ACUTE CARE, INC. Supports Series – Fair Telehealth Reimbursement

ACUTE CARE, INC. Supports Series – Fair Telehealth Reimbursement


January 4, 2021

On August 04, 2020 President Trump signed the Executive Order on Improving Rural and Telehealth Access. Under this order, the Centers for Medicare and Medicaid Services (CMS) will expand telehealth benefits for Medicare beneficiaries.

CMS is seeking input from the public to determine which telehealth services should be permanently covered.

The Executive Order calls for the expansion of telehealth services to be made permanent, particularly in rural areas where telehealth is particularly useful.

“Rural healthcare providers, in particular, need these types of flexibilities to provide continuous care to patients in their communities. It is the purpose of this order to increase access to, improve the quality or, and improve the financial economics of rural healthcare, including increasing access to high-quality care through telehealth,” the Executive Order states.

ACUTE CARE, INC. supports making the expansion of telehealth services permanent, and ensuring that telehealth providers are reimbursed in a manner that makes delivery of that essential service financially sustainable.
CMS outlined the scale and scope of the expansion on their website:

Telehealth waivers from the Centers for Medicare & Medicaid Services (CMS)


Temporary policy changes during the Coronavirus pandemic

 

  • CMS has issued temporary measures to make it easier for people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) to receive medical care through telehealth services during the COVID-19 Public Health Emergency.
  • Some of these changes allow providers to:
  • Conduct telehealth with patients located in their homes and outside of designated rural areas
  • Practice remote care, even across state lines, through telehealth
  • Deliver care to both established and new patients through telehealth
  • Bill for telehealth services (both video and audio-only) as if they were provided in person

Temporary expansion of telehealth services during COVID-19

During the public health emergency, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) may serve as distant telehealth sites and provide telehealth services to patients in their homes.

The American Medical Association notes:
Because of the coronavirus and temporary waivers on Medicare limitations, though, the usage numbers skyrocketed. A McKinsey & Co. report estimated that physicians saw between 50 and 175 times more patients via telehealth than they did prior to the pandemic.
The Telebehavioral Health Institute reports:

Continued telehealth reimbursement is finding bipartisan support at the national level and in many states. According to TBHI’s research team, it is likely, however, that the future of continued legislative permissiveness will continue to be hazy until January of 2021. The upcoming election and continued uncertainty about COVID seem to have stolen the thunder from the legislative storm that introduced many continued as well as new reimbursement possibilities for telehealth. However, it is getting increasingly clear that significant legislation regarding the permanence of current telehealth legislation will NOT pass this year.  

Fierce Healthcare reports:

Leading healthcare experts released a report this week outlining major policy recommendations to support the expanded use of telehealth in the wake of the COVID-19 pandemic.

The Taskforce on Telehealth Policy’s recommendations include lifting limitations on originating sites, allowing telehealth for various types of conditions and reinstating the Health Insurance Portability and Accountability Act (HIPAA) provisions temporarily lifted during the public health emergency.

The report also recommends that policymakers take steps to expand access to broadband and technology infrastructure to promote equity and not exacerbate care disparities.Source: https://www.fiercehealthcare.com/practices/task-force-releases-report-advising-congress-telehealth-policy-but-one-physician-group

Deloitte notes:

New telehealth policies will likely need to balance potential increased access to services with potential cost increases, as well as payment and licensing changes and what they may mean for provider business models

Source: https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-realizing-the-potential-of-telehealth.pdf

Physician Practice puts it this way:
This is a critical topic for physicians and practices. Legislators need to hear from their constituents about the importance of moving legislation forward. Providers and patients can call or write to share their stories of how telehealth has positively impacted lives. There is power in numbers, and providers should also look to join in advocacy efforts of their professional associations. The American Medical Association, American Academy of Family Physicians, and American Academy of Pediatrics are just a few of many associations actively advocating for telehealth and providing resources to their members. The industry must work together and stand with physicians and advocacy groups in supporting proactive action until this issue is addressed. The pandemic changed the way we deliver healthcare. Reimbursement needs to follow.
 
ACUTE CARE, INC. believes in the present and future benefit of telehealth, and supports legislative and payor support for its continued evolution and innovation, and the positive clinical and financial outcomes involved in its widespread adoption.

Paul Hudson, FACHE
Chief Operating Officer