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Connected Care Update

August 10, 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.

Alliance News

The Taskforce on Telehealth Policy Tele-Town Hall: (8/4) The Taskforce, a multi-stakeholder effort convened by the Alliance for Connected Care, NCQA and ATA held a Public Policy Comment Town Hall on August 4. A recording of the widely-attended event can be viewed here.

  • Healthcare IT News: (8/4) – Healthcare IT News covered the Taskforce’s Town Hall this week. Alliance Executive Director Krista Drobac pointed out that, it's important to make sure "we don't hold telehealth to a higher standard than in-person care."

More than 200 Organizations Sign Letter Endorsing Protecting Access to Post-COVID-19 Telehealth Act: (8/3) – The Alliance worked to convene over 200 organization in a letter to House Telehealth Caucus Representatives Thompson, Welch, Matsui, Schweikert, and Johnson endorsing the Protecting Access to Post-COVID-19 Telehealth Act of 2020 (HR 7663). View the letter. We are tracking these and other bills on the Alliance website.

Executive Branch Telehealth Activity/Guidance

CMS Administrator Verma: (8/7) – CMS Administrator Verma and a member of the White House Coronavirus Task Force, convened a roundtable discussion on the effects the coronavirus disease 2019 on care delivery, and the impact of telehealth on patient access to care. Administrator Verma said the White House Executive Order earlier this week represents a seismic shift, initiating a new era of healthcare delivery in America. Participants, including Amwell, described the ways providers are using telehealth to expand access.

CMS Physician Fee Schedule: (8/4) – CMS issued the calendar year (CY) 2021 Physician Fee Schedule proposed rule. Comments are due by October 5. The rule makes payment and policy changes under Medicare Part B for physicians, with significant telehealth provisions included. View a summary of the PFS here. View the press release, fact sheet and proposed rule.

White House Executive Order: (8/3) – President Trump issued an Executive Order on improving rural health and telehealth access. The EO directs the HHS Secretary to announce an innovative payment model to enable rural healthcare transformation, develop and implement a strategy to improve rural health infrastructure, submit a report describing policy initiatives to improve rural health, and directs the HHS Secretary to propose regulation that would extend certain telehealth flexibilities. View a summary of the Executive Order here. View the press release, EO, and fact sheet.

Updated CMS Risk Adjustment FAQ: (8/3) – CMS updated FAQs on risk adjustment for telehealth and telephone services during COVID-19. The FAQs update the list of codes to include three additional e-visit codes (98970-98972). View the FAQs.

Congressional Activity and Legislation

The Alliance for Connected Care continues to update a recent telehealth legislation page.

Ways and Means Committee Rural and Underserved Communities Health Task Force: (8/6) - Roundtable discussion on "Examining the Role of Telehealth During COVID-19 and Beyond." The discussion  focused on broadband and reaching rural and underserved communities, which included a large discussion on continuing access to audio-only services, telehealth and technology education and training, program integrity and preventing fraud, waste and abuse, continuation of telehealth flexibilities during COVID-19 and beyond.  It also included conversation around geographic and originating sites and proper reimbursement structure such as encouraging capitation models.

VA Mission Telehealth Clarification Act: (8/5) – Senate Veterans’ Affairs Committee passed by voice vote fourteen bills including the VA Mission Telehealth Clarification Act (S. 3643/H.R.3228) introduced in the Senate by Sens. Loeffler (R-GA), Sinema (D-AZ) and Blackburn (R-TN) and in the House by Rep. Carter (R-GA) and seven bipartisan cosponsors, which would authorize certain postgraduate health care employees and health professions trainees of the Department of Veterans Affairs to provide treatment via telemedicine. View the press release, bill text and list of bills passed. We are tracking these and other bills on the Alliance website.

TREAT Act: (8/4) – Sens. Murphy (D-CT) and Blunt (R-MO) introduced the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (S. 4421), which would provide temporary licensing reciprocity for telehealth and interstate health care treatment. View the press release and bill text.

Ranking Member Walden Blog: (8/5) – House Energy & Commerce Committee Ranking Member Walden (R-OR) issued a blog on expanding rural telehealth and highlights President Trump’s recent EO on improving rural health and telehealth access. The blog also calls for passing the Telemental Health Expansion Act of 2019. View the blog.

News and Reports

JAMA Telehealth Studies: (8/3) – Two studies published this week in JAMA highlight barriers to telehealth. View the STAT News article here.

The New York Times: (8/3) – The biggest hurdle to widespread adoption by both the government and insurers is the potential cost. “We need to give providers time to get more comfortable,” said Dr. Scott Josephs, the chief medical officer for Cigna. To make remote medicine successful and worthwhile, doctors and medical groups need to invest in technology and train staff. “If they don’t have the time, they won’t make the investments,” he said.

