Is Telehealth Here to Stay?

June 17, 2020 By: Ken Magness

CMS Administrator and industry experts say, YES!

It’s been a trend that’s been talked about and predicted to increase over the last decade, but it wasn’t until the world was hit with the COVID-19 pandemic for telehealth to really take off. The healthcare industry saw an unprecedented rise in telehealth amidst the pandemic, and this trend will continue, according to industry leaders at the Value-Based Care Summit | Telehealth20: Virtual Series.

The vast majority (91%) of conference attendees said the role of telehealth had increased at their organization since March 2020. And over two-thirds (68%) were explicitly motivated to participate in telehealth programs because of COVID-19.

An overwhelming majority (96%) of attendees believe telehealth’s role will continue to grow in the industry. Only 4% of respondents believe telehealth’s role will stay the same.

Organizations will continue building their telehealth programs to support success—68% said they planned to further invest in telehealth following the public health emergency. Another 44% said they plan to invest in IT infrastructure and capabilities, which support telehealth solutions. Robust IT capabilities allow telehealth programs to thrive.

“CMS’ rapid changes to telehealth care are a godsend to patients and providers and [allow] people to be treated in the safety of their home,” said Seema Verma, Centers for Medicare & Medicaid Services Administrator, in an earlier press release. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

Telehealth helps reduce disparities in care.

The expansion of telehealth coverage has provided care opportunities for rural populations that didn’t exist before. Now, a new bill introduced this week in the House would ensure Medicare coverage for telehealth services provided by federally qualified health centers (FQHCs) and rural health clinics (RHCs) and eliminate the originating site facility and location requirements for distant site telehealth services.

The bill, the Helping to Ensure Access to Local Telehealth (HEALTH) Act of 2020, would make permanent connected health coverage included in the CARES Act, which only lasts as long as the COVID-19 emergency, and bring into the spotlight one of the most troubling barriers to widespread telehealth adoption.

“Patients and providers alike will benefit from permanent telehealth access even once the virus is under control,” Chris Shank, CEO and President of the North Carolina Community Health Center Association said in a press release. “Allowing patients to connect virtually to their health care provider removes significant barriers like transportation, which disproportionately affects patients with lower incomes and those living in rural communities. The HEALTH Act will reduce longstanding barriers to healthcare access by reducing red tape and providing sustainable reimbursement for telehealth services provided by community health centers.”

The nation’s current economic problems and the soaring unemployment rate will leave millions without health insurance and potentially push them toward the roughly 1,400 FQHCs and 4,300 RHCs. Many of these facilities predominately provide care for underserved populations and communities. Prior to COVID-19, these facilities weren’t considered a distant site for telehealth by CMS, so opportunities for reimbursement were few and far between. The HEALTH Act aims to permanently change that.

More providers want equal telehealth reimbursement after COVID-19.

The American College of Physicians wrote a letter to Seema Verma on June 4 stating, “Changes in payment policy address some of the biggest issues facing physicians as they struggle to make up for lost revenue and provide appropriate care to patients.”

The letter went on say, ““This extension should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits.”

Many private payers have followed Medicare, enacting their own telehealth coverage and reimbursement policies during the crisis. This led to a 4,347 percent increase in telehealth claim lines among the privately insured population from March 2019 to March 2020.

But the telehealth flexibilities are only temporary, expiring at the end of the public health emergency period—a restriction providers are saying could result in the closures of organizations already struggling to make ends meet.

“Given the uncertainly around the timeline for a COVID-19 vaccine or treatment, many expect that the virus will continue to spread well into 2021,” the College stated. “Therefore, as the need to contain the virus and maintain appropriate social distancing protocols continues into next year, it is unlikely that in-person visits to practices will return to pre-pandemic levels as patients remain uncomfortable with making these in-person visits and physicians schedule fewer patients to be seen in the office.”

Payment parity, as well as clear telehealth billing guidance from CMS, is necessary for ensuring a smooth and safe transition to normal operations for the healthcare industry, the College stated. But others are also urging policymakers to consider permanent implementation of other telehealth billing flexibilities, such as the ability to provide care remotely in the homes of patients.

The current commercial payer telehealth deadlines 

Even though providers are calling for extended telehealth coverage, here is a list of the existing payer telehealth flexibilities and patient cost share dates. 

Payer Policy Modification and Flexibilities Dates - As of 6/4/20

Payer

Telemedicine Flexibilities

Patient Cost Share

Aetna

Until 8/4/2020

Until 6/4/2020

BC/BS - LA

Not yet determined

Until 5/31/2020

BC/BS - AR

Until end of PHE

Until end of PHE

Pending June newsletter

7/24/2020

7/24/2020

BC/BS - MS

From 3/16/2020 until end of PHE

From 3/16/2020 until end of PHE

7/24/2020

7/24/2020

BC/BS - Federal

 

From 3/10/2020 until end of PHE

7/24/2020 (for Teledoc)

Cigna

Until 7/31/2020

Until 7/31/2020

Humana

From 3/6/2020

From 2/4/2020

Medicare

From 3/1/2020 until end of PHE

From 3/1/2020 until end of PHE

7/24/2020

7/24/2020

Medicaid- LA

Until end of PHE

N/A

7/24/2020

Medicaid- MS

From 3/1/2020 Until 6/30/2020

 

Medicaid- AR

Until end of PHE

 

7/24/2020

Tricare

 

 

Pending Humana Military guidance

United Healthcare

Medicare Advantage—until 9/30/2020

Medicare Advantage—until 9/30/2020

Commercial—until 7/24/2020

Commercial—until 7/24/2020

 

MGMA also provides a useful resource for Commercial Health Plan COVID-19 Policies that is updated regularly.

We hope you all are staying safe and healthy!


Ken MagnessKen Magness is a focused healthcare professional with more than a decade of experience in helping clients understand the true value of automation in the revenue cycle management process. As the Strategic Initiatives Leader at Quadax, Ken and his team are passionate about connecting with healthcare providers to help them create and leverage the appropriate technology solutions to optimize the revenue cycle process and improve the experience of their patients and staff.

 

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