Alliance for Connected Care: Alliance and Over 110 Organizations Request CMS to Ensure Telehealth Practitioners Privacy Are Protected (10/20) - The Alliance for Connected Care co-led 112 organizations in a letter requesting that the Centers for Medicare and Medicaid Services (CMS) to take action on preserving the benefits of telehealth by ensuring telehealth practitioners working from a home-based (or other) location do not need to report that private residence to the federal government for purposes of either enrollment or billing. Currently, CMS allows practitioners to render telehealth services from their home without reporting their home address on their Medicare enrollment or billing paperwork. This will end on December 31, 2023. The current location-based enrollment structure is outdated and does not support providers new operational and privacy concerns faced in a digital age.
Selected News Coverage:
Politico Pro: "Over 170 organizations convened by the Alliance for Connected Care, including Amazon, the ERISA Industry Committee and Walmart, are pushing Senate leadership to take up a bill that would expand access to telehealth for people on high-deductible health plans."
Inside Health Policy:"The Alliance for Connected Care deeply appreciates the ongoing work of CMS in meeting with us about this issue over the past several years. Our intent with this letter is to emphasize the importance of the upcoming deadline and the need for a longer-term solution to ensure we continue to fully leverage the capabilities of telehealth for both Medicare beneficiaries and providers."
mHealth Intelligence: "The letter asks CMS to work with practitioners without a physical practice location to develop an alternate method of determining a location that is not the home address for payment purposes."
Health Leaders: “This is an extremely important issue for the healthcare providers in general and the telehealth community in particular,” the letter concludes. “As providers are beginning to update their practice and systems in a post pandemic era, we should arm them with the tools to continue to offer telehealth services as they see clinically appropriate.”
National Institutes of Health (NIH): Telehealth Supports Retention in Treatment for Opioid Use Disorder (10/18) - Starting buprenorphine treatment for opioid use disorder through telehealth was associated with an increased likelihood of staying in treatment longer compared to starting treatment in a non-telehealth setting. A study analyzing Medicaid data from 2019-2020 in Kentucky and Ohio found that receiving buprenorphine treatment via telehealth was not associated with an increased likelihood of nonfatal overdose, providing additional evidence to suggest that patients were not harmed by having increased access to buprenorphine treatment through telemedicine. This study suggests that telehealth may increase treatment access and retention, strengthening the evidence that receiving addiction care through telehealth is to be safe and beneficial, and that it should be made available to those who need it.
Department of Health and Human Services: Resource for Health Care Providers on Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies for Telehealth (10/17) - The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a resource as recommended by the Government Accountability Office, to help health care providers explain to patients, in plain language, the health information privacy and security risks that are present when using remote communication technologies such as video conferencing websites and applications (“apps”) for telehealth. The information in this resource expands on the Department’s existing resources for health care providers on preparing patients for telehealth with a focus on privacy and security.
The Alliance for Connected Care maintains a tracker on legislation with significant telehealth or remote patient monitoring provisions.
Telehealth Research, Reports and Surveys
AIDS and Behavior: Mixed Methods Analysis of Telehealth Experience, Satisfaction, and Quality of Care During the COVID Pandemic Among Persons with HIV in Washington, DC (10/24) - High satisfaction was seen for telehealth services when used by patients with HIV (PWH). PWH were asked about their use of telehealth for care related to HIV, their housing status, residence, clinic type, general telehealth use, and satisfaction with HIV care. Participants were 4 times more likely to use telehealth if they were using a community clinic compared with a hospital-based clinic, and individuals living with type 2 diabetes were more likely to report using telehealth for visits for HIV compared with those without diabetes. The researchers concluded that telehealth was well received and had high satisfaction in the urban and racially diverse cohort of PWH in Washington, DC. HIV care could be strengthened as long as the technology is applied in an equitable manner for all PWH. For additional coverage, see AJMC.
Public Policy Institute of California: Telehealth Usage among Low-income and Undocumented Californians (10/17) - Statewide telehealth use jumped dramatically among low-income Californians covered by Medi-Cal in March 2020, when telehealth visits began to be reimbursed at the same rates as in-person visits. There was comparable trends in California’s community health centers (CHCs)—primary care clinics that serve all comers—for Medi-Cal and undocumented patients. Telehealth will continue to be an important resource for undocumented patients after Medi-Cal is expanded to all residents, regardless of age or immigration status, in January 2024. However, challenges lie ahead, particularly in addressing language barriers common among immigrants and enhancing technological literacy.
Kaiser Permanente: Telehealth Primary Care Outcomes Remained Steady Well Into 2021 (10/16) - During the COVID-19 pandemic, Kaiser Permanente patients became much more likely to visit their primary care doctor by video or phone. A study found these patients had similar medical outcomes whether they saw their doctor in-person or virtually. These findings, on top of our previous research, suggest that telemedicine looks like it’s addressing a need, without generating major signs of safety concerns. Telehealth was used more often than in-person visits for certain health concerns, such as mental health (80% of visits were virtual), followed by general gastrointestinal issues (70%), back pain (58%), and abdominal pain (57%).
JAMA Network Open: Use of Prenatal Telehealth in the First Year of the COVID-19 Pandemic (10/10) - Prenatal telehealth use was more common among Hispanic, Asian or Pacific Islander, and Indigenous respondents compared to non-Hispanic White respondents, as well as those living in urban areas vs rural areas. The study highlights the importance of considering patients' preferences when incorporating prenatal telehealth into their care, suggesting that it should be adapted to meet individual needs.
RAND Corporation: Utilization and Spending on Mental Health Services Among Children and Youths With Commercial Insurance (10/3) - Spending on mental health services for children and adolescents has risen by more than one-quarter since the beginning of the COVID-19 pandemic, continuing to rise even as the use of telehealth plateaued. The study found that use of telehealth for pediatric patients increased more than 30-fold during the early months of the pandemic and remained at 23 times normal by August 2022, even as in-person care reached 75 percent of pre-pandemic levels. The findings suggest that telehealth care for mental health filled a critical need for pediatric patients after the emergence of the COVID-19 pandemic and continues to support a substantial proportion of pediatric mental health care. For additional news coverage, see The Washington Post.
Telehealth News and Market Developments
Fast Company: What's Holding Telemedicine Back? (10/23) - Telehealth is capable of bringing doctor-patient relationships into the 21st century. Licensing and credentialing limitations, rapid regulatory movement, and general resistance to change are still significant barriers holding back telehealth. Eradicating these barriers is more than a dollars-and-cents issue—it would save lives. Telehealth companies and their leaders need to chip away at the institutional biases and norms that maintain the barriers mentioned above by taking control of the conversation. Consumers need increased access to quality health care and more-frequent interactions with health care providers. Telehealth makes this possible, and regulators need to take it seriously as a part of the health care experience they shape for hundreds of millions of people.
GNC Health: GNC Expands into Virtual Health Care with GNC Health (10/23) - GNC announced the expansion of its virtual health care service, GNC Health. GNC Health now offers membership plans for individuals and families with three tiers-- Basic, Plus, and Premier-- becoming a nationwide service that makes proactive wellness more accessible and helps consumers Live Well. With a GNC Health membership, individuals and families can schedule free and convenient virtual medical appointments from the comfort of their own homes with board-certified doctors for many common health conditions at no additional cost. GNC Health supports a wide range of treatment and care needs such as, allergies and asthma, sexual health, skin conditions, cold and flu, physical therapy, mental health therapy, and more. For additional coverage, see mHealth Intelligence.
Health Leaders: Military Health System Commits to Telehealth Expansion (10/20) - The US Defense Department’s health care department is dealing with a shortage of mental health providers and a lack of access for military members, veterans, and their families who need mental health care. To improve access, the Military Health System is replacing its Video Connect program with a hybrid platform developed by Amwell and Leidos that will support virtual and digital health tools as well as in-person care. The rollout of the $180 million ‘Digital First’ program will come in stages over the next two years.
American Hospital Association: Expanding Patient Access to Care No Matter Where They May Be (10/20) - President and CEO of AHA, Rick Pollack released a blog highlighting how telehealth has helped connect patients virtually without the necessity of in-person visits. This has been a revolutionary development in health care delivery. The AHA recently wrote House and Senate leaders urging lawmakers to realize the full potential of telehealth services by passing the CONNECT Act to remove many of the barriers that currently limit access to care. Making these important flexibilities permanent past their current expiration in 2025 would expand the telehealth to an even greater number of people and provide hospitals and health systems with effective tools to continue to advance health in a fast-changing health environment.
PR Newswire: Telehealth Start Up for Women's Health Care (10/19) - Glenn Gaunt MD, a telehealth startup, announced its launch, offering an option other than traditional health care by providing accessible and convenient health care services to patients from the comfort of their homes. Dr. Gaunt offers specialty services that focus on postmenopausal symptoms, weight loss management, medication supervision, monitoring of chronic conditions, and general women's health issues.
Healthcare IT News: How Care for Cough Can Benefit from RPM (10/17) - New monitoring devices could help reduce staggering costs and improve quality of life for patients with chronic diseases such as COPD, asthma and chronic cough. Healthcare IT News interviewed Dr. Peter Small, chief medical officer at Hyfe AI, a vendor of AI algorithms that arm remote patient monitoring technologies, including for cough tracking, to talk about these very issues.
mHealth Intelligence: Using Telehealth to Address Side Effects of Cancer Immunotherapy (10/16) - Duke Health’s telehealth service improved care and lowered hospitalizations among cancer patients with endocrine immune-related adverse events. Established in May 2020 by Afreen Shariff, MD, the service connects Duke oncologists with the endocrine team at the Duke Endo-Oncology Program, a collaboration program between Duke Cancer Institute and the Department of Medicine Division of Endocrinology, Metabolism, and Nutrition. The service has undoubtedly proved beneficial at Duke Health, and scaling it outside the institution could help extend much-needed endo-oncology expertise to community cancer centers where most people receive cancer care. But it is impossible without support from health care payers.
American Medical Association (AMA), "Commercial Payer Patchwork is Holding Back Telehealth's Promise." For telehealth and digitally enabled care to live up to the full potential that technology offers, private health plans need, among other things, to expand what Current Procedural Terminology (CPT®) codes they cover and increase their transparency about coverage and payment.
Xtelligent Healthcare Media, "4th Annual Connected Health Virtual Summit." At Xtelligent Healthcare Media's 4th Annual Connected Health Virtual Summit in October, leaders from prominent health systems discussed these themes, delving into the opportunities and challenges of leveraging connected care efforts in underserved areas, as well as the importance of digital health equity and strategies for closing digital health gaps.