Please find below the latest developments in federal and state virtual care policy as well as research, data, and polling on the use of virtual care.
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Alliance News
Alliance for Connected Care: Alliance Submits Comments in Response to CMS RFI on Medicare Advantage (8/31) – The Alliance for Connected Care submitted comments
in response to the request for information from the Centers for Medicare & Medicaid Services (CMS) on the Medicare Advantage (MA) program. The Alliance specifically commented on the role that telehealth has played in providing access to care in the MA program and key policy considerations for CMS to ensure this care modality is available and effectively utilized within the MA program moving forward. Top recommendations to CMS include:
- Move forward with dramatic expansions to the use of telehealth to meet network adequacy requirements;
- Clarify that the use of diagnoses obtained through audio-visual telehealth for risk adjustment purposes will continue after the end of the PHE; and
- Promote additional paths to access practitioners across state lines by supporting licensure portability and ensuring that these providers count toward appropriate network adequacy requirements.
Inside TeleHealth: Telehealth Stakeholders Push HDHP Extension, Peg Cost at $90 Million Per Year (8/30) - Telehealth stakeholders are urging the Senate to pass a two-year extension of pre-deductible coverage for telehealth services under high-deductible health plans (HDHP), and estimate the extension could cost around $90 million per year based on former Congressional Budget Office scores and information heard on Capitol Hill. The program is inexpensive for the number of American’s served compared to other health care programs that are typically estimated to cost billions of dollars, according to insurance experts and telehealth lobbyists. The Alliance for Connected Care, among other telehealth stakeholder groups, have organized a sign-on letter to push for a clean two-year extension of telehealth flexibilities in the Senate this fall, which would include provisions around HDHP telehealth. The deadline to sign-on is September 12.
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Administration
Centers for Medicare & Medicaid Services: Increased Use of Telehealth for Opioid Use Disorder Services During COVID-19 Pandemic Associated with Reduced Risk of Overdose (8/31) – CMS, the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH) collaborated on a study
that examined the receipt of telehealth services, medications for opioid use disorder (MOUD), and experiencing a medically treated overdose among individuals with opioid use disorder (OUD) starting a new episode of care prior to the pandemic compared to those during the pandemic. The study found that the expansion of telehealth services during the COVID-19 pandemic was associated with individuals staying in treatment longer and reducing their risk of medically treated overdose. For additional news coverage, see The Hill and PoliticoPro.
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“The COVID-19 pandemic was an unexpected shock to the US healthcare system, which consequently offered a unique opportunity to investigate the impact of healthcare delivery methods on health outcomes among those who were newly diagnosed with OUD. The findings showed that telehealth improved the receipt and retention of MOUD, suggesting that this method of healthcare delivery may address common barriers to OUD-related treatment such as transportation and perceived stigma associated with OUD,” said lead analyst Carla Shoff, Ph.D., social science research analyst at CMS.
“The expansion of telehealth services for people with substance use disorders during the pandemic has helped to address barriers to accessing medical care for addiction throughout the country that have long existed,” said Wilson Compton, M.D., M.P.E, deputy director of the National Institute on Drug Abuse and senior author of the study. “Telehealth is a valuable service and when coupled with medications for opioid use disorder can be lifesaving. This study adds to the evidence showing that expanded access to these services could have a longer-term positive impact if continued.”
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Defense Health Agency: Make Sure You Understand Recent TRICARE Telehealth Policy Changes (8/30) – At the start of the COVID-19 pandemic, the Defense Health Agency (DHA) made several temporary updates to the TRICARE benefit regarding telehealth. In this notice, the DHA provides an overview of updated policies in audio-only telehealth, cost-shares and copayments, and telehealth provider use of telemedicine services.
National Institute of Standards and Technology: Cybersecurity Office Will Consider Telehealth Uses Of Smart Home Tech (8/30) – The National Cybersecurity Center of Excellence (NCCoE) at the National Institute of Standards and Technology (NIST) has released the final project description for Mitigating Cybersecurity Risk in Telehealth Smart Home Integration. The publication of this project description continues the process to further identify project requirements and scope, along with hardware and software components for use in a laboratory environment. The project description notes that the scope of this guidance will be limited to patients using smart devices for communications with clinicians like scheduling appointments, sharing health history information, and requesting prescription updates.
Department of Veterans Affairs: High-Value Digital Health Care (8/28) – The Department of Veterans Affairs (VA) released a new public resource - The Playbook: Digital Healthcare Edition - which features strategies the VA uses to make sure digital technology reaches all Veterans. The resource provides a transparent overview on how the VA is using personal information and health data, and works to ensure the very best treatment options are available.
