September 20, 2021

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.

The Alliance for Connected Care continues to maintain and update a COVID-19 website tracking guidance from federal agencies on telehealth and remote patient monitoring including a state emergency waiver tracking chart.

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Alliance News

Comment Letter on Proposed Calendar Year (CY) 2022 Medicare Physician Fee Schedule: The Alliance for Connected Care submitted comments on the Medicare Physician Fee Schedule (PFS) Proposed Rule for calendar year (CY) 2022, which includes several important reforms with respect to telehealth. The Alliance applauds the proposal to retain all Category 3 telehealth codes through the end of Calendar Year (CY) 2023 to provide an opportunity to collect and study data on the telehealth experience during the COVID-19 public health emergency.

In addition to emphasizing several overarching priorities, the Alliance commented on many specific proposals including: 

• Support for Temporarily Retaining Category 3 Codes Until the End of Calendar Year 2023
• Permanent Addition to the Medicare Telehealth Services List 
• Remove Restrictions on Medicare Beneficiary Access to Mental and Behavioral Health Services Offered Through Telehealth
• Feedback Regarding Audio-only Telehealth Visit Policies 
• Rural Health Clinics and Federally Qualified Health Centers (and Critical Access Hospitals)
• Direct Supervision Via Telehealth 
• Remote Therapeutic Monitoring
• Virtual Care in the Diabetes Prevention Program 
• Provider Home Address Enrollment Reporting 

Alliance Joins Letter Calling on CMS to Address Critical Access Hospital Telehealth: The Alliance joined roughly 20 other groups in calling on CMS to address Critical Access Hospital (CAH) telehealth.

"We agree that telehealth payment should be addressed for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and also believe outpatient behavioral therapy services offered by Critical Access Hospitals (CAHs) are a key component of a comprehensive rural behavioral health strategy."

Administration

The New York Times: Biden Administration Seeks to Expand Telehealth in Rural America (9/19) – The Biden Administration is making numerous investments in telemedicine as a means to improve health in rural America. Last month, HHS announced that it was distributing nearly $20 million to strengthen telehealth services, which includes roughly $4 million to bring primary, acute and behavioral health care directory to patients via telehealth. “Telehealth expands access to care and is a vital tool for improving health equity,” said Diana Espinosa, the acting administrator of the Health Resources and Services Administration

Department of Veterans Affairs: The Department of Veterans Affairs published a $1 billion contract opportunity aimed at procuring remote patient monitoring and telehealth services to meet the needs of veterans. The Veterans Healthcare Administration (VHA) consistently seeks advances in digital health technologies to:

1. improve the quality of health for Veterans
2. increase the quality of health care available throughout VHA
3. improve the efficiency of health care providers and staff
4. increase Veterans’ overall satisfaction with VA/VHA

The contract intends to establish a multiple award contract that can serve the entire United States and its territories for medically prescribed home telehealth platforms and peripherals to eligible veteran beneficiaries using standardized ordering processes.

Proposals are due by October 12, 2021.

State Telehealth News and Activity

Fierce Healthcare: Northwell Health inks deal with Walgreens to provide telehealth, primary care in NY retail stores (9/16) – Northwell Health and Walgreens have entered into a five-year partnership to expand digital health services for consumers in the State of New York. The partnership will involve retail health clinic collaborations at select Walgreens throughout the tri-state area to create more access to primary care, particularly in underserved communities. Northwell telehealth providers are also now accessible via the Walgreens Find Care platform across the state to expand access to virtual emergency care services in the home.

EMS 1: Ohio FD implements telehealth EMS program as part of CMS trial (9/16) – The Akron Fire Department in Ohio will be participating in the CMS ET3 Model. As part of the model, the department will collaborate with Cleveland Clinic to use telehealth to allow EMTs and paramedics to let patients talk to a physician before making a trip to the emergency room. This collaboration is intended to get patients care faster. Since January, the pilot has grown to equip all 14 ambulances within the Akron Fire Department with telehealth and been used about 1,100 times.

WFXR: Gov. Northam announces telehealth partnership for veterans in Southside Virginia (9/16) – Virginia Governor Ralph Northam announced that Southside Virginia veterans will soon have access to quality health care through a pilot telehealth service. The Virginia Department of Health and the Salem Veterans Affairs Health Care System will establish a new point of access at the Martinsville Health Department for telehealth services provided by the US Veterans Health Administration.

mHealth Intelligence: Supporters Blame Politics for Failed Alaska Telehealth Legislation (9/15) – A recent bill introduced by Alaska Governor Dunleavy (SB 3006) that would have expanded telehealth services in the state died in the Alaska House. The bill initially passed out of the Alaska State Senate, after adding several amendments: one that would have allowed residents to refuse a COVID vaccine on philosophical, medical or religious grounds, one that would have forced organizations requiring vaccination proof to accept a positive COVID-19 test or antibody test, and one that would have banned organizations from requiring a vaccination for access to open or public areas. The House voted to remove these amendments but added a separate amendment to require hospitals to change current emergency policies to allow hospitalized patients to have a support person by their bedside. When sent back to committee, the bill did not pass back to the full House for a vote, thus killing the bill.

JD Supra: Florida Joins List of States Requiring Licensure for Genetic Counselors (9/15) – Florida joined a number of states that require licensure of genetic counselors by the Florida Department of Health. The Genetic Counseling Workforce Act, which became effective on July 1, 2021, requires genetic counselors to meet specific qualifications and examination requirements and to register to hold a genetic counseling license in the state. However, despite the ease with which genetic counselors could evaluate a patient’s health and family history via telehealth, the Florida legislature did not add genetic counseling to the list of Florida telehealth providers, likely due to a legislative oversight. The law also does not distinguish between out-of-state and in-state counselors, which could further complicate the law.

