Bloomberg Law: More Telehealth Data Urged Before Making Eased Rules Permanent (3/25) – Many medical groups have called on lawmakers to make broader telehealth permanent because it increases health care access and convenience. “Telehealth can encourage people to access necessary care when they would otherwise put it off because of a long commute to a doctor’s office. The modality is ideal for post-acute care check-ins and chronic disease management”, according to Krista Drobac, executive director of the Alliance for Connected Care.
MedPage Today: Expect Telehealth Rule Changes to Stay in Place -- At Least for a While (3/23) – The public health emergency (PHE) necessitated by the pandemic has been extended through mid-April. Congress has already extended pandemic-era telehealth flexibilities for 151 days, or about 5 months, once the PHE ends. Krista Drobac, executive director of the Alliance for Connected Care, commented on telehealth trends during the pandemic, noting: “Private employers were much further ahead than Medicare in terms of offering telehealth. On the commercial side, employers were able to offer discounted telehealth services to people with health savings accounts. There are 35 million Americans in the commercial market with health savings accounts, and they were able to access telehealth before the deductible.”
Inside Health Policy’s Telehealth: Lobbyists Regroup After Omnibus Gives Only 151-Day Telehealth Extension (3/21) – Telehealth lobbyists are regrouping on their next steps to seek permanent telehealth expansion after the omnibus funding package temporarily extended Medicare telehealth waivers for 151 days after the PHE expires. Krista Drobac, executive director of Alliance for Connected Care, said she would welcome permanent legislation, but added she is unsure whether there will be enough information available to lawmakers to make them comfortable passing anything permanent. “Of course, we would welcome a permanent fix, but given that the MedPAC and OIG reports required in the omnibus aren’t due until next summer, it’s more likely we are talking about another extension,” Drobac said. “It’s all about data at this point.”
Inside Health Policy’s Inside Telehealth: Becerra’s Statements May Bode Well for Telehealth Reg Relief (3/21) – During a recent press conference, HHS Secretary Becerra said that HHS will take aggressive steps to protect telehealth care options that help meet communities’ needs after the conclusion of the COVID-19 public health emergency. Stakeholders say HHS has the capacity to preserve and expand certain telehealth services on its own without congressional intervention, including creating new Healthcare Common Procedure Coding System (HCPS) codes for telehealth options, expanding the list of eligible health care providers that can use telehealth services, and lifting the originating site restrictions for Medicare beneficiaries. Secretary Becerra’s statements signal that the Administration might be supportive of legislative and regulatory reforms to continue the expanded use of telehealth.
Federal Communications Commission: FCC Announces Final Group of Approved Projects for Connected Care Pilot Program (3/16) – The Federal Communications Commission (FCC) announced
its fourth and final set of approved Connected Care Pilot Program projects. With the newly 16 selected projects, which will receive nearly $30 million in funding, the Connected Care Pilot Program is set to fund 107 projects serving patients in 40 states plus D.C. The additional projects selected will address a number of critical health conditions such as high-risk pregnancy/maternal health, mental health conditions, opioid dependency, COVID-19, and chronic conditions.
Federal Communications Commission: FCC to Authorize $640M for Broadband Expansion (3/10) – The FCC plans to authorize more than $640 million to support new broadband deployments in 26 states, which will help boost access to virtual health care. Through its COVID-19 Telehealth Program, the agency awarded $47.89 million in new funding to 100 health care organizations last month to support the growth of telehealth programs. The agency also released a proposal that aims to change how payment rates are determined for rural providers using telecommunications, including telehealth.
Making Advances in Mammography and Medical Options (MAMMO) for Veterans Act: (3/24) – On March 24, the Senate unanimously passed the bipartisan, bicameral MAMMO for Veterans Act (S. 2533/H.R. 4794), which would improve mammography services furnished by the Department of Veterans Affairs. Notably, the bill would improve access to screening, care, and treatment for rural veterans by allowing for care partnerships to be created via telehealth. It would also implement a three-year pilot program to provide telescreening mammography services for veterans who live in locations where access to breast imaging services at a VA facility is difficult or unfeasible.
