Telemedicine growth has been limited by lack of uniform coverage policies across insurers and states, and hurdles to establishing telemedicine in health systems (e.g. Figure 2: Telemedicine Is Being Used in Many Scenarios during the COVID-19 Pandemic. For purposes of Medicaid, telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. In 2019, large employers projected that healthcare costs were going to rise by 5% for the sixth year in a row, according to a survey by the Business Group on Health. Meanwhile an estimated 15% of physicians had used telemedicine to facilitate interactions with their patients. Many states are issuing emergency orders to remove in-person requirements before engaging in telehealth, for the duration of the public health emergency (e.g. Similarly, utilization of telemedicine by traditional Medicare and Medicaid and beneficiaries enrolled in managed care plans had been trending upward, but remained low. If the U.S. wishes to invest in telemedicine over the longer term, more permanent measures may need to be taken. These members now have access to on-demand primary care and EAP services through telemedicine. In response to the unprecedented pressure to expand services and control the transmission of the novel coronavirus, the federal government, many states governments and commercial insurers are expanding coverage of telemedicine and relaxing existing regulations. This limits telehealth’s reach for Medicare beneficiaries without access to smartphones or other video communications. Changes to Traditional Medicare: Based on new waiver authority included in the Coronavirus Preparedness and Response Supplemental Appropriations Act (and amended by the CARES Act), the HHS Secretary has waived certain restrictions on Medicare coverage of telehealth services for traditional fee-for-service (FFS) Medicare beneficiaries during the coronavirus public health emergency (first issued on January 31, 2020, and renewed on April 21, 2020). These visits are more limited in scope than a full telehealth visit. First Choice Health First Health ... We are following COVID-19 safety protocols and have measures in place to care for you via telehealth no matter your location. Health systems have rapidly adapted to implement new telehealth programs or ramp up existing ones. To combat the growing financial responsibility on employers, companies are increasingly turning to self-insured healthcare models to lower costs. Actions to rapidly expand telemedicine could come with tradeoffs, including concerns over privacy and quality of care. There are a myriad of telemedicine laws and regulations determine who can deliver which telemedicine services to whom, in what location, in what fashion, and how they will be reimbursed. In response to COVID-19, some state Medicaid programs that would normally require written consent have waived this requirement; for example, providers caring for Medicaid beneficiaries in Alabama, Delaware, Georgia, and Maine can now obtain verbal consent for telemedicine, rather than having the patient sign a written consent form. And even when regulations are temporarily lifted to facilitate telemedicine, health systems and patients will have their own challenges in implementing and accessing these services. While studies show some interest in telehealth among older individuals, concerns include perceived poorer quality of care, privacy issues and difficulty using technology. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment. One survey projects a possible 5.3% increase in health plan costs for large employers in 2021. Filling the need for trusted information on national health issues, Gabriela Weigel, Potential concerns to this approach include the possibility that protected health information (PHI) that is discussed or sent over a non-HIPAA compliant platform may be accessed, shared or even sold by these platforms. Urgent Care Center Network Get the care you need when you need it at an urgent care center in our network–no appointment needed. First Choice SafeLink Phone Program First Choice by Select Health of South Carolina is proud to be working with SafeLink Wireless (PDF) to offer the Lifeline program at no cost to you! As clinicians seek new ways to serve patients and stem the rapid spread of the novel coronavirus in the United States, policymakers and insurers have looked to telemedicine or telehealth to provide care to patients in their homes. (Figure 2). 2. Despite most states moving to expand Medicaid coverage of telehealth services, these changes are not uniform across states, and barriers to implementing and accessing telehealth more broadly are likely to remain during this emergency. Figure 5: Key Changes to Coverage Restrictions for Medicare Fee-for-Service During the COVID-19 Emergency. Telehealth virtual visits available for CA, FL, GA, ME, NM, PA, TN, WA . While larger health systems may have the financial resources to do this, smaller and more rural practices may be stretched thin as it is. Before the onset of the COVID-19 pandemic, utilization of telemedicine in the U.S. was minimal. CMS has also expanded access to the types of services that made be provided via audio-only telephones. The federal government has focused on broadening telemedicine access for Medicare beneficiaries, and waiving enforcement of HIPAA to enable use of video platforms like Facetime and Skype. During the COVID-19 outbreak, there are many clinicians who are first-time users of telemedicine, who must ensure they are covered before providing services. Based on the results of a March 2020 KFF Health