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Telehealth Research, Reports and Surveys
JAMA Network Open: Assessment of Clinician Diagnostic Concordance with Video Telemedicine in the Integrated Multispecialty Practice at Mayo Clinic During the Beginning of COVID-19 Pandemic From March to June 2020 (9/2) – Researchers from Mayo Clinic conducted a study examining how concordant to an in-person diagnosis provisional diagnoses established at a video telemedicine visit are for patients presenting with a new clinical problem. The study found that telehealth can be just as accurate as in-person visits for diagnosing a variety of medical conditions. Provisional diagnosis on the virtual visits was consistent with the in-person reference standard in 86.9 percent of the cases analyzed. For additional coverage, see Becker’s Hospital Review.
American Journal of Nursing: Telehealth Benefits (9/1) – In the article “Telehealth Expansion During the COVID-19 Pandemic and Beyond”, authors Hanna B. Demeke and Erica Umeakunne enumerate some of the benefits of telehealth. Janice Hawkins highlights the environmental benefits of telehealth in this short addendum letter, noting telehealth’s impact on reducing the carbon footprint of the health care delivery systems.
Center for Connected Health Policy: A Decade of Telehealth Policy (8/30) – The Center for Connected Health Policy released a ten-year anniversary report, which looks back on telehealth policy in the United States. The report captures some highlights, significant changes, and environmental factors that had an impact on telehealth policy development in the nation. The report also provides context on how telehealth policy came to be where it is today.
MD Live: Insights into Modern Behavioral Health Care (8/29) – Alliance board member MD Live published a report from multiple, robust behavioral health studies throughout 2021. The report found that members want individualized, dynamic approaches to best support behavioral health engagement, especially through telehealth. MD Live also offered insights on how to better address shifting member expectations, deliver more comprehensive care, and improve outcomes.
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Telehealth News and Market Developments
Modern Healthcare: Behavioral Health Provider Shortage Strains Systems and Communities (8/31) – Geisinger, a Pennsylvania-based integrated health system, expanded employee recruitment efforts and hired an external telepsychiatry service to increase its behavioral health capacity. The external telepsychiatry service, Project Extension for Community Health Outcomes (ECHO), uses video conferencing to train, advise and support primary care providers, and bolster the workforce. Project ECHO empowers providers to provide telehealth services.
The Joint Commission: Speak Up at Your Telehealth Visit (8/31) – The Joint Commission launched a new patient safety campaign, entitled “Speak Up at Your Telehealth Visit,” which aims to educate consumers on navigating virtual health care. The campaign is part of the Joint Commission’s larger Speak Up program, which launched in 2002 to encourage patients to be active members in their care. The campaign includes videos, infographics, and other resources to ensure patients can navigate virtual health care services. For additional coverage, see Becker’s Hospital Review and Healthcare Innovation.
Rutgers New Jersey State Policy Lab: Is Telehealth a Solution to the Mental Health Crisis in the Post-Pandemic Era? (8/30) – This article provides a recap of federal action on telehealth, including the Senate Finance Committee tele-mental health resource and the Bipartisan Safer Communities Act. The article also highlights the convenience of telehealth for both the provider and patient. Specifically, LGBTQ+ adults often experience challenges in finding local therapists that they can trust; however, telehealth has enabled LGBTQ+ persons to access therapists across the country with whom they feel comfortable connecting.
Healthcare IT News: An Inside Look at a National Bilingual Telemedicine Service (8/29) – Galileo, a data-driven medical group, recently launched a telehealth service that delivers 24/7 primary and multi-specialty care in both English and Spanish. Dr. Jason Chirichigno, the physician clinical systems leader at Galileo, highlights the operations of virtual care in 50 states and explains how bilingual services can improve health equity.
Medical, Marketing, and Media: The Virtues of Virtual: Patients Reflect on Post-Pandemic Telehealth (8/29) – The Deloitte Center for Technology, Media, and Communications released its 2022 edition of the Connectivity and Mobile Trends study. Respondents found telehealth to be more convenient, easier to find appointment times that suit their schedule, and provides the ability to see a health care provider more often.
The Hill: Advancing telemedicine beyond COVID-19 is the beginning of a revolution in dementia care (8/27) – In this op-ed, Jason Karlawish, MD, professor at the University of Pennsylvania’s Perlman School of Medicine, details his experience in caring for patients living with dementia during the COVID-19 pandemic. Video or audio telemedicine gave his patients access to care, made possible when Medicare waived limitations on the practice of telehealth in response to the public health emergency. Not only did telemedicine benefit Dr. Karlawish’s patients, but their caregivers. Dr. Karlawish calls for the continuance of telehealth beyond the pandemic to support the 8.8 percent of adults age 65 or older living with dementia.
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State Telehealth News and Activity
Sun Journal: MaineHealth Lands Grant for Rural Maternal Health Care (8/31) – The Health Resources and Services Administration (HRSA) announced a $1 million grant, renewable over four years, for MaineHealth to expand rural maternal health care through a telehealth program. The goal of the program is to build a statewide telehealth system across rural Maine to connect obstetric providers and patients with experts at hospitals that provide higher levels of care.
