Event Recordings –

Telehealth and Medicare Advantage: Trends and Best Practices for Health Plans During COVID-19

Navigating Telehealth Reimbursement Policy Changes in the Time of COVID