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Telehealth has emerged as a significant component of the healthcare landscape during the COVID-19 pandemic. Regulators will need to take action to ensure access to telemedicine beyond the pandemic.
As the COVID-19 pandemic spread across the country, once bustling waiting rooms went quiet. Telehealth and other virtual care offerings became the preferred way for providers to meet patients’ medical needs, while also ensuring they remained safe from the virus.
In fact, in March of 2020, 97% of healthcare leaders said they expanded telehealth access during the pandemic, with Medicare beneficiaries’ use of telehealth increasing 149,000%.
Today, the question remains as to whether telehealth usage will continue as a go-to option in the foreseeable future.
The answer, however, largely depends on whether reimbursement incentives and other regulatory changes that supported telehealth offerings during the public health emergency (PHE) remain or are expanded post-pandemic.
Regulatory changes are needed
Recently, there have been positive steps signaling that regulators see benefits in telehealth and could potentially extend support of virtual care options long into the future.
The Centers for Medicare & Medicaid Services (CMS) released its calendar year (CY) 2022 Medicare Physicians Fee Schedule (PFS) Final Rule, which reflects the Biden Administration’s strategy to improve the nation's healthcare system with "better accessibility, quality, affordability, empowerment and innovation."
For the coming year, CMS implemented provisions of Section 123 of the Consolidated Appropriations Act (CAA), which removed geographic location restrictions for virtual mental health services. Patients are now able to access telehealth services in their homes rather than having to visit a qualifying healthcare site for diagnosis, evaluation and treatment of mental health and substance use disorders. The rules also enable rural health centers to provide mental health services virtually.
As part of these changes, CMS will now also allow audio-only communications — rather than requiring both audio and video two-way interaction between patients and remove providers — easing the burden on patients who may have technology limitations.
These changes are significant in many ways, but perhaps most important because counseling and therapy services will be more readily available to individuals in vulnerable populations. This includes the treatment of substance use disorders and services provided through opioid treatment programs, and otherwise helps address at-risk patients where social barriers to care prevent individuals from seeking help in person.
CMS also continues to evaluate other telehealth services — such as the ability for Federally Qualified Health Centers and Rural Health Clinics to serve as distant telehealth sites and provide services to patients in their homes — that were temporarily added during the public health emergency.
Currently, the nearly 200 temporary telehealth services will remain on the list through December 31, 2023, which will give the CMS and other stakeholders time to gather data to support permanently adding these Medicare telehealth services.
Consumers drive innovations
While these latest CMS actions provide evidence that telehealth is here to stay, more needs to be done to address changing consumer expectations that are reshaping healthcare.
Experiences with telehealth during COVID-19 made both patients and providers more comfortable with the concept of virtual care and the technologies used to support it.
According to a recent survey, for example, approximately 83% of patients say they're likely to continue relying on telemedicine once COVID-19 subsides and the public health emergency is lifted. The reason? They believe the quality of care is equivalent to in-person visits, with the added benefit of convenience.
The tide has turned for providers, too, as they’ve embraced telehealth and integrated it into their practices, using telehealth for both sick and well visits, prescription refills, post-op follow-ups and more.
An October 2021 Greenway Health survey of ambulatory care providers found 78% of respondents said they expected to increase their telehealth use to some degree in the future. Another survey of healthcare executives by the Deloitte Center for Health Solutions and the American Telemedicine Association supported those findings, noting that at least 25% of all outpatient, preventative, long-term care and well-being services would move to virtual delivery by 2040.
When announcing the CY2022 PFS, CMS Administrator Chiquita Brooks-LaSure noted, “The COVID-19 pandemic has highlighted the gaps in our current healthcare system and the need for new solutions to bring treatments to patients, wherever they are.”
For patients and providers, telehealth and other virtual care offerings provide this opportunity.
In all, the move of so many core healthcare services to virtual delivery is paramount to bridging gaps in care, promoting health equity and ensuring more people have access to comprehensive care.
While it’s clear that telehealth is here to stay, we must also ensure that we don’t create wider chasms in our healthcare system. The temporary rules — such as allowing Federally Qualified Health Centers and Rural Health Clinics to serve as distant telehealth sites for more than just mental health and substance abuse disorders — should be made permanent.
David Cohen is chief product and technology officer at Greenway Health, a leading health information technology services provider. He has more than 20 years of enterprise information technology leadership experience, with the most recent 15 years focused on healthcare.