July 26, 2020
by Tricia Barrentine Guay and Anthony Montoya
The COVID-19 Public Health Emergency has propelled telehealth into the spotlight, with impressive numbers of patients accessing care virtually out of safety, necessity and convenience. Health care payers and providers rapidly adapted to new methods of care delivery and reimbursement to meet the needs of patients. As result, patient and provider satisfaction is high and demand for telehealth is unlikely to wane.
Consumers enjoy the flexibility and ease provided by accessing care where they are, when they need it. A national survey conducted by the Alliance of Community Health Plans (ACHP) and ACMP shows that 89 percent of telehealth users reported high satisfaction with the experience, which is driving use across the country. During the last week of April, 1.7 million Medicare beneficiaries received telehealth services, according to CMS. This compared to only 13,000 telehealth visits per week for this population previously. This dramatic increase in utilization is partly the result of new telehealth flexibilities in Medicare afforded by CMS.
It’s clear that telehealth is here to stay and building on its momentum is critical to ensuring continued access and utilization. Notably, policymakers on both sides of the Capitol are engaged in furthering this progress.
On July 23, ACHP hosted a virtual briefing to highlight the recent successes of virtual care and advocate for Congressional action to make current flexibilities permanent, ensuring telehealth services are accessible and affordable beyond the public health emergency.
Representative Mike Thompson (D-CA), Founder and Co-chair of the Congressional Telehealth Caucus, joined the briefing to discuss ongoing efforts to maintain recent telehealth flexibilities in federal programs. He also voiced support for expanding broadband to improve patient access and incorporating telehealth into provider training to ensure its success in care delivery moving forward.
ACHP members have long been at the forefront of telehealth. In the midst of the pandemic, our community-based nonprofit health plans quickly and nimbly innovated to improve telehealth capabilities and reach more consumers. This week’s briefing was an opportunity to highlight those innovations and address critical elements of telehealth care delivery including rural health, telehealth operations and the social determinants of health.
In terms of access, telehealth has been a critical vehicle in improving access to care in rural America. As Julie Brussow, CEO of Security Health Plan in Wisconsin noted, for rural patients, health care is not just a trip to the doctor – it’s often driving many miles, staying in a hotel, and having as many tests done in one visit as possible. Brussow also highlighted the uptick in utilization of behavioral health services via telehealth, as more Americans experience effects during the pandemic and consumers are indicating they are more likely to take advantage from the comfort and privacy of their own home.
SelectHealth and affiliated Intermountain Healthcare in Utah, having offered telehealth for years, were able to quickly expand virtual services in the wake of the public health emergency. With the infrastructure in place, Intermountain was easily able to adapt, taking advantage of 15 federal waivers to better serve Medicare and Medicaid patients, increasing physician access by allowing telehealth regardless of state boundaries and prescribing controlled pharmacy treatments via telehealth. Overall, SelectHealth has recorded a 1,000 percent increase in telehealth utilization since March.
Addressing social needs has become even more essential as a result of the economic impact of COVID-19. Kaiser Permanente has long been focused on the needs of patients outside of the exam room. Through virtual care during the pandemic, the organization has been able to assist 45,000 eligible individuals in applying for nutrition assistance programs by prompting patients via their smart phones and other electronic devices, noted Dr. Sarita Mohanty, VP for Care Coordination, Medicaid and Vulnerable Populations. Dr. Mohanty also noted the opportunity for telehealth to play a vital role in assessing and addressing social needs but only if the industry works together to provide equitable access for all patients.
Much of the recent progress in telehealth is a result of the critical flexibilities now permitted in federal programs, established by CMS during the public health emergency. Unfortunately, many of these critical flexibilities will expire. Congressional action is necessary to maintain access to telehealth and foster continued innovations in virtual care. ACHP has made several recommendations to Congressional leaders, including:
- Easing originating site and geographic restrictions to ensure patients can access services from home when needed
- Allowing access to more telehealth providers and services
- Addressing telehealth in Medicare Advantage risk-adjustment calculations to ensure that all encounters are included in risk calculations
- Relaxing federal licensure requirements to allow telehealth services across state lines
- Expanding broadband access
COVID-19 has highlighted the overdue need to modernize existing virtual care policies and regulations. Consumer demand, fundamental health risks and the unsustainable cost of care present policymakers with a rare opportunity to make immediate and lasting impact on our health care system. Now is the time to make permanent additional flexibilities and tools for health plans and providers to deliver high-value care via telehealth.