Healthcare IT News: (8/3) – Children’s Hospital Colorado expanded their telemedicine program during COVID-19 and experienced a 5,500% growth in telehealth visits in less than one month. “As our hospital has returned to more normal operations, our system is much better prepared to address a potential reemergence of COVID-19, if it occurs as numerous models predict,” said John F. “Fred” Thomas, director of telehealth services at Children’s Hospital Colorado. “Additionally, it has allowed us to evaluate a right-sizing of our telemedicine capacities and a thorough evaluation of right-fit for proportion of telemedicine and in-person visits.”

Center for Connected Health Policy: (8/4) – CCHP released an issue brief on policy barriers FQHCs face in utilizing telehealth for opioid use disorder (OUD) pre and during the COVID-19 PHE. The issue brief provides a comparison of reimbursement and prescribing policies pre-COVID and during the COVID-19 PHE. CCHP notes several barriers that still remain for FQHCs to deliver MAT services via telehealth, including the different rate FQHCs receive for delivering telehealth services compared to their normal PPS rate, as well as issues around broadband connectivity, patient and provider education, and liability coverage.

The New York Times: (8/4) – The op-ed in the New York Times highlights the potential for telehealth to expand access to medication-assisted treatment and MAT providers. Silvana Mazzella, associated executive director at Prevention Point said telemedicine has helped the patients who can use it. “It’s a reduction of the hassle, wait times, anxiety and fear of withdrawal in a waiting room,” she said. She said telemedicine patients have proven more likely to fill their prescriptions than patients who had appeared in person in the past.

Healthcare IT News: (8/4) – Patients and caregivers have become comfortable with online and virtual care models with the expansion of telehealth services during COVID-19. These patients will likely demand a permanent shift to virtual care delivery in the future.

United.AI: (8/5) – Alliance Board Member Dave Ryan with Intel was interviewed to discuss Intel’s Health & Life Sciences Business, AI and telehealth. “Now spurred by the pandemic crisis and its impact, health care delivery systems around the world are forced to adopt telehealth or collapse. This sudden rush to implement is now proving those long held beliefs to be true and care at a distance to be both vital and highly viable,” he said.

The Commonwealth Fund: (8/5) – The Commonwealth Fund issued a report on what a post-pandemic regulatory and payment landscape should look like. Dr. Ateev Mehrotra and others and others rightly note that policymakers look to alternative payment models, including ACOs, for ways to expand telehealth coverage. The report offers six recommendations to encourage high-value telemedicine.

Fierce Healthcare: (8/5) – A new survey of more than 1,000 consumers age 64 and older found that nearly one-third of consumers age 64 and older say they monitor their health using a wearable. In addition, prior to COVID-19 only 1 in 10 used telemedicine. According to the survey, during COVID-19, 44% of seniors have used telemedicine and 43% say they intend on using telemedicine once COVID-19 passes. We are tracking these and other surveys on the Alliance website.

mHealthIntelligence: (8/6) – Krista Drobac, Executive Director of the Alliance for Connected Care was quoted in an mHealthIntelligence article on the proposed 2021 PFS and White House executive order on improving rural health and telehealth access, which were released this week.

  • “The Alliance for Connected Care is pleased to see the Administration prioritizing access to telehealth services,” added Krista Drobac, that organization’s executive director. “Our members are looking forward to utilizing new telehealth codes and continuing to leverage some existing telehealth tools after the pandemic.” Krista also highlighted Congress’ necessary role in continuing access to telehealth.
  • “The vast majority of barriers to telehealth are statutory,” she pointed out. “We need Congress to take clear, permanent action to expand access to telehealth for seniors, and to allow them to use it in any location. Without these statutory barriers addressed permanently, CMS cannot take the thoughtful, measured steps needed to allow the medical community to plan for, and carefully implement long-term telehealth strategies to benefit seniors.”

Business Wire: (8/6) – New research from Everyday Health and Klick Health finds almost half of all people surveyed said they prefer healthcare professionals who offer phone or web-conference-based consultations.

Business Wire: (8/6) – Cerner and Xealth announced a collaboration to give patients access to their own digital data so they can be more engaged in their treatment plans.

Multi-Governor Telehealth Announcement(8/7) - The governors of Washington, Oregon, Nevada and Colorado announced they will be working together to identify best practices that support telehealth services. Their work will be guided by seven principles including: access, confidentiality, equity, standard of care, stewardship, patient choice and payment/reimbursement. View the press release. Coverage: mHealthIntelligence 

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