Archive for Telehealth

 

Study of Cardiac Telehealth Yields Interesting Results

Increased use of telehealth among cardiac patients as a result of the COVID-19 pandemic has produced some interesting results.

According to a study published by JAMA Open Network,

…[cardiology] patients using COVID-era remote visits were more likely to be Asian, Black, or Hispanic individuals, have private insurance, and have cardiovascular comorbidities. Compared with pre-COVID in-person visits, clinicians during COVID-era video and telephone visits had a significantly lower odds of ordering any medication as well as most tests.

The use of telehealth has increased significantly since the start of the COVID-19 pandemic and the introduction of temporary Medicare regulations that encourage the use of telehealth as an alternative to visits to doctors’ offices.

Learn more about the study, how it was conducted, its limits, and the implications of its findings in the JAMA Open Network study “Patient Use and Clinical Practice Patterns of Remote Cardiology Clinic Visits in the Era of COVID-19.”…

MedPAC: Go Slow on Expanding Medicare Telehealth

MedPAC wants Medicare to test the impact of telehealth on health care under non-COVID-19 conditions before moving forward with expanding the tool’s use in the Medicare population.

In a news release accompanying its recently released annual report to Congress on Medicare payment policy, the Medicare Payment Advisory Commission writes that

In the report, we present a policy option for expanded coverage for Medicare telehealth policy after the PHE is over. Under the policy option, policymakers should temporarily continue some of the telehealth expansions for a limited duration of time (e.g., one to two years after the PHE) to gather more evidence about the impact of telehealth on beneficiary access to care, quality of care, and program spending to inform any permanent changes. During this limited period, Medicare should temporarily pay for specified telehealth services provided to all beneficiaries regardless of their location, and it should continue to cover certain newly-covered telehealth services and certain audio-only telehealth services if there is potential for clinical benefit.

The policy option also specifies that after the PHE ends, Medicare should return to paying the physician fee schedule’s facility rate for telehealth services and collect data on the cost

Coronavirus Update: March 31, 2020

Coronavirus Update: March 31, 2020

Yesterday the federal Centers for Medicare & Medicaid Services (CMS) published a major update of Medicare and Medicaid regulations that included blanket waivers of a large number of Medicare and Medicaid regulations and requirements.  The following is a summary of the major aspects of this new regulation.

New Policies and Waivers From Medicare and Medicaid Regulations and Requirements

CMS has introduced dozens of changes that involve waivers from current regulations and requirements.  A comprehensive, 26-page CMS document describing these changes can be found here and below are the highlights organized into four broad categories:

  • increasing hospital capacity (what CMS calls “hospitals without walls”)
  • expanding the health care workforce
  • increasing the use of telehealth in Medicare
  • reducing paperwork

 

Increasing Hospital Capacity

  • CMS is waiving the enforcement of section 1867(a) of EMTALA to permit hospitals to screen patients at off-site locations to help prevent the spread of COVID-19.
  • CMS is waiving certain requirements under the Medicare conditions of participation allow for flexibilities during hospital and psychiatric hospital surges, permitting non-hospital buildings/space to be used for patient care and quarantine sites.
  • For the duration of the public health emergency, CMS is waiving certain requirements under the

Home Health Agencies Expanding Scope of Endeavor

In the coming years, home health agencies will be providing a broader scope of services.

With many such agencies already offering medication management technology, remote patient monitoring, image-sharing technology, and mobile apps for e-visits, many are planning to do more.  More than a quarter of home health providers plan to move into or expand their telehealth offerings in the coding years and many already provide chronic care services, with more planning to do so in the coming years.

Home health providers also are moving into palliative care, veteran-specific services, and mental health services.

Behind some of this expansion of scope is the federal government, which this year authorized Medicare Advantage plans to offer non-skilled, in-home support services to chronically ill patients.

Learn more about the ways in which home health care may change in the coming years in the Healthcare Dive article “Home health agencies expanding, rolling out more telehealth services.”

CMS to Congress: You’re the Impediment to Greater Use of Telehealth

The primary obstacle to Medicare making greater use of telehealth is current laws, the Centers for Medicare & Medicaid Services has told Congress in a new report.

The report, mandated by the 21st Century Cures Act, outlines the extent of telehealth utilization today, describes its benefits, and suggests potential new and expanded uses for telehelath, but it also notes that

Current restrictions on eligible telehealth originating sites appear to be the greatest barrier to preventing the expansion of Medicare telehealth services.  The two most significant Medicare restrictions are:  1) requiring the originating site to be located in certain types of rural areas; and 2) not allowing the beneficiary’s home to be an eligible originating site.

Congress’s mandate did not include a request for recommendations and CMS did not offer any.

Learn more about how Medicare uses telehealth today, how it could use telehealth more extensively if the opportunity presented itself, and what the barriers are to greater use of telehealth in the CMS report to Congress Information on Telehealth, which can be found here.…