"The Committee believes that temporary licensure flexibilities enacted during the COVID-19 pandemic offer a unique opportunity to continue past FTC research into the effect of occupational licensure on health care competition."
The Alliance for Connected Care thanks the Committee for including this important language. As states began to roll back licensure flexibilities over the past year or so, it has caused delays/disruption in care for patients who relied on telehealth to see their providers in another state. This study would help examine some of the trends/flexibilities in place during the pandemic from the competition standpoint to see where there may be roadblocks that can be addressed.
Office of the Assistant Secretary for Planning and Evaluation (ASPE): Medicare Telehealth Trends Dashboard (7/20) - ASPE's Office of Health Policy has developed an interactive Medicare Telehealth Trends Dashboard with aggregated Medicare FFS claims from 2019 to 2021. This data may be updated in the future. Users can address their own policy and research questions of interest on Medicare FFS telehealth trends by manipulating charts on the dashboard by beneficiary characteristics, visit specialty – primary care or specialist and whether the primary reason for the visit was for a behavioral health condition, and by state, urban/rural location or health professional shortage area based on where the beneficiary resides. State profiles on telehealth use are also available.
Federal Trade Commission (FTC): Telehealth Privacy and Security from Online Tracking Technologies (7/20) - The FTC and the Department of Health and Human Services' (HHS) Office for Civil Rights (OCR) sent a letter to approximately 130 hospital systems and telehealth providers to alert them about the risks and concerns about the use of technologies, such as the Meta/Facebook pixel and Google Analytics, that can track a user’s online activities. These tracking technologies gather identifiable information about users, usually without their knowledge and in ways that are hard for users to avoid, as users interact with a website or mobile app.
The continuation of virtual direct supervision through December 31, 2024, including an RFI to continue beyond that. Specifically, CMS is seeking comments to help it consider how telehealth services can be furnished in all residency training locations beyond December 31, 2024.
Beginning in CY 2024, claims billed with place of service (POS) 10 (Telehealth Provided in Patient’s Home) be paid at the non-facility PFS rate. CMS expects practitioners will be functionally maintaining all of their PEs, while furnishing services via telehealth. CMS recognized that providers of telehealth still need to maintain brick and mortar, so they are going to pay at the office rate.
Allowing a separate payment for RPM and RTM services using HCPCS code G0511, either along or with other payable services on an RHC or FQHC claim for dates of service on or after January 1, 2024.
An update to the review process of additions to the Medicare Telehealth Services List. CMS is soliciting comments on its proposal analysis procedures.
The implementation of provisions of the CAA, 2023.
The addition of marriage and family therapists (MFTs) and mental health counselors (MHCs) to the list of practitioners who are eligible to furnish Medicare telehealth services at the distant site.
ASPE: State Medicaid Telehealth Coverage Policy Decisions Since the COVID-19 Public Health Emergency (7/12) - ASPE contracted with RAND Health Care to catalogue and assess state changes to Medicaid telehealth policies during the COVID-19 PHE through May 2022 and identify the driving circumstances, motivations, and evidence supporting telehealth policy decisions during the COVID-19 Public Health Emergency (PHE). The purpose of this study was to review changes to state Medicaid telehealth policies and/or new policies enacted during the COVID-19 PHE, examining policies that were rolled back, as well as those made permanent in part or in whole.
National Institute on Drug Abuse: RFI for Data on the Impact of Telehealth Initiation of Controlled Substances Permitted Under the COVID-19 PHE (7/6) - The purpose of this request for information (RFI) is to solicit data on the impact of telehealth initiation of controlled substances which were permitted under the COVID-19 Public Health Emergency (PHE) and subsequently extended on May 11, 2023, when the PHE ended.
The purpose of this RFI is to solicit data that address:
Benefits associated with telehealth prescribing of controlled substances, including prescription opioids, stimulants, benzodiazepines, and dissociatives
Harms associated with telehealth prescribing of controlled substances, including prescription opioids, stimulants, benzodiazepines, and dissociatives
Comparative diversion risk of prescriptions initiated via telehealth vs. in person
House Energy and Commerce Committee: Full Committee Markup of Health Bills (7/19) - The House Energy and Commerce Committee held a markup on several bills, including the Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824), which would allow employers to offer limited telehealth benefits to part-time and seasonal workers. The bill passed, as amended, by a vote of 29-20.
The Alliance for Connected Care tracks legislation with significant telehealth or remote patient monitoring provisions.