House Energy & Commerce Committee: E&C Democrats Outline Priorities on Implementation of Bipartisan Infrastructure Law’s Broadband Investments
(3/21) – Seventeen Democratic members of the House Energy & Commerce Committee’s Communications and Technology Subcommittee wrote a letter
to Alan Davidson, Assistant Secretary of Commerce for Communications and Information at the National Telecommunications and Information Administration (NTIA). The letter outlined their recommendations and priorities as the agency implements the broadband programs in the Bipartisan Infrastructure Law. Committee members noted affordability as a major barrier to broadband access and urged NTIA to provide the most possible help to those struggling to afford broadband service by making low-cost offering requirements as widely available as feasible.
To keep up to date on current telehealth legislation moving through Congress, the Alliance updates a tracker of major federal telehealth legislation here.
Telehealth Research, Reports and Surveys
Globe Newswire: SmileDirectClub Survey Reveals Growing Popularity and Acceptance of Telehealth (3/24) – A recent survey by SmileDirectClub found that consumers want telehealth services to continue following the accelerated adoption of telehealth during the pandemic. Nearly eight in 10 people (77 percent) had a neutral to positive experience, and more than half of respondents (59 percent) agreed or strongly agreed that they are more open to receiving care through telehealth as a result of the pandemic. The continued acceptance of telehealth will allow health and dental care providers to create more affordable and accessible experiences for patients, without sacrificing safety or quality.
mHealth Intelligence: Telehealth Supported Care for Community Mental Health Centers (3/23) – A recent
study published in the Journal of Medical Internet Research Mental Health found that telehealth supported care continuity during the COVID-19 pandemic for community mental health center patients with serious mental illness. Researchers found that female patients between 18 and 34 with less severe diagnoses, such as anxiety disorder, posttraumatic stress disorder, and major depressive disorder, were most likely to use telehealth. Researchers concluded that telehealth was highly resourceful for community mental health center patients during the COVID-19 pandemic, and it will continue to open possibilities for future methods of care.
HIT Consultant: Telemedicine-Supported Medication-Assisted Treatment Should Remain Available After Pandemic (3/23) – According to a survey conducted by Bicycle Health, 100 percent of patients believe that telemedicine-supported Medication-Assisted Treatment (MAT) should remain available even after the pandemic comes to an end. Patients reported affordability as the biggest barrier to joining an opioid recovery program, as well as not finding a program they trust that is located in their area. Telemedicine makes these recovery programs available and accessible to more people.
Healthcare IT News: Telehealth Can Effectively Manage COVID-19 At Home, Study Finds (3/23) – A University of Iowa study
published in the Journal of Telemedicine and Telecare found that an at-home telemonitoring program was an effective and sustainable way to manage COVID-19 for patients. Most patients did well with the program, with observed rates of hospitalization and mortality lower compared to national and regional averages. The study highlights a novel method of providing health care in a technology-driven world, reducing the utilization of hospital resources while also allowing timely identification of disease progression and rapid escalation to inpatient care when necessary.
American Medical Association: AMA Survey Shows Widespread Enthusiasm For Telehealth (3/23) – A survey
by the American Medical Association (AMA) found that 85 percent of physicians now use telehealth and 70 percent plan to continue using virtual services after the pandemic. However, only eight percent of physicians currently use remote patient monitoring. The survey also found that more than two-thirds of telehealth providers said they use audio-only modalities to offer telehealth services. Most physicians (54 percent) agree that telehealth increased their professional satisfaction, and 62 percent believe it has helped boost patient satisfaction. Physicians view telehealth as providing quality care to their patients, and policymakers and payers have come to the same conclusion. This survey shows adoption of telehealth is widespread, as is the demand for continued access to virtual care for Medicare patients.
mHealth Intelligence: Telehealth Helped Maintain Type 1 Diabetes Care Among Kids During Pandemic (3/22) – A study
published in BMC Pediatrics found that the utilization of telehealth devices, such as continuous glucose monitors (CGMs), helped providers continue to care for children with type 1 diabetes as the COVID-19 pandemic upended health care delivery. Between 2019 and 2020, outpatient visits decreased among pediatric type 1 diabetics with commercial insurance, but not those with non-commercial insurance. Researchers concluded that increased adoption of continuous glucose monitors and extensive use of telemedicine visits may have ameliorated the impact of the pandemic on disease management.
