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Connected Care Update

October 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.

Federal Updates

CMS: (10/16) – CMS released a survey of Medicare beneficiaries during COVID-19. In addition to forgone care and preventative health behaviors, the survey asked about the impact of the pandemic on daily life and well-being, availability of telemedicine appointments, access to technology, and sources of information about the pandemic.

Highlights include:

  • 60% reported that this provider currently offers telephone or video appointments.
  • 58% reported that their provider offers both telephone and video appointments
  • 22% reported that their provider offered telemedicine appointments before the pandemic
  • 57% reported that their provider offered a telemedicine appointment to replace an appointment during the pandemic

View an Infographic with a snapshot of the survey results here. A link to the public use file detailing the survey results is here.

Centers for Medicare & Medicaid Services (CMS): (10/14) – CMS added 11 new telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. View the press release with a list of codes.

CMS also released a new supplement to its Medicaid and CHIP telehealth toolkit that provides new examples and insights into lessons learned from states that have implemented telehealth changes. View the press release and Toolkit.

Finally, CMS released a new data snapshot on telehealth utilization among Medicaid and CHIP beneficiaries during COVID-19. The snapshot shows that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600% when compared to the same period from the prior year. The data also shows that adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states. View the press release and Snapshot.

Physician-Focused Payment Model Technical Advisory Committee (PTAC): (10/14) – As a reminder, comments are due by October 30 to inform PTAC’s review of telehealth and PFPMs. PTAC previously released questions for stakeholder feedback on the role telehealth can play in optimizing health care delivery and value-based transformation in the context of Physician-Focused Payment Models (PFPMs). Comments are requested by October 30 but can be submitted later. Additional information

    State Telehealth News

    Office of the Insurance Commissioner Washington State: (10/15) – The Washington State Insurance Commissioner Mike Kreidler extended the state’s COVID-19 emergency order through November 13, 2020. This order allows for continued coverage of telehealth services via various modalities including telephone and video platforms.

    mHealth Intelligence: (10/14) – A coalition compromised of health care organizations called on Illinois lawmakers to mandate payment parity for telehealth services. This came as part of a 10-part urging lawmakers to make emergency provisions around connected health access during COVID-19 permanent.

    mHealth Intelligence: (10/12) – California Governor Gavin Newsom signed the Community Paramedicine or Triage to Alternate Destination Act of 2020, which would enable local EMS providers to develop community paramedicine programs. The programs would help divert patients from hospital emergency rooms to more appropriate sources of care by using telehealth or mHealth tools that triage 911 calls at home.

    BioSpace: (10/12) – In partnership with Samsung, Ohana Health Plan (which is part of Centene Corp.) provided five Hawaii-based FQHCs with 150 free smartphones so patients can participate in telehealth services. This effort was done in hopes of bridging gaps in care for rural and underserved communities that may lack access to compatible devices to utilize telehealth.

    West Virginia News: (10/9) – Rep. David McKinley (R-WV) convened a roundtable discussion with CMS Administrator Seema Verma and health care industry leaders in the State of West Virginia. Flexibility in telehealth was spoken about at length, with several providers highlighting the need to address broadband infrastructure needs in order to make telehealth services more accessible across the state.

    Papers, Surveys, and Studies

    Check out the Alliance for Connected Care studies and polling website for more resources.  

    Ascension: (10/15) – Ascension released a white paper that outlines recommendations on what Congress, the Administration, states, and private payors can do to ensure patients have continued access to virtual care modalities going forward.

    Commonwealth Fund: (10/15) – Researchers at Harvard University, the Commonwealth Fund, and Phreesia released updated data finding that for the first time since March, weekly outpatient visits in September and October returned and even slightly exceeded pre-pandemic levels. The report includes updated telemedicine charts, including on the use of telemedicine among medical specialties and across provider organizations.

    Millbank Memorial Fund: (10/15) – Millbank released an issue brief on telebehavioral health, finding that telehealth is just as effective as in-person care for certain behavioral health conditions; telehealth is not harmful compared with in-person behavioral health care; and the cost of telebehavioral health care can be lower than in-person visits.

    National Organization for Rare Disorder (NORD): (10/15) – NORD released a report on ensuring access to telehealth for rare diseases. Some of the major findings include: 70% of respondents would like the option of telehealth for medical appointments in the future; 88% of respondents who were offered a telehealth appointment during COVID accepted and 92% said it was a positive experience; 62% of patients have been prevented from attending work due to a rare disease and 26% of children have missed school as a result of their rare disease. Also, 39% of patients traveled at least 60 miles to receive medical care. The burden of travel is so great that 17% have moved or considered relocating to be closer to treatment to manage their condition long-term.

    Wiley Online Library: (10/14) - A telemedicine pilot focused on genetics and metabolic patients aimed to increase patient access to care by easing the burdens of transportation, missed work, school disruption, and nosocomial exposure. The study found that pre-COVID-19, the demographics of our patients, and types of diagnoses seen in the genetics telemedicine program were very similar. Post-COVID-19 however, genetics telemedicine volumes rapidly increased. The study notes that challenges in the program included scheduling issues, technical problems, billing questions, and, most significantly, state licensure regulations.