Telehealth Research, Reports and Surveys
Cancer Medicine: Telehealth Use and Perceptions Among Prostate Cancer Survivors (7/16) - Telemedicine proves especially useful in instances where in-person care is unavailable or not feasible for patients. In regard to cancer survivors, 55 percent believed that telehealth was a good resource for more basic forms of care or an initial consolation. Telehealth increases access to care and has the potential to reduce cancer disparities.
mHealth Journal: Overview of Telehealth in the United States Since the COVID-19 PHE - A Narrative Review (7/15) - This narrative review focuses on highlighting telehealth research and evaluation that took place from March 2020 to February 2023 in the outpatient setting of the United States health care system. The research conducted during the COVID-19 PHE shows that telehealth was primarily used as a substitute for in-person care, to maintain continuity of care for established patients, and has not had a negative impact on clinical outcomes or resulted in increasing health care costs. Studies show high patient and physician satisfaction, similar clinical outcomes and suggest that telehealth is used as a substitute for in-person care. The findings of this narrative review have direct implications for key stakeholders using telehealth now and beyond the COVID-19 pandemic. Patients, physicians and providers, health care leaders and administrators, as well as policymakers should consider how telehealth should continue to be reimbursed and regulated even as the COVID-19 PHE expired in May 2023.
American Medical Association (AMA): How States Can Boost Telehealth With More Flexible Licensure (7/13) - When the COVID-19 pandemic began, temporary waivers of telehealth coverage and payment regulations boomed at the state and federal levels to meet the increased demand for virtual medical care. To keep pace, state and federal licensure requirements also were waived, enabling physicians to work across state lines and provide care in areas hardest hit by the pandemic without having to apply for licenses in those states. Today, however, nearly all states have lifted those temporary licensure flexibilities. But numerous states are exploring policies to ensure they retain the authority to regulate and oversee the practice of medicine for their residents while also accounting for modern-day realities of patient movement, physician shortages and the regionalization of health care delivery. An AMA issue brief outlines the spectrum of approaches states are adopting for telehealth licensure and provides model language for states to consider when seeking to implement licensure flexibilities.
Information Systems Research: Impact of Telehealth and Process Virtualization on Health Care Utilization (3/28) - A study by University of Texas researchers found that insurance plans should expand their telehealth coverage to include more providers and close the health care access divide in rural locations, which can reduce subsequent hospitalizations and unnecessary costs. The authors found that telehealth’s benefits can be seen in treating conditions and diseases with “high virtualization potential” such as mental health, skin problems, metabolic conditions and musculoskeletal diseases. Telehealth can also function as a gateway to healthcare for individuals who live in rural areas. Additional research is needed for "less virtualization potential" specialties. For additional coverage, see Fierce Healthcare.
Telehealth News and Market Developments
PR Newswire: HealthSnap and Prisma Health Expand Program (7/19) - HealthSnap, a virtual care management platform, and Prisma Health, a health care organization in South Carolina, announced the expansion of their existing Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) program following improved provider and patient experience, and clinical outcomes. Originally announced in July 2022, the program has already shown meaningful results across Prisma Health's chronic populations including hypertension, heart failure, Type 2 Diabetes, and obesity. This success has led to expanding Prisma Health's remote care programs. This expansion will enable wider access, including 81 new primary care physicians to provide RPM and CCM service access to more than 20,000 individuals in high-risk chronic populations.
Dermatology Times: Addressing Disparities in Atopic Dermatitis (AD) with Telehealth (7/19) - A teledermatology clinic that was launched in a church is the model for a program aimed at creating new channels for underserved residents to access health care. The George Washington University School of Medicine and Health Sciences is partnering with Pfizer Global Medicine Grants to launch a grant program in Washington DC. The program will offer up to $250,000 to create telehealth programs that expand access to education and resources on inflammatory dermatoses such as Atopic Dermatitis, which affects as many as 30 million people in the US. The project aims to locate clinics in popular community meeting spots like churches, salons, libraries, homeless centers, and health clinics.
PR Newswire: Innovative Telehealth Platform HIPAA LINK is Breaking Down Barriers for Mental Health Practitioners (7/19) - HIPAA LINK, a telehealth platform specializing in streamlining telehealth through digital therapeutics, is now live, providing a compelling alternative for mental health practitioners worldwide. HIPAA LINK was designed from the ground up by mental health practitioners to help reduce or eliminate any friction associated with running a telehealth practice. HIPAA LINK users enjoy better quality and more reliable connections than industry peers, with a 99.98% uptime guaranteed – meaning dropped calls are virtually non-existent.
American Hospital Association (AHA): AHA Supports Legislation to Make Permanent Certain Telehealth Flexibilities (7/18) - AHA voiced support for the Protecting Rural Telehealth Access Act (S.1636/H.R. 3440), which would protect access to telehealth services under the Medicare program. The legislation was introduced in May. AHA also urged the legislation’s sponsors to further expand the permissible originating sites to any location in which a patient receives a telehealth service, and permanently expand the provider types eligible to perform telehealth services. Read AHA letters to the lead sponsors of the Senate and House bills.
