Whereas the elevated use of telehealth through the pandemic allowed many sufferers to keep up entry to care, reimbursement for a big portion of those visits might finish with the general public well being emergency, creating challenges for low-income sufferers who depend on such providers, in keeping with a brand new study from RAND.
The examine checked out information from billable outpatient main care and behavioral well being visits at 41 federally certified well being facilities that operated at 534 places in California from February 2019 to August 2020.
Throughout the pandemic, the FQHCs skilled a speedy enhance in telehealth utilization because the clinics substituted in-person look after video and phone visits.
For main care visits, 48.1% occurred in-person, 48.5% by way of phone and three.4% by way of video. Comparatively, for behavioral well being visits, 22.8% occurred in-person, 63.3% by way of phone and 13.9% by way of video.
Phone visits peaked in April 2020, comprising 65.4% of main care visits and 71.6% of behavioral well being visits, in keeping with the examine.
WHY THIS MATTERS
The Facilities for Medicare and Medicaid Providers defines telemedicine as “using interactive telecommunications gear that features, at a minimal, audio and video gear.”
Previous to the pandemic, CMS solely reimbursed for telehealth providers if each audio and video had been used. However with the onset of COVID-19, the company issued short-term flexibilities for suppliers to get reimbursed for each video and audio-only telehealth providers.
These flexibilities allowed hundreds of thousands of weak sufferers to proceed to obtain care through the pandemic – particularly those that obtained care at an FQHC, which supplies healthcare providers to individuals of all ages, no matter their capacity to pay or whether or not they have medical health insurance.
“Over 3 million beneficiaries have obtained telehealth providers by way of conventional phone,” mentioned former CMS Administrator Seema Verma in a Health Affairs blog. “Meaning practically one-third of beneficiaries that obtained a telemedicine service did so utilizing audio-only phone expertise.”
Regardless of that a good portion of telehealth visits through the pandemic had been performed over the telephone, CMS has signaled that it could cease reimbursing for audio-only visits when the general public well being emergency ends.
“Whereas we’re not proposing to proceed to acknowledge these codes for cost underneath the PFS within the absence of the PHE for the COVID-19 pandemic, the necessity for audio-only interactions might stay as beneficiaries proceed to attempt to keep away from sources of potential an infection, resembling a physician’s workplace,” the company mentioned in its 2021 Physician Fee Schedule fact sheet.
Eliminating protection for audio-only telemedicine visits would disproportionately affect underserved communities that will face boundaries to accessing video expertise, in keeping with Lori Uscher-Worth, the examine’s lead writer and a senior coverage researcher at RAND.
“Decrease-income sufferers might face distinctive boundaries to accessing video visits, whereas federally certified well being facilities might lack assets to develop the mandatory infrastructure to conduct video telehealth,” she mentioned. “These are necessary issues for policymakers if telehealth continues to be broadly embraced sooner or later.”
THE LARGER TREND
On the finish of 2020, Congressmen Jason Smith (R-MO) