The Washington Post: Many Republicans are ready to end the public health emergency (4/12) – The Biden Administration renewed the public health emergency declaration that was set to expire at the end of the week, ensuring the continuation of critical resources to battle the coronavirus pandemic. But the decision comes amid increasing pressure from Republicans to wind down such supports and to treat the virus as endemic. Without the public health emergency, telehealth services would not be available to millions of Medicare beneficiaries. However, according to Krista Drobac, the executive director of the Alliance for Connected Care, “It’s possible to unwind the public health emergency without necessarily triggering the legal authority until later.”
Inside Telehealth: Telehealth Groups Split Over Potential Interstate Licensing Frameworks (4/12) – Telehealth stakeholders are divided over how to best facilitate interstate licensing of medical professionals to make virtual health care services available across state lines and maintain access to care for patients even after the COVID-19 pandemic ends. The Alliance for Connected Care would like to see a a more uniform system for licensing of health care practitioners to unlock the full potential for telehealth across state lines.
According to a recent survey
from the Alliance for Connected Care and Morning Consult, practitioners and patients overwhelmingly support telehealth use across state lines, with more than 84 percent of practitioners supporting the option to treat patients across state lines.
Health Resources & Services Administration: Best Practice Guide - Telehealth for Maternal Health Services (4/13) – The Health Resources & Services Administration (HRSA) released their Maternal Health Best Practices Guide, which highlights the needs and procedures for a successful maternal telehealth program. The guide provides insight on closing equity gaps with telehealth, community telehealth needs, billing for maternal telehealth, and preparing patients and providers for maternal telehealth.
HHS Office of the Assistant Secretary for Preparedness & Response: Renewal of Determination that a Public Health Emergency Exists (4/12) – On April 12, HHS Secretary Xavier Becerra renewed the current public health emergency (PHE). The PHE will now continue for another 90 days, meaning expanded telehealth access will continue during this time frame.
Healthcare IT News: VA study shows benefits of telestroke program for patients (4/12) – A Department of Veterans Affairs-funded study
published in Neurology found that a telestroke program helped prevent unnecessary hospital transfers for patients. Researchers found that the chance of being transferred to another facility decreased by 60 percent after the program’s implementation and increased the likelihood of timely stroke treatment. The analysis suggests that telestroke provides additional benefits for both patients and health systems. By reducing unnecessary transfers, appropriate lower acuity patients may be cared for within their local community with the added benefit of remaining closer to their family and social support.
White House: Bipartisan Infrastructure Law Rural Playbook (4/11) – The White House released the Bipartisan Infrastructure Law Rural Playbook, which will serve as a roadmap for delivering opportunity and investments in rural America and is intended to help rural communities understand the available funding for infrastructure provided by the Bipartisan Infrastructure Law and other sources. One notable inclusion in the playbook was the Tribal Connectivity Broadband Program. The Department of Commerce’s National Telecommunications and Information Administration (NTIA) will administer an additional $2 billion in funds to tribal governments to be used for broadband deployment on tribal lands, as well as for telehealth, distance learning, broadband affordability, and digital inclusion. The Consolidated Appropriations Act, 2021 initially established this program with $1 billion in grant funds.
House Ways & Means Committee: Survey: Americans Overwhelmingly Support Access to Telehealth (4/11) – GOP Members of the House Ways & Means Committee highlighted a recent survey from the Alliance for Connected Care, which found that the overwhelming majority of Americans support continued access to telehealth after the pandemic. Ranking Member Representative Kevin Brady (R-TX) stated, “We need to build on these successes and permanently extend further telehealth flexibilities that can help seniors.”
Telehealth Research, Reports and Surveys
mHealth Intelligence: Telemedicine expands care access for spine patients (4/14) – A study
published in the Global Spine Journal found that visits conducted through telemedicine increased accessibility for spine patients with low socioeconomic status. Spine patients missed 51.3 percent of in-person appointments, significantly higher than the 24.7 percent of telemedicine appointments that patients did not attend, among other findings. Researchers concluded that telemedicine was a helpful care delivery method for spine surgeons and patients were less likely to miss virtual appointments compared to in-person appointments.