Tracking Poll, nearly seven in 10 adults 65 and older (68%) say they have a computer, smart phone or tablet with internet access at home (compared to virtually all adults ages 30-49 and 85% of adults ages 50-64). Accepting Medicare, Cigna. CA, ME, MD, NM, ND, UT) have issued guidance to relax state-specific privacy standards for telehealth during the state of emergency. While use of telemedicine in the U.S. had been minimal prior to COVID-19, interest in and implementation of telemedicine has expanded rapidly during the crisis, as policymakers, insurers and health systems have looked for ways to deliver care to patients in their homes to limit transmission of the novel coronavirus. Our Rising Star Awards nomination deadline has been extended. A study of Medicaid claims data showed beneficiaries enrolled in Medicaid managed care plans were more likely than those in FFS programs to use telemedicine. To make these services more readily accessible to patients, some insurers are working to increase their numbers of in-network telehealth providers within their existing networks of care, while others are contracting with specific telehealth vendors to provide these services. Clinicians must ensure their malpractice or liability insurance covers telemedicine, and if needed, that it covers services provided across state lines. For patients with possible coronavirus infection, taking a thorough history via telemedicine is relatively straightforward, including reviewing symptoms, travel history and exposure history. During a telemedicine visit, a patient may see providers from their usual source of care, like Stanford Health, Kaiser Permanente, or Mount Sinai, or they may interact with providers employed by a stand-alone telemedicine platform like Amwell or Virtuwell. Figure 3: Who Regulates Telemedicine in Health Plans? Telehealth visits are quickly becoming a mainstay of healthcare during the COVID-19 pandemic. “FCH was built on the promise that a provider-centric model is a better alternative to the fragmented care delivery approach of large national insurers,” said Clyde Walker, First Choice Health board chair, in a statement. And don’t miss these top workplace benefit stories from EBN’s editorial team. This could create discrepancies in access and continuity of care. Employers including Walt Disney Company and Costco cinched the 51-100 spots on Glassdoor’s annual “Best Places to Work” awards. Telemedicine can enable providers to deliver health services to patients at remote locations, by conducting “virtual visits” via videoconference or phone (Figure 1). This brief presents some of the many policy changes that have taken place in the field of telehealth by the federal government, state governments, commercial insurers and health systems in just the few short weeks since the COVID-19 outbreak hit the U.S. We highlight key considerations in achieving widespread implementation of telemedicine services during this pandemic and beyond, including easing of telemedicine regulations, broadening insurance coverage, strengthening telecommunications infrastructure, and patient facing issues like connectivity and quality of care. Contact Our Office for a Telehealth Appointment With a Primary Health Care Provider or for Behavioral Health . Telehealth Visits – As of March 6, 2020 First Choice VIP Care Plus has expanded telehealth in compliance with new CMS guidance, to include coverage in all areas (not just rural), in all settings, the use of popular video chat applications, and the increase of allowed services. For patients utilizing telemedicine during the COVID-19 emergency for non-respiratory complaints, virtual evaluation may prove challenging as well. First Choice Health is making it easier for even more employers to forgo traditional health insurance plans by expanding their coverage area and services during the pandemic. Gaps in technology access and use among some groups of patients may also be a concern. high startup costs, workflow reconfiguration, clinician buy-in, patient interest). After many years of slow growth, telemedicine use has exploded across the nation in a few short weeks. First Choice Health, a Seattle-based health plan administration and services company, will begin offering members access to virtual care visits, effective Jan. 1. Many states are also mandating fully-insured private plans to cover and reimburse for telemedicine services equally to how they would for in-person care (service parity and payment parity). In 2020, the company expanded coverage to include more than 55,000 new members across the country. Figure 4: Actions to Expand Telemedicine Availability During the COVID-19 Pandemic. The National Consortium of Telehealth Resource Centers (NCTRC) currently urges health centers to sign a Business Associate Agreement (BAA) with their chosen platform, to agree that the data exchanged are safeguarded. Opens in a new window. Your healthcare provider can contact you over the phone or the computer while you continue to practice social distancing. Ensuring service parity and payment parity for telemedicine care as compared to in-person care, to help expand covered services for patients, and incentivize clinicians to provide this model of care, Ensuring patients can access telemedicine services from their homes (home as “originating site”), to further enable social distancing practices, Allowing use of audio-only phone for telemedicine visits, to help ensure access for patients who do not have live-video technology, Investing in telecommunications infrastructure for less-resourced sites of care, and