Bloomberg Law: Federal Audits of Telehealth to Shape Its Post-Pandemic Future
(9/8) – The Justice Department and Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) have been investigating whether the expansion of telehealth services during the pandemic opened the door to fraud and abuse. The agencies launched a $4.5 billion health care “fraud takedown” of telemarketers and telemedicine companies as a result, which involves auditing telehealth providers to determine appropriate safeguards for program integrity. Krista Drobac, Executive Director of the Alliance for Connected Care, said that OIG audits could also provide an important corrective to the sensationalized picture from the takedown, saying “to the extent that there’s fraud in telehealth and telemedicine, it’s no different from in-person care, and no more frequent. And in some ways telehealth is better from a fraud perspective because of the electronic trail it leaves behind.”
Advisory Board: Is the pandemic-era telehealth boom coming to an end? (9/8) – Telemedicine grew in popularity throughout the pandemic for patients and providers alike. With state emergency orders expiring, including waivers for out-of-state medical licenses and other telehealth flexibilities, many patients are left without access to important virtual care. This article explores how telemedicine flourished during the pandemic, how these expirations threaten telemedicine’s continued usage, and Advisory Board’s take on how health care leaders need to act now to ensure telemedicine flexibility. Notably, the article mentions work the Alliance for Connected Care is doing around cross-state licensure, citing a tracker
of out-of-state licensure flexibilities that shows at least 21 states still have emergency orders with licensure flexibilities in place.
State Telehealth News and Activity
The Hartford Courant: Connecticut community colleges adding telehealth counseling, but some say it’s not a replacement for in-person services (9/8) – The Connecticut State Colleges and Universities system announced plans to provide community college students with free telehealth counseling services this fall through TalkNow, an on-demand mental health support system, using nearly $660,000 in federal COVID relief aid. Some mental health providers who work on school campuses had mixed feelings, saying this should not be viewed as a solution to often lacking adequate in-person care offerings on such campuses.
Associated Press: Alaska seeks out-of-state medical personnel amid virus surge (9/7) – Officials in Alaska have requested help from over 470 out-of-state medical personnel in response to recent surges in COVID cases in the state, including nurses, patient care technicians and respiratory therapists. Governor Mike Dunleavy has asked lawmakers to consider legislation that would allow Alaska to participate in the Nurse Licensure Compact, while the bipartisan state legislature has asked the governor to issue a disaster declaration in response to this pandemic wave.
Arizona Physician: Expansion of Telehealth in Arizona: Implications for Rural Healthcare Communities (September 2021) – Arizona adopted a major telehealth bill, House Bill 2454, which has the promise to drastically decrease barriers to health care access faced by residents of Arizona’s rural communities, as well as simplify the process for providing care to patients living in rural parts of the state. An executive order signed by the governor at the start of the pandemic to expand telehealth was beneficial for many patients in the state, however all the benefits are set to expire at the end of the public health emergency, which is why the state acted to pursue legislative action for such policies. The bill will allow physicians to provide telehealth via audio-only encounters, and allow physicians licensed in another state to provide telehealth services to Arizona patients - both of which will positively impact rural communities’ access to care.
Telehealth Research, Reports and Surveys
Healthcare Dive: Telehealth claims drop to lowest level since before pandemic, Fair Health finds (9/9) – According to new data
from Fair Health, telehealth claim lines as a percentage of all medical claims dropped 10 percent from May to June, despite a month of stability. Virtual care claims fell from five percent of all medical claims in May to 4.5 percent in June, the lowest level recorded since the start of the pandemic. Telehealth use had previously risen two percent from April to May for comparison, following three months of declines. The sharpest decrease in telehealth use occurred in the Northeast region, where utilization fell 12 percent from May to June.
University of Michigan Institute for Healthcare Policy & Innovation: An evaluation of telehealth use by Medicare beneficiaries in 2020 (9/8) – This policy brief examined national Medicare claims data to better understand whether the use of telehealth led to an increase in the overall volume of outpatient evaluation and management (E&M) services delivered to Medicare beneficiaries. The study findings mitigated some concerns that telehealth expansion will increase the overall use of services – while telehealth use surged during the early months of the pandemic, it plateaued through the end of December 2020. Additionally, the increase in telehealth use has not led to an increase in the overall volume of E&M services, suggesting that telehealth is still being used as a substitute for in-person care.