    American Academy of Physician Assistants: (10/10) – AAPA released a telemedicine data brief noting trends and implications of telemedicine use by physician assistants in June 2020. The brief finds that in June 2020, almost two in three PAs said they used telemedicine in their practice, an increase from the roughly one in 10 as of February 2020. Of those who reported that they were using telemedicine, more than 75% did not use it prior to the pandemic. Most PAs said they began using telemedicine in their practice to maintain social distancing for nonemergent visits (85.2%). About 7.2% of PAs are reported using it more than half of their time. While more than one third of PAs (36.2%) still do not use telemedicine in their practice, most of those nonusers (69.5%) said they are interested in telemedicine to some degree.

    The Infectious Diseases Society of America: (10/9) – A policy paper by IDSA’s Telehealth & Emerging Technology (TET) Work Group was accepted for publication. The paper describes the digital divide, emphasizes the relevant to infectious diseases and HIV practice, underscore the need to study the issue and develop interventions to mitigate its impact and provide suggestions for optimizing telemedicine in ID and HIV clinics.

    American Society of Clinical Oncology: (10/7) – A survey published last week examined patients’ and physicians’ experience with telemedicine at Houston Methodist Cancer Center during the COVID-19 pandemic. Among 1477 patients who participated in a telemedicine visit, the majority (92.6%) were satisfied. Patients felt their clinician addressed their concerns (96.8%) with satisfactory quality (96.7%) and adequate privacy (97.1%). Most patients (73.2%) reported they would choose telemedicine in the future and 65.2% of clinicians were satisfied with the telemedicine experience.

    Telehealth News

    Boehringer Ingelheim: (10/15) – Boehringer Ingelheim announced a collaboration with the Yale Clinical and Translational Research Accelerator to launch a study exploring digital health technologies for adults with heart failure. The goal of the study is to determine the impact of three digital health technologies on patient outcomes, clinical efficiencies, and the improvement in patient quality of life.

    98point6: (10/15) – 98point6, an on-demand digital primary care service that delivers personalized consultation, diagnosis, and treatment to patients across the country, announced a $118 million Series E fundraising round to further support its growth and success. The text-based primary care platform now has more than 240 commercial partnerships—accounting for three million members.

    Health Affairs: (10/14) – A blog issued in Health Affairs describes the opportunities and challenges for teledermatology. The blog notes that physicians, insurers, and policymakers must collaborate and share key COVID-19 telemedicine lessons learned to leverage this technology’s promise to increase efficiency, convenience, and access to specialists for patients across the country.

    PR Newswire: (10/14) – Blue Cross Blue Shield Federal Employee Program announced that it will make telemedicine visit coverage permanent as part of its benefits package starting in 2021. The program covers about 5.5 million federal employees, retirees and their families across the U.S. In 2021, the Federal Employee Program will cover virtual consultations and medical evaluation and management services with primary care providers and specialists as a regular benefit, even after the pandemic is over.

    The University of Alabama at Birmingham: (10/13) – Advanced ICU Care and UAB Medicine announced a strategic telemedicine partnership, which brings together leading health care innovators to advance the practice and operational models of tele-ICU care.

    mHealthIntelligence: (10/13) – The AMA and seven leading associations launched the Behavioral Health Integration (BHI) Collaborative aimed at helping providers add telemental health to the primary care platform. The BHI Collaborative will also present a webinar series, which includes an October 22 session on ‘Implementation Strategies for Virtual Behavioral Health Integration.’

    Healthcare IT News: (10/13) – Tyto Care launched this week its artificial intelligence-powered diagnostic support tool, aimed at improving the quality of remote triage. The tool, which has been submitted to the FDA for clearance, will initially detect abnormalities in lung exams.

    Notable Telehealth Commentary

    “We believe patients will start to see telehealth as a durable and desirable part of their health care experience. The future gold standard of care will integrate both in person services and telehealth customized around the patient’s needs and their doctor’s advice,” HHS Secretary Alex Azar said in a virtual address at the Better Medicare Alliance Medicare Advantage Summit.

    Upcoming Events

    October 20 – October 21 – World Congress, The Association for Behavioral Health and Wellness (ABHW), “Payers’ Behavioral Health Management and Policy Summit.”

    October 21 – Primary Care Collaborative, “Making the Call on the Best Use of Telehealth in Primary Care.”

    October 22 – American Medical Association, Behavioral Health Integration (BHI) Collaborative, “Keys to Success: Implementation Strategies for Virtual Behavioral Health Integration.”

    October 22 – California Emerging Technology Fund, “Action Plan for Telehealth in California: Fact-Finding Listening Conference.

    October 27 – McDermott Will & Emery, “Provider Panel: Lessons Learned from Deploying Telehealth Strategies in COVID-19.”

    November 19 – Southwest Telehealth Resource Center, Arizona Telemedicine Program, “2020 Mid-Year Rural Health Policy Roundup.” 

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