Healthcare Finance News: Telehealth Will Endure, But Providers Are Managing Expectations (3/22) – According to recent survey
by UnitedHealth Group, telehealth technology has been cited for its convenience, especially when usage skyrocketed during the COVID-19 pandemic, but there are also frustrations from providers. The survey found 58 percent of providers were frustrated with the quality of care they can provide through virtual platforms, and 55 percent said they have to manage patient expectations for virtual visits. However, despite these concerns, 93 percent of providers said they would continue to use telehealth when the public health emergency ends.
mHealth Intelligence: Telehealth Cut Missed Appointments Among Kids With TB by 11 Percent (3/21) – A study
published in the Tropical Medicine and Infectious Disease journal found the implementation of telehealth had a significant impact on missed follow-up appointments among pediatric patients with tuberculosis infections (TBI), reducing the rate of missed visits by 11.1 percent. Before implementing telehealth, 16.9 percent of TBI patients missed appointments between 2016 and 2019. In 2021, after telehealth services were implemented, 54.2 percent of follow-up TBI visits took place virtually. The missed follow-up appointment rate for children with TBI declined from 16.9 percent to 5.8 percent.
Insider Intelligence: A window into how doctors are using telehealth—and where there’s room for improvement (3/21) – A recent survey
by Optum found that the top-used health care services conducted via telehealth were primary care (54 percent), prescription refills (26 percent), and chronic care (16 percent). While telehealth enables providers and patients to have a direct line to each other, it can vary from provider to provider, so it’s important that patient communication and data isn’t left in silos and that different clinicians can easily access the data they need to seamlessly coordinate care.
Drug Topics: Telehealth Services Evaluated Vs Standard Care for Diabetes (3/20) – A study presented at the American Pharmacist Association Conference found that the telehealth diabetes management program (telephone or video visits) may be a successful method to improve diabetes management by 1) lowering A1c and 2) improving immunization rates. Researchers emphasized that having a comprehensive telehealth diabetes care model, which includes assessing transportation as a barrier to care, can lead to better coordination of care and access in a low income, uninsured population.
Physician’s Weekly: Telehealth May Increase Access to Substance Use Treatment During COVID-19 (3/19) – A recent study
published in the Journal of Addiction Medicine, which examined patient characteristics associated with the use of phone versus video-enabled tele-medication for opioid use disorders (tele-MOUD) during COVID-19, found that most tele-MOUD encounters completed by patients (79.62 percent) were video visits. Of these encounters, 23.08 percent were telephone visits. Notably, elderly patients and patients who were less educated (and who also disproportionately experience a digital divide) were more likely to rely on a telephone visit for their care. The study suggests that both video and telephone telehealth visits may be helpful in accessing treatment for opioid use disorders, though patient characteristics of each group may differ slightly.
American Journal of Managed Care: Digital Technology Could Be Helpful for COPD Management in the Future (3/2) – A recent narrative review published in the Therapeutic Advances in Respiratory Disease journal found that digital technology can be beneficial for patients with chronic obstructive pulmonary disease (COPD) to learn proper self-management of the disease, such as learning the correct inhaler technique. Telehealth interventions were associated with fewer hospitalizations and emergency department visits for patients with COPD. Health care providers cited their concern about telehealth visits as they cannot take social and physical cues from the information given to them. The researchers recommended that health care professionals get proper training in digital innovations to address their concerns.
State Telehealth News and Activity
JD Supra: Tracking Telehealth Changes State-by-State in Response to COVID-19
(3/25) - Manatt Health has developed a federal and comprehensive 50-state tracker for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic. New state-level developments over the past two weeks include: 1) Oregon passed House Bill 4034, which allows physicians and physician assistants licensed in Oregon to use telemedicine to provide health care services to patients physically located in Oregon without being present in the state at the time of service delivery; and 2) Indiana passed Senate Bill 284, which allows certain Medicaid providers, such as FQHCs and Rural Health Clinics, to be reimbursed for telehealth and adds additional practitioners to the definition of “practitioner” for the purposes of practicing telehealth.
Nebraska Department of Health and Human Services: Nebraska State Unit on Aging Announces Partnership (3/25) – The Nebraska State Unit on Aging and GetSetUp, a virtual social learning platform designed for older adults, partnered to help bridge the digital divide and combat social isolation for residents in Nebraska. The partnership provides live interactive classes for older adults in their own homes, and will include online training opportunities for adults age 60+ to learn how to effectively use technology to meet with their doctors via telehealth, among other activities.