Healthcare Dive: Hospital telehealth leveling off at one-fifth of medical appointments, research finds (9/7) – A new survey
from KLAS Research and the Center for Connected Medicine found that the use of telehealth for patient visits seems to have leveled off at 20 percent or fewer of all appointments. Over 80 percent of hospital executive respondents to the survey, which was conducted between May and June 2021, said one-fifth or fewer of their facility’s appointments were being conducted virtually, with many systems with 30 percent or more of services being virtual responding that they anticipate this percentage to decline as the pandemic wanes. Despite these statistics, many provider organizations continue to look to expand their virtual care services to better manage patient populations while keeping costs down, including through chronic care management, behavioral health and urgent care.
mHealth Intelligence: Mayo Clinic RPM Model Improves Outcomes for Acute COVID-19Treatment (9/7) – According to a study
by Mayo Clinic, remote patient monitoring programs are safe, feasible, and yield positive health outcomes for acute COVID-19 treatment. The health system expanded its multi-state RPM program during the pandemic to treat patients with the virus at home, adapting an original RPM program that helps patients with chronic care management to support COVID-19 patients. Thus far, 7,074 patients across 41 states have participated in one of two RPM models, depending on their risk factors, between March and November 2020. Only 9.4 percent of all patients were admitted to the hospital within 30 days of enrollment or discharge, and the average length of stay was three days for low-intensity patients and 6.4 days for high-intensity patients.
Aledade: Getting the Price Right: Looking Toward the Future of Telehealth (9/3) - Aledade’s policy team provided their recommendations for a flexible and equitable payment model for telehealth services in their new policy paper Getting the Price Right: Looking Toward the Future of Telehealth. Aledade asserts that, in a value-based care model, integrating telehealth can help ensure that primary care practices can have hybrid models of care, seeing patients both in-person and virtually, while making sure that the primary care relationship can continue and thrive.
Telehealth News and Market Developments
Becker’s Hospital Review: Cleveland Clinic, Amwell to offer telehealth 2nd
opinion service to Anthem members (9/8) – Cleveland Clinic and Amwell announced a joint virtual health venture called The Clinic, which is teaming up with Anthem to offer plan members access to the Clinic’s telehealth second opinion service. This service offers patients support from 3,500 Cleveland Clinic physicians via online consultations.
mHealth Intelligence: Using Remote Patient Monitoring to Improve Diabetes CareManagement (9/8) – The University of Mississippi Medical Center (UMMC) has partnered with North Mississippi Primary Health Care to leverage remote patient monitoring (RPM) to increase patient access to diabetes care management and improve health outcomes. The goal of UMMC is to reach at least 1,000 patients in eight cities across the state through the RPM program, which will provide mobile-optimized tablets to individuals who enroll in the program.
Modern Healthcare: Advocate Aurora, Teladoc among group seeking telemedicine quality research
(9/8) – A group of researchers through the Society to Improve Diagnosis in Medicine coalition, which includes groups like Advocate Aurora Health and Teladoc Health, are working to inform research on technological obstacles and virtual clinical experiences and the effectiveness of future of telehealth to assess the quality of digital health. The coalition has launched a project called TeleDx that surveys patients, clinicians, hospitals, health systems and telehealth companies to gauge their experiences with telemedicine. The project found that patients and providers need research to inform their decisions on whether care can be managed virtually or if it warrants an in-person visit
Mount Sinai: Mount Sinai Health System Launches Comprehensive Mobile App for Patients (9/7) – Mount Sinai Health System launched the MyMountSinai mobile app, which will help patients manage their medical information, communicate with their doctors, and get details on health services available through the health system. The app will allow patients to schedule telehealth visits through their smartphone and other personal devices, and includes features such as the ability to conduct video visits with providers.
Washington Post: Telemedicine – a boon for many in the pandemic – threatened with cutbacks
(9/4) – Telehealth flourished during the pandemic, making access to medical care possible and bringing with it the potential for long-term promise to reach individuals in remote communities, nursing homes, low-income areas, and other communities that face barriers in access to care. With state emergency orders mandating the coverage of telehealth visits and waiving licensure requirements for out-of-state providers starting to expire, many patients are discovering telemedicine is no longer an option for them, which has raised concern across the country. For example, Megan McKnight, a physician assistant at Johns Hopkins Bayview Medical Center, relied on telemedicine to build rapport with patients with a history of trauma or anxiety. When her team was informed that after July 1, all visits needed to be strictly in person, she found herself “trapped in a disturbing paradox: unable to treat patients who could not physically travel due to COVID-19 concerns, but now also unable to provide virtual care.”
Healthcare IT News, “HIMSSCast: How telehealth will settle in through the pandemic and beyond.” In this episode of HIMSSCast, Oak Street Health Regional Medical Director Dr. Laolu Fayanju joined Healthcare IT News Senior Editor Kat Jerich and host Jonah Comstock to discuss telehealth, remote patient monitoring, and choosing the right patients and use cases for virtual care.