Managed Healthcare Executive: More Evidence of Mental Health Services Shifting to Telehealth (4/13) – According to a Health Affairsstudy, people with conditions such as schizophrenia did not make the switch to telehealth as readily as people with anxiety and some other disorders. The average number of monthly encounters, in-person and via telehealth, for bipolar disorders fell by 10.6 percent in 2020 compared to the pre-pandemic years of 2016, 2017 and 2018. There was also a decline in encounters for depression (-8.2 percent) and schizophrenia and other psychotic disorders (-8.5 percent). Encounters for anxiety and fear-related disorders increased by 12.1 percent. These findings suggest that the volume of telehealth encounters dropped for certain conditions in part because of relatively lower telehealth uptake among these groups. Researchers concluded that telehealth may be uniquely suited to deliver mental health services, but caution about the need for strategies to meet the needs of people with “more serious mental health comorbidities.”
University of Houston: Racial and Ethnic Disparities in Telemedicine Usage Persist During Pandemic (4/13) – According to a study
published in the Journal of General Internal Medicine, the rapid implementation of telemedicine didn’t bridge the gap in racial and ethnic health disparities as much as people had hoped. Researchers found that African Americans were 35 percent and Hispanics were 51 percent less likely to use telemedicine compared to White people. The study also found that individuals younger than 18 years old and older adults were less likely to have a telemedicine visit when compared to non-elderly adults, as were those covered under Medicaid or who were uninsured. The findings suggest that the promise of the positive impact of telemedicine on health care use and health outcomes could elude underserved populations.
mHealth Intelligence: Assistance With Connecting to Virtual Visits Can Help Close Care Gaps (4/12) – According to a study
conducted by Kaiser Permanente, having medical assistants work with patients to connect to video visits could help narrow the digital divide. Researchers examined data on telehealth visits from Oct. 1 through Oct. 31, 2020 and compared video visits in medical offices that used virtual rooming more often with those that did not. Of the 136,699 video visits studied, 83.6 percent involved a successful connection to the video visit. The use of virtual rooming in medical offices varied, ranging from 4.6 percent to 97.2 percent. The researchers noted that the use of a medical assistant seemed to reduce the technology gap.
Cystic Fibrosis News Today: Telehealth Added to Latest Digital-friendly NORD State Report Card (4/12) – Alliance Advisory Board Member the National Organization for Rare Disorders (NORD) has updated its State Report Card
to make it more digitally friendly and added telehealth to its categories of rare disease policy issues in a nod to its increased use during the ongoing COVID-19 pandemic. The State Report Card focused on nine policy issues affecting the rare disease community, including Medicaid financial eligibility, medical nutrition, newborn screening, prescription costs, rare disease advisory councils, step therapy, and — for the first time this year — telehealth. According to Heidi Ross, acting vice president of NORD, “Rare disease patients have appreciated having the option of telehealth and so we feel like it is important to permanently and appropriately integrate telehealth into our health care system.”
mHealth Intelligence: Stakeholders Call for Continued Access to Telehealth (4/11) – Researchers from the Center for Connected Medicine (CCM) and KLAS believe that continuing access to telehealth will enhance the future of health care. As the COVID-19 pandemic becomes more normalized, many hospitals have terminated in-person care for non-emergency visits. However, CCM states that, currently, 20 percent of all appointments are virtual. The findings within a CCM report concluded that maintaining affordable costs and managing the health of patient populations are two benefits that telehealth provides.
State Telehealth News and Activity
Troutman Pepper: Massachusetts Health Care Laws are Bellwethers of National Trends Two Years Into the Pandemic (4/14) – Massachusetts Governor Charlie Baker testified before the Joint Committee on Health Care Financing about the comprehensive health care legislation he introduced last month, which comes on the heels of an earlier reform law passed in 2021 that increased insurance coverage for telehealth services. This legislation builds upon the robust telehealth provisions of this prior health care bill by expanding patient access to telehealth by lifting restrictions on providers authorized to render telehealth services. The bill would allow any provider, whether located in the state or outside the state, to deliver telehealth services as long as they are compliant with federal and state licensing requirements and the patient is located within Massachusetts.
JD Supra:Tracking Telehealth Changes State-by-State in Response to COVID-19 (4/11) – The latest 50-state tracker for policy, regulatory, and legal changes related to telehealth during COVID-19 outlines recent updates from Illinois, Kentucky, Utah, and Washington related to telehealth policy. Notable bills that are moving through each state include Utah Senate Bill 237, which passed this week and would establish the Counseling Compact allowing Licensed Professional Counselors in any compact state to practice in other compact states so long as such practice is in line with the compact rules. Washington passed House Bill 1708, which forbids a hospital from billing a facility fee if they serve as an originating site for an audio-only telehealth visit.
Telehealth News and Market Developments
Harvard Business Review: The Telehealth Era is Just Beginning (4/17) – When used appropriately, digital health care improves patient health, reduces costs, and makes care more equitable and accessible to anyone with a smartphone. Its use has soared during the COVID era. The authors of this article argue that providers around the world should aggressively strive to tap telehealth’s full potential even after the pandemic ends, and takes readers inside Alliance member Intermountain Healthcare, one of telehealth’s earliest adopters and most effective users in the United States. The authors show how telehealth can reduce expensive and unnecessary trips to the ER, reduce America’s chronic disease crisis, address disparities in care, make specialty care faster and more efficient, and provide access to the best doctors.
Inside Telehealth: Take-Home COVID Tests Create New Telehealth Opportunities (4/14) – The Food and Drug Administration’s approval of take-home COVID-19 tests opens the door for other self-diagnosable tests for strep throat or the flu to be paired with a virtual doctor’s visit and an overnight lab test to confirm the results. Former FDA Commissioner Scott Gottlieb called for coupling a self-diagnosable test with a telehealth appointment and sending another sample to an overnight lab to confirm the result. This method could address about 70 percent of pediatric visits.
AP News: Bipartisan Push on Mental Health Crisis That COVID Worsened (4/13) – Congress and the Biden Administration are working to address mental health and drug problems. One priority includes preserving access to telehealth services that proved its usefulness throughout the pandemic. The Senate Finance Committee is considering increased spending on in-school mental health services, broader use of telehealth for youth and more financial support to train youth mental health workers. Telehealth has become a standard tool for mental health and drug treatment counseling. Lawmakers, particularly in rural areas, are pushing to make telehealth coverage permanent.
Inside Telehealth: Insurers Balk at Proposed Oversight of Telehealth in Essential Health Benefits, But Providers Pleased (4/13) – In December, the Administration proposed refining the non-discrimination policy for essential health benefit plan designs, and raised some potential concerns with the promotion of telehealth. Insurance groups say that telehealth is a critical tool in ensuring access to care and expressed concern that defining those services as potentially discriminatory could undermine the growth of the services. However, providers appreciate that CMS will monitor plan designs that encourage telehealth over in-person care, as those may disadvantage certain populations, and ensure that plan designs that incentivize telemedicine do so in a non-discriminatory manner.
Prism Reports: For Disabled Women of Color, Telehealth Has Been a Pandemic Lifeline (4/12) – Telehealth has allowed members within the disability community to obtain the medical support they need from the safety of their own homes. This is particularly true for Black, Indigenous, and other women of color (BIWOC). In this article, two disabled women of color shared their experiences with telehealth and why it matters to them that access to telehealth services shouldn’t be diminished by the general public’s desire to “return to in-person everything.”
MedCity News: Telehealth Reform Made Care Affordable and Accessible (4/12) – The pandemic was a springboard for innovation, and in the past two years, the rapid growth of telehealth has led to better outcomes for patients. However, many telehealth waivers are set to expire within months after the public health emergency ends. Telehealth has become a great equalizer in a health care system where social and economic disparities continue to affect patient care. It provides an affordable and convenient option for patients, particularly those from underserved communities such as rural areas, elderly and differently-abled people, who may not be able to visit a doctor in person. Congress must provide the Department of Health and Human Services the authority and flexibility to continue all federal telehealth waivers once the administration declares an end to the public health emergency.
mHealth Intelligence: Banner Health Unveils Telehealth Program for Obstetrics (4/11) – Phoenix-based Banner Health has launched a pilot program providing virtual consultations to support obstetrics care in rural communities. The obstetrics telehealth project will connect family physicians with obstetric privileges in rural areas to obstetrics specialists. The consultations may occur over the phone between the two physicians or through a telehealth cart that can be brought to the patient's room, allowing for a three-way virtual conversation. More than 50 percent of rural counties have no hospital-based obstetrics services, and rural hospitals report higher rates of postpartum hemorrhage and blood transfusion during labor and delivery than urban hospitals. Telehealth provides an opportunity to connect specialty practices to rural communities.
Healthcare IT News, “Telehealth and what’s ahead for healthcare IT.” In this episode of HIMSS TV, Tom Leary, HIMSS SVP of government relations, explains how HIMSS works with Congress to improve telehealth access and remote patient monitoring.