University of Pennsylvania Almanac: Penn Medicine: $5.7 Million NCI Grant for New Cancer Telehealth Research Center of Excellence (8/30) – The University of Pennsylvania (Penn) Telehealth Research Center in Cancer Care (Penn TRACE), based at the Penn Center for Cancer Care Innovation (PC3I) at the Abramson Cancer Center (ACC), will become one of four National Cancer Institute (NCI) Telehealth Research Centers of Excellence. Supported under the Cancer Moonshot initiative, the grant will fund the design and testing of new telehealth strategies across the lung cancer care continuum, from screening to molecular testing to survivorship, with an emphasis on lung cancer morbidity and mortality, health disparities, and the digital divide. It will also incentivize more research on telehealth’s impact on patient outcomes, patient-provider communication, and health care use.
California Health Care Foundation: Ensuring Equity in Telehealth (8/29) – The California Health Care Foundation published a blog on telehealth’s potential to extend care to millions of underserved people, but only if they are able to access it. Sofi Bergkvist, the president of the Center for Care Innovations, a nonprofit dedicated to supporting the health care safety net, emphasizes the huge potential telehealth can have to improve equity and access to care. In particular, the drop in no-show rates highlights how telehealth allowed health care providers to see patients who experience difficulties making it into the clinic.
University of Virginia (UVA) Health: UVA Health, Community Partners Expand At-Home Patient Monitoring (8/29) – Backed by more than $700,000 in grants from the Federal Communications Commission and the Department of Agriculture, six UVA partner sites will receive 40 reusable patient-monitoring kits, including tablets with an internet connection and medical equipment such as blood pressure cuffs, thermometers and scales. Supported by UVA Health’s Department of Population Health, five of the six health centers will focus their home monitoring efforts on patients with heart failure, while Central Virginia Health Services will support pregnant women at higher risk for giving birth prematurely.
MedCity News: Going Virtual Can Save Lives: The Case for Making Telehealth a Permanent Part of Addiction Treatment (8/29) – State and federal legislators eased telehealth restrictions relatively early during the COVID-19 pandemic to facilitate critical health interactions without exposing more people to the virus. This article provides an overview of addiction treatment via telehealth in New Hampshire.
Gillette News Record: Wyoming Considers Joining Interstate Mental Health Care Compacts (8/29) – The Wyoming Joint Labor, Health and Social Services Committee considered two draft bills this month that would allow the state to join interstate psychology and counseling compacts. By enabling professionals licensed in one compact state to practice in all compact states, advocates say the agreements would give Wyoming patients access to more counselors and psychologists, and give Wyoming providers access to larger markets. The Committee voted to move forward with the draft bills and formally finalize them in its next meeting.
Daily Montanan: Expanding Telehealth Means Improving Mental Health Care (8/28) – Kevin Hamm, the chief executive officer of Treasure State Internet & Telegraph, asked elected officials to do more to increase health care and mental health treatment access in Montana. In this article, he highlights policies to mandate telehealth and mental health care coverage by Medicaid, Medicare, and private insurers as well as reliable internet services via broadband.
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Sign-On Opportunities
Alliance for Connected Care: Multi-Stakeholder Letter to Congress Urging Senate Action on Telehealth This Fall – Join the Alliance for Connected Care, American Telemedicine Association (ATA), College of Healthcare Information Management Executives (CHIME), Connected Health Initiative, Consumer Technology Association, Executives for Health Innovation, Health Innovation Alliance, HIMSS, Partnership to Advance Virtual Care and the more than 260 organizations in urging Senate action on passing a clean two-year extension of telehealth flexibilities this fall. The deadline to sign on is September 12. To read the letter and sign-on, click here.
National Hospice and Palliative Care Organization: Telehealth Data Collection Letter – The National Hospice and Palliative Care Organization is circulating a sign-on letter to Senate Finance Committee and House Ways & Means Committee Leadership, requesting that Congress require CMS to collect data on the use of telehealth in hospice care by adding a new code or modifier to the hospice claim form. To read and sign-on to this letter, click here.
Upcoming Events and Hearings
September 13-14 – Upper Midwest Telehealth Resource Center, “2022 UMTRC Annual Conference.”
September 15, 22 and 29 – Nashville Entrepreneur Center, “Telehealth Academy 2022.” (Alliance for Connected Care Speaking)
September 26-28 – Northwest Regional Telehealth Resource Center, “Annual Conference: Innovation in Telehealth.”
September 28-30 – The Association for Behavioral Health and Wellness, “Behavioral Health and Well-Being Congress.”
September 29-30 – Northeast Telehealth Resource Center, “8th Annual Regional Conference: Exploring the Telehealth Universe.”
October 10-12 – Becker’s Hospital Review, “The Future of Business and Clinical Technologies.”
October 13 – Dickinson Wright, “How Will Telehealth Evolve as the Pandemic (hopefully) Draws to a Close?”
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