Telehealth Research, Reports and Surveys

American Medical Association: Survey shows video telehealth’s broad reach 6 months into pandemic (9/15) – The AMA Physician Practice Benchmark Survey—which focuses on practice arrangements and payment methodologies of post-residency physicians found that telehealth use by physicians skyrocketed from 25 percent in 2018 to almost 80 percent in 2020. Furthermore, almost 85 percent of psychiatrists connected with the patients via video visit or telephone during the height of the pandemic.

Mercer: 2021 Health on Demand Delivering the benefits employees want now (9/13) – A new report from employee benefits consultancy Mercer finds 73 percent of employees used telemedicine or other digital health solutions. Furthermore, more than three-quarters (77%) of individuals who used telemedicine or digital healthcare for the first time said they intent to keep using it, and 84 percent of employees said they will use or increase their use going forward.

University of Michigan: Tele-psychiatry a resounding success in 5-year trial (9/13) – A five-year study published in JAMA Psychiatry found that telepsychiatry in rural, federally qualified health centers was a resounding success for patients who had screened positive for bipolar disorder and/or post-traumatic stress disorder, commonly known as PTSD. The trial, called The Study to Promote Innovation in Rural Integrated Telepsychiatry, or SPIRIT, was designed to identify the best approach to delivering tele-mental health services to rural primary-care clinics.

Telehealth News and Market Developments

Politico: How virtual care can endure after COVID (9/15) – The coronavirus pandemic showed how remote monitoring technology can be used on a wide scale to keep tabs on patients from afar. And insurance companies are increasingly betting that they can use these internet-connected devices to lower their costs, by helping them manage patients’ chronic conditions. Beyond the pandemic, experts see the technology playing a growing role in caring for patients with chronic disease.

Fierce Healthcare: CareFirst unveils new virtual primary care practice, CloseKnit (9/15) – Blues insurer CareFirst is launching a new virtual primary care practice called CloseKnit. CloseKnit will offer a slew of healthcare services in a virtual-first delivery model, including preventive care, urgent care, behavioral health care, care coordination and insurance navigation.

Modern Healthcare: Google, ProMedica invest in hot virtual market (9/14) – Google and ProMedica Health System are entering the growing digital physical therapy market. The companies are separately investing in Cincinnati-based IncludeHealth to launch an operating system that any provider can use to offer virtual physical therapy through any device, helping patients adhere to their treatment plans and keeping them from straying outside their health systems' networks.

Press release: Anthem and Boulder Care Partner to Provide Evidence-based Telehealth Addiction Treatment to Members in Ohio (9/14) – Anthem Blue Cross and Blue Shield in Ohio and Boulder Care have partnered to provide evidence-based telehealth addiction treatment to Ohioans covered by employer-based, individual and Medicare Advantage plans.

Modern Healthcare: Payer investment in virtual substance abuse treatment grows (9/14) – Highmark Health landed a new partnership with virtual alcohol use disorder provider Ria Health to provide its more than 6 million members with virtual access for alcohol use disorder treatment.

Health Affairs: Seizing The Moment For Telehealth Policy And Equity (9/13) – Doctors out of the University of Chicago issued a blog in Health Affairs recommending steps to promote more equitable digital health access, including education and engagement with an equity lens, value-based care and reimbursement, telephone-only visits, broadband, and others.

Healthcare IT News: Groups Recover Together sees great success treating opioid use disorder via telehealth (9/13) – Groups Recover Together a national healthcare company for individuals with opioid use disorder based in Burlington, Massachusetts stood up a telehealth platform and transitioned to 100% virtual care in March, 2020. The company surveyed its members and found 87% said they felt as supported or more supported in a virtual care model.

Upcoming Events

September 20, Manatt, “Sustaining Telehealth Success: Integration Imperatives and Best Practices for Advancing Telehealth in Academic Health Systems.”

September 24, Center for Connected Health Policy, “Medicaid & Telehealth Data Collection: Surveys, Studies & Advisory Groups.”

October 1, Center for Connected Health Policy, “Medicaid & Other State Agencies Telehealth Policies for Patients with Disabilities.”

October 1, AHIP, “Investing in the Future of Digital Care Delivery.”

October 5, Modern Healthcare, “The road ahead: What providers need to know for long-term success in virtual care.”

October 6, Becker’s Hospital Review, “How the pandemic changed families’ views on pediatric telehealth care.”

October 8, Center for Connected Health Policy, “Medicaid & Permanent COVID-19 Telehealth Policies.”

October 12, AHIP, “Digital Adoption in Health Care: Reaction or Revolution?”

October 13, AHIP, “Creating a High-Impact Telehealth & Remote Patient Monitoring Program.”

Past Events

Rural Matters Podcast Discussion on Telehealth. The bi-weekly podcast highlights federal efforts to expand telehealth to rural areas in the last year. Heather Dimeris, the Director of HRSA’s Office for the Advancement of Telehealth, discusses changes in 2020 that increased telehealth visits to health centers to more than 28 million, with nearly 6 million of these visits in rural-serving facilities.

American Medical Association, “Q&A: Ochsner Health taking telehealth program to all 50 states, D.C.” Ochsner Health is currently working to expand its services to provide remote patient monitoring services in all 50 states and Washington, D.C. In this interview, Dr. David Houghton, MD, the medical director for Ochsner’s telehealth and digital medicine programs, spoke with AMA about the organization’s digital medicine program, the plans to extend it into all 50 states and DC, how it works, and how it helps patients.

Please subscribe to this newsletter and send any news or events to crystal.wallace@connectwithcare.org for inclusion.