In the current political climate, it’s easy to believe that nothing is getting done to improve healthcare (or anything else, for that matter) because everything is so polarized. Yet there is one area that is quietly but quickly growing as a result of heavy bipartisan support: telehealth.
The reason telehealth is rising above the political noise is simple – it makes sense, especially as healthcare makes the transition from fee-for-service to value-based care. More importantly, it’s an idea that practically everyone on all sides of the healthcare debate agrees makes sense.
It starts with the simple fact that the technology to enable telehealth is nearly ubiquitous. According to Pew Research, 81% of Americans now own a smartphone, and more than half (52%) own a tablet. So the basic required to connect patients to providers electronically are already in place.
The key, however, is healthcare’s growing emphasis on keeping people healthy versus treating them when they are ill as a result of the transition from fee-for-service (FFS) to value-based care. Whether you are a fiscal conservative looking to reduce the cost and footprint of government-sponsored healthcare, or a social liberal who believes good health is a basic human right, value-based care has a lot to offer.
And telehealth can help us get there by making it easier for providers to monitor the health of their patients, and for patients to contact their providers rather than waiting until a health issue gets so bad they can’t stand it anymore.
Here are some of the ways in which legislators on both sides of the fence are not just supporting telehealth but helping it proliferate.
- H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment [SUPPORT] for Patients and Communities Act – This Act, which took effect July 1, 2019, enables the home of an individual to be used as a site for treatment and recovery from opioid abuse if it has telehealth connections. This is particularly important for older adults or those in rural areas who may have difficulty going to an outpatient clinic for treatment, and especially for older Americans who live in rural areas, where deaths from opioid addiction are 10X more than the nation as a whole.
- Home becomes approved site for telehealth consult for Medicare patients with End-Stage Renal Disease (ESRD) – As of January 1, 2019, Medicare patients with ESRD who are receiving dialysis in their homes can now consult with their physicians via telehealth services rather than going into the offices. Physicians are being reimbursed as long as they encode the encounter under HCPCS/CPT code 90963.
- Reintroduction of the Reducing Unnecessary Senior Hospitalization (RUSH) Act of 2018 – H.R. 6502 seeks to give skilled nursing facilities (SNFs) more financial incentives to connect patients to the emergency department (ED) via telehealth during an emergency rather than disrupting resident lives by automatically transferring them to the ED at the hospital. The original bill, which was introduced in 2018, had bipartisan support from three Republicans and two Democrats. It was reintroduced in 2019 with 10 cosponsors, including four Republicans and six Democrats, and is awaiting further action.
- Telehealth becomes a standard benefit in Medicare Advantage plans – Beginning January 1, 2020, telehealth services (including remote patient monitoring) must no longer be considered “optional” coverage in Medicare Advantage plans for which members must pay extra. Instead, the Centers for Medicare and Medicaid Services (CMS) will now allow telehealth as a standard, covered benefit in all plans, enabling beneficiaries to seek care in their homes rather than requiring them to go to a healthcare facility. Additionally, anyone with basic Medicare coverage can now have a virtual check-in with their physicians by phone or video chat. Previously, that option was restricted to beneficiaries in rural areas only.
- State-level changes in Medicaid programs – While the changes above affect telehealth care at the Federal level, we are also seeing changes at the state level in Medicaid programs. Many states are recognizing the value of allowing the home to be recognized as a site of care for its Medicaid populations, and are changing their program accordingly. Giving Medicaid beneficiaries the option of connecting to their physicians via technology rather than in-office visits helps overcome multiple barriers to care, including transportation challenges, the need to take unpaid time off of work and coordinating care for well children when one child is ill. These changes in Medicaid benefits are being observed in both red and blue states.
Health plans have already proven that a well-designed population health management program that focuses on value-based care can help reduce utilization of the two highest-cost services a hospital offers – ED visits and inpatient stays – by as much as 50% or more for certain populations. Remote patient monitoring and other telehealth programs simplify the process of keeping populations healthy by giving clinicians early warning about negative trends in chronically ill patients. And by making it easy for all patients to communicate with their physicians’ offices about their health whenever they need it.
Support and momentum for telehealth are gathering at every level, from the grassroots to the government. If you’re not already planning to take advantage of the benefits of telehealth in your government-sponsored program, it’s time for us to talk.