ensuring internet access to patients in rural areas. Juliette Cubanski Follow @jcubanski on Twitter Many health systems encourage patients to shift to telehealth as a first choice to discuss possible symptoms, rather than going to the hospital emergency room. This requires they be licensed to practice across state lines. Many hospitals have instructed patients with suspected coronavirus symptoms or exposure to call their doctors or turn to telemedicine first, before showing up to the emergency room or urgent care visit. Changes to Medicare Advantage: Medicare Advantage plans have been able to offer additional telehealth benefits not covered by traditional Medicare and have flexibility to waive certain requirements with regard to coverage and cost sharing in cases of disaster or emergency, such as the COVID-19 outbreak. Serving local communities since 2015. Few states permitted “audio-only” telephone care to qualify as a telehealth service. With new telehealth flexibility and relaxation of privacy laws in response to COVID-19, some of these financial hurdles may be lessened. HIPAA), federal prescribing laws for controlled substances, grant funding for telehealth initiatives and Medicare coverage of telehealth. A recent poll found 23% of adults have used telehealth services in light of the COVID-19 pandemic. Prior analysis shows that the majority of large employer plans, including those that are self-insured, cover some telemedicine services. The federal government has focused on loosening restrictions on telehealth in the Medicare program, including allowing beneficiaries from any geographic location to access services from their homes. Telemedicine solutions may also be less feasible for seniors. Partner with First Choice Telehealth Solutions and watch your providers quickly transform patient care to a new level of performance. Amrutha Ramaswamy Follow @amrutha__ram on Twitter Medicare is also temporarily expanding the types of providers who may provide telehealth services. For customers who have saved our website as a “Favorite” or “Bookmark”, please update the settings. States are also using 1915(c) Appendix K waivers to enable the provision of home and community-based services (HCBS) remotely by telehealth for people with disabilities and/or long-term care needs. Almost all states are issuing emergency policies in response to the COVID-19 outbreak to make telehealth services more widely available in their Medicaid FFS programs and/or through Medicaid managed care plans. We are pleased to inform you that with effect from July 1, 2020, the ATH website address (URL) for First Choice users will be changed as follows. U0001:CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel. This may involve providing direct funding for health systems and smaller practices to implement telemedicine. The Federation of State Medical Boards is tracking these updates, and finds that currently 49 states have issued waivers regarding licensure requirements during the COVID-19 emergency. During the COVID-19 pandemic, there are multiple scenarios in which patients and providers are utilizing telemedicine to enable remote evaluations between a patient and a provider, while respecting social distancing. For Family Medicine, Primary Care and Behavioral Health, download tips for an Apple or Androiddevice. Hawaii is the only state to require malpractice carriers to offer telemedicine coverage, and insurance premiums may be higher if covering telemedicine. Prior to the start of the COVID-19 outbreak, more than 50 U.S. health systems already had telemedicine programs in place, including large health centers like Cleveland Clinic, Mount Sinai, Jefferson Health, Providence, and Kaiser Permanente. Read the complete guide including trust, advantages, benefits & types of telemedicine app “Tighter relationships between providers and employers reduce costs and improve outcomes, and as we transition from 2020 into 2021, FCH is developing new partnerships and products built around this concept.”. A Monument Health telemedicine visit is similar to an in-clinic appointment using videoconferencing. Since they already know your medical history, they’re a great first choice. difficulty breathing) or with complex comorbidities, evaluation from their home via telemedicine may not be appropriate, as in-person care intervention may be needed. Health systems will need to decide whether to invest in telemedicine infrastructure for long-term use, or if they are looking for shorter term, potentially cheaper, solutions solely to respond to this acute crisis. Many states are newly allowing FQHCs and RHCs to serve as distant site providers, and expanding which professions qualify as eligible to provide telehealth services through Medicaid. The federal government has taken actions to broaden and facilitate the use of telemedicine, particularly though Medicare. Your PCP should always be your first choice for care (both in-person and virtual visits). The Seattle-based healthcare company connects self-insured employers across the country with providers in … Many insurers are reducing or eliminating cost sharing for telemedicine, for a limited period of time. That has an impact on cost for people and their employers,” Okigwe said in a previous report. Telehealth Policy Before the COVID-19 Emergency: The use of telehealth in the Medicaid program has grown as states have sought to address barriers to care including insufficient provider supply (especially specialists), transportation barriers, and rural access challenges. 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