STAT News: How Telehealth Startups Are Trying to Fill the Menopause Care Vacuum (7/17) - In the last five years, more than a dozen telehealth companies have started up to serve women in and approaching menopause, including with hormone therapy. The most successful startups caught the wave of virtual care adoption set off by the pandemic at the same time menopause has become far more visible as an undertreated health concern. And while these nascent companies haven’t garnered the same beefy investments as broader telehealth offerings, investors are starting to see that menopause is far from a niche market.
Becker's Hospital Review: Cleveland Clinic Bets on Telehealth to Reduce Costs and Reach Younger Patients (7/17) - Cleveland Clinic is still betting on virtual care to lower costs and to reach patients who are more comfortable accessing care online. Cleveland Clinic recently announced that its new $80 million hospital in Mentor, Ohio, will have telehealth technology installed in inpatient and outpatient rooms, which will allow patients to consult remotely with physicians from different locations. The hospital continues expanding its reach with telehealth as it sees its potential to lower costs and decrease how often patients are using health care resources in the future.
Healthcare IT News: Commonwealth Care Alliance Shares Key Lessons From its Robust Telehealth Program (7/17) - Commonwealth Care Alliance (CCA), a health care services organization, uses telemedicine for its patient population. CCA specializes in managing complex care for individuals dually eligible for Medicare and Medicaid, as well as those who narrowly miss the threshold for Medicaid. As a health care services organization, it delivers and coordinates whole-person care that integrates primary care, acute care, behavioral health, and long-term services and supports, while addressing the social factors that impact health.
Samaritan Health Service: New Telemedicine Platform to Launch in August (7/17) - Samaritan Health Services will roll out its new telemedicine platform, the Epic Video Client, in August. Work is underway now to ensure the service will be easy to access and use by patients and clinicians alike. Patients will find the new platform easy to manage. The new platform gives health care professionals the ability to securely launch video visits, update clinical documentation and review patient histories within the Epic electronic health records system.
HealthLeaders: Comforcare's CEO on Remote Patient Monitoring Use to Ensure Consistent Care (7/13) - Remote patient monitoring enables providers and agencies to "bridge the gap" of care in between times caregivers or nurses aren't present. ComForCare, a home health provider that also offers caregiving services , initiated their partnership with Connected Home Living, Connected Care, nine months ago, implementing the technology into their in-home care protocol. Connected Home Living is a remote patient monitoring and telehealth services provider. HealthLeaders spoke with J.J. Sorrenti, CEO of Best Life Brands, the parent company of ComForCare/At Your Side Home Care, on how the partnership came to be and the process of introducing the technology into operations.
HCP Live: Revolutionizing Rheumatology: Exploring the Impact of Telemedicine in Transforming Care (7/11) - The benefits of telehealth are clear, such as reducing travel time and increasing flexibility and access to care. Rheumatic disease, particularly pediatric patients, has served as a proving ground for this technology as these patients often reside in areas where the availability of rheumatologists is severely limited. In the United States, for example, 6 states only have 1 pediatric rheumatologist, and 9 states have none. By reducing the need for physical visits and providing convenience to patients who have to travel long distances, telemedicine has the potential to alleviate some of that hassle.
Becker's Hospital Review: Intermountain's Pediatric Telehealth Program Expands (7/10) - Intermountain Health expanded its telehealth program, which would allow the emergency department to connect with the Primary Children's Hospital trauma and pediatric ICU specialists. Intermoutain's emergency room physicians can connect with Primary Children's specialists for patient consultations whenever necessary. Primary Children's Hospital specialists will be available for consultation 24/7.
Intermountain Health: Intermountain Fillmore Community Hospital Uses Telehealth to Help Moms Succeed at Breastfeeding (7/10) - Intermountain Fillmore Community Hospital used telehealth so a certified lactation consultant at Intermountain Orem Community Hospital could consult remotely with a Fillmore Hospital nurse who worked in labor and delivery, and the patient who wanted to breastfeed. Through telehealth, nurses have remote access to lactation consultants that provide them with additional training and tips, so they can help news moms solve common breastfeeding challenges – like how to hold and position the baby – and the more unique breastfeeding challenges.
Urology Times, "Expert Discusses Advocacy for Maintaining Telemedicine Reimbursement." In this installment of “Begin Your Journey,” urologist Amanda C. North, MD, talks with host Scott A. MacDiarmid, MD, FRCPSC, about burnout among women urologists as well as advocacy work regarding telemedicine reimbursement. North is an associate professor of urology at Montefiore Medical Center in Bronx, New York. MacDiarmid is a urologist with Alliance Urology Specialists in Greensboro, North Carolina.