Great news! Telehealth is likely to stay and expand in the future. In the post-pandemic world, telehealth is projected to become an increasingly important part of provider practices going forward.Telehealth has presented multiple benefits during the pandemic by expanding access to care, reducing COVID-19 exposure to clinical staff and patients, preserving scarce supplies of PPE and reducing patient demands on facilities. Congress and the Center for Medicare and Medicaid Service's (CMS) waiver of limitations on reimbursement for telehealth services vastly increased patient access to telehealth services.
On March 2, 2021, the House Committee on Energy and Commerce;s Subcomittee on Health held a hearing on "The Future of Telehealth: How Covid-19 is Changing the Delivery of Virtual Care ("Hearing"). One key takeaway from the Hearing is that there is broad, bipartisan support for reimbursing telehealth services rendered to traditional Medicare beneficiaries - even after the pandemic. In the House Committee on Energy Chairman Frank Pallone, Jr's Memorandum, he provided the following statistics -- "(a)s a result of the pandemic and the flexibilities in place, patients are increasingly using telehealth to access health care services. Before the public health emergency ("PHE"), approximately 13,000 beneficiaries in Medicare FFS received telehealth services in a week compared to an estimated 1.7 million individuals receiving telehealth services in a week in April 2020. According to CMS data, over 9 million Medicare FFS beneficiaries received a telehealth service or other virtual service between mid-March through mid-June in 2020."
The Statement of the American Hospital Association (AHA) presented for the Hearing highlighted the following positive outcomes resulting from the increased use of telehealth during the PHE included: 1.) increased access to specialists; 2.) avoided hospitalizations; and 3.) improved outcomes. The AHA also asserted its support for continued coverage and reimbursement for audio-only services and the "Temporary Reciprocity to Ensure Access to Treatment Act" (TREAT Act, S. 168 and H.R. 708) that would allow for temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states. The AHA also urged Congress to work in conjunction with CMS to provide adequate reimbursement for the substantial upfront and ongoing costs of establishing and maintaining the necessary virtual infrastructure, including secure platforms, licenses, IT support, scheduling, patient education and clinician training.
Further, on March 25, 2021, the "Ensuring Parity in MA and PACE for Audio-Only Telehealth Act," bipartisan legislation was introduced in the U.S. House of Representatives to help ensure Medicare Advantage (MA) enrollees who cannot access the video component during telehealth visits are able to access care thorough audio-only components during the pandemic. This is especially beneficial for seniors who live in rural areas without access to computers and broadband internet speeds that support video connections. The objective of this legislation is to remove barriers to care that these individuals would otherwise experience. It also provides for adequate compensation for providers by requiring MA plans to reimburse them for audio-only visits at the same rate as if they were in-person visits. Further California, Georgia, Colorado and Massachusetts have passed legislation to require private insurers to reimburse telehealth and audio-only services with parity to in-person visits.
Health experts predict telehealth usage will remain greatly increased compared to pre-pandemic times. Moreover, the increased levels of remote patient monitoring with the aid of technology, like EKGs and pulse oximeters, will most likely remain. These digital tools have proven to be highly effective and cost-efficient ways to provide high quality patient care. However, there are some concerns that the following factors may result in a decreased use of telehealth post-pandemic:
1.HIPAA compliance requirements for all healthcare communications;
2. Requirement tha patient and doctor have an established relationship;
3. Potential reduced reimbursement rates; and
4. Increased anti-fraud, waste and abuse efforts.
Despite these concerns and challenges, the impact of telehealth on patients' availability to access healthcare through telehealth during the pandemic, has been immeasurable. The expansion of telehealth has resulted in reduced no-show rates, which boosts revenue for many medical providers. Further, telemedicine has had the largest impact on mental health appointments, with private insurers stating almost half their telehealth claims were for mental health services. While the long-term benefits and limitations of telehealth will require additional study, the tremendous value it has provided is apparent. The current data suggests we have entered into a new era of medicine where telehealth services will be a core aspect of the physician-patient relationship.