Telehealth News and Market Developments
Inside Health Policy’s Inside Telehealth: Hike in Telehealth Boosts Use of AI Data to Tailor Equitable Patient Care (3/25) – The increase in telehealth during the pandemic has boosted health care providers’ ability to use patient data collected via artificial intelligence (AI) to market and tailor care based on an individual’s psychographic information. The patient demographic data can also be used by Medicare Advantage plans to improve their star ratings by culling real-time information on their beneficiaries’ care and health outcomes. More accessible targeted care based on AI can help improve patient outcomes if they can participate in telemedicine appointments.
Morgan Lewis: Special Telehealth Rules for HSAs Return—Briefly (3/22) – The Consolidated Appropriations Act of 2022, which was signed on March 15, again permits first-dollar coverage for telehealth services without jeopardizing high-deductible health plan health savings account (HSA) eligibility. This provision is effective April 1, 2022 through December 31, 2022. Plan sponsors must now consider if implementing this feature is worth the administrative lift for the nine months it is available.
The Daily Record: Johns Hopkins Saw Huge Increases of Telemedicine Use (3/22) – Alliance Member Johns Hopkins Medicine saw a surge in telemedicine visits with one million remote appointments recorded at the health system’s six hospitals in 16 months. With patients enrolled in Medicare, Medicaid, or who were dually insured, Johns Hopkins Medicine emphasized the need for Medicare to continue paying for expanded telemedicine services. Without expanded coverage, health systems would face a quandary because they would want, clinically and ethically, to continue offering such services to all patients, not just those with private insurance.
mHealth Intelligence: How Providers Can Optimize Telehealth Workflows and Improve Experience (3/21) – Telehealth workflows and human factors considerations need to be fine-tuned as virtual care becomes a mainstay in health care delivery to ensure patient safety and clinician wellbeing. The rapid expansion of telehealth services did not leave providers much time to set up intuitive and standards-based workflows for virtual visits. A whole separate team may be needed to address the cognitive overload that comes from the excessive amounts of data that telehealth and remote care can provide. It's time for providers to fine-tune their processes and ensure all stakeholders can use and benefit from virtual care modalities.
Fierce Healthcare: Why the “Great Resignation” is Driving Physicians to Explore Opportunities in Telemedicine (3/21) – The pandemic has exacerbated burnout and staffing shortages, causing more hospital staff to seek better work/life balance, relieve themselves from prolonged overworked conditions, or lessen their exposure to COVID-19. More physicians are finding these opportunities by moving into telemedicine roles. Physicians cite flexibility, safer working conditions, and fresh income opportunities as some of the reasons to switch into telemedicine. Telemedicine is changing the way hospitals and doctors deliver care, allowing them to utilize technology to deliver better options for patients.
Teladoc Health: Teladoc Health Announces Virtual Care Transformation Model for Employers
(3/21) – Teladoc Health announced a Virtual Care Transformation Model, a strategic framework that will help employers and health plans to assess and advance their health care programs by proactively integrating virtual care as a way of improving access, lowering costs, and providing better health outcomes to individuals. The model is based on five core dimensions of a virtual care strategy and is meant to help understand the current gaps that impede organizations from reaching their virtual care goals.
Kaiser Family Foundation, “Health Wonk Shop: Telehealth – Beyond the Public Health Emergency.” Congress extended coverage for certain telehealth services in Medicare for 151 days after the pandemic-era public health emergency comes to an end, but beyond that extension, the future of telehealth services in Medicare and more broadly remains uncertain. In this webinar, expert panelists with diverse perspectives, including Alliance for Connected Care executive director Krista Drobac, joined series moderator Larry Levitt in a discussion exploring future directions for telehealth policy, including challenges facing its expanded use, impact on patient care and effects on the U.S. health care system.
American Medical Association, “Making the Rounds: How managing COVID-19 crystalized operations for data and telehealth at UCSD.” In this episode of Making the Rounds, Brian Clay, MD, internal physician and a chief medical information officer at the University of California San Diego, shares his experience with clinical informatics including interoperability, open notes for patients, data literacy and more. This episode is part of the health IT series by the MSS Committee on Health Information Technology, hosted by Shivani Bhatnagar, a medical student at the Texas College of Osteopathic Medicine.