Telehealth Research, Reports and Surveys
Health Affairs: New Coding Modifier Offers Opportunity to Investigate Audio-Only Telehealth (11/18) – Prior to the pandemic, Medicaid program coverage of audio-only telehealth services was limited. During the early stages of the pandemic, Medicaid beneficiaries were significantly less likely to complete telehealth visits compared to commercially insured patients. In September 2021, the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Panel accepted the addition of the CPT Modifier 93 code for synchronous audio-only telehealth, and the code became active on January 1, 2022. This article provides an overview of the rationale for and process of creating the CPT Modifier 93 code.
Inside Telehealth: Most Midterm Voters Support Free Telehealth Pre-Deductible
(11/17) – The Alliance to Fight for Healthcare conducted an election night poll, which found that an overwhelming majority of midterm voters want telehealth services to be covered before individuals meet their deductibles. Of voters who supported Democrats in the midterm elections and were polled, 91 percent support Congress allowing telehealth to be free pre-deductible. Support for telehealth access remains high across insurance groups as well – 81 percent of people with employer insurance and private insurance support the measure, and roughly 77 percent of people with government insurance or on Medicare telehealth access, support the measure. Voters who identify as women generally support access to telehealth pre-deductible more than those who identify as men, polling at 85 percent and 73 percent support, respectively.
The New England Journal of Medicine: Informing the Debate about Telemedicine Reimbursement — What Do We Need to Know? (11/17) – Researchers from Harvard Medical School and RAND Corporation shared their perspectives on telehealth, including the support for extending current telehealth flexibilities for two years. The researchers note that the effect of telehealth needs to continue to be studied. Before permanent telehealth legislation is passed, policymakers need to understand whether there is an ideal amount of telehealth that should be part of hybrid care models to provide the best care to patients.
Epstein Becker Green: 2022 Telemental Health Regulations Unlock Access and Evolve Compliance Practices (11/17) – A 2022 report from law firm Epstein Becker Green (EBG) shows that an increase in the global prevalence of anxiety and depression is accompanied by requests for more mental health assistance, ultimately leading to states sustaining and widening regulatory flexibilities to expand telehealth services. EBG highlighted an increase in regulatory flexibilities, leading to a spike in telehealth use for mental and behavioral health care. The report detailed how telemental health services became more accessible across states in 2022. States broadened telemental health coverage under state Medicaid programs, joined interstate professional licensure compacts, and expanded requirements for remote prescribing.
NEJM Catalyst: CareConnect: Adapting a Virtual Urgent Care Model to Provide Buprenorphine Transitional Care (11/16) – Medications for opioid use disorder (OUD) such as buprenorphine are the gold standard for treatment of OUD, but patients face many barriers accessing these medications. To address this gap, a team at Penn Medicine created CareConnect, which leveraged new regulatory flexibilities during the COVID-19 pandemic that allow for virtual prescribing of buprenorphine. The program is enhanced by a substance use navigator team that assesses patients, supports patients and clinicians throughout a patient’s care journey, and links patients to longitudinal OUD care programs based in primary care or specialty behavioral health. CareConnect shows that buprenorphine telehealth prescribing can be adopted by generalist clinicians.
JAMA Network Open: Comparison of Visit Rates Before vs After Telehealth Expansion Among Patients with Mental Health Diagnoses Treated at Federally Qualified Health Centers (11/15) – According to this research letter, high telehealth availability at federally qualified health centers (FQHCs) was associated with better care engagement during the COVID-19 pandemic for patients enrolled in Medicaid who had mental health diagnoses. The study assessed whether FQHC-level telehealth availability was associated with visit rates for 11,267 patients with mental health diagnoses (e.g., depression, anxiety, bipolar disorders) enrolled in Medicaid. This study suggests that care delivery models that support telehealth as part of mental health care may be associated with improved engagement for patients enrolled in Medicaid.
Johns Hopkins Medicine: Audio Phone Visits with Medical Providers Remain Crucial Links to Delivering Equitable Health Care, Say Johns Hopkins Medicine Experts (11/14) – Two telemedicine experts and a historian at Alliance board member Johns Hopkins Medicine found that audio-only telephone visits are an essential link to health care providers for patients without access to video visit options. They note that insurance coverage enacted during the pandemic for certain types of audio-only visits should continue, and without it, health care providers risk widening disparities in care experienced by people who are often marginalized.
American Medical Association: AMA Issues Blueprint for Optimizing Digitally Enabled Care (11/14) – AMA released a Blueprint for Optimizing Digitally Enabled Care, which describes six pillars that can help optimize digital health practices. AMA notes that investments, technology adoption, and patient needs play a significant role in how digitally enabled care evolves and how it can be used to improve access and care quality. Specifically, state lawmakers and regulators should support coverage of telehealth on the same basis as in-person care, equitable payment for virtual care, and narrow exceptions to licensure for out-of-state physicians providing ongoing care to an existing patient via telehealth. For additional coverage, see mHealth Intelligence.
American Heart Association: An Overview of Telehealth in the Management of Cardiovascular Disease: A Scientific Statement from the American Heart Association (11/14) – The American Heart Association (AHA), an Alliance advisory board member, released a scientific statement which reviews definitions pertinent to telehealth discussions, summarizes the effect of telehealth utilization on cardiovascular and peripheral vascular disease care, and identifies obstacles to the adoption of telehealth that need to be addressed to improve health care accessibility and equity. Advances in technology have enabled the growth of telehealth strategies to improve patient care and medical resource accessibility, which has led to more equitable care. The COVID-19 pandemic improved the telehealth infrastructure through necessity but also uncovered systemic weakness, limitations, and inequities. See the AHA press release here.
MITRE Corporation: Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook (11/14) – The Food and Drug Administration (FDA) and the MITRE Corporation released an updated version of the Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook, which provides guidance for health organizations on using regional collaboration to address device security threats. Specifically, the guide highlights a set of practice guides for securing medical devices, including for telehealth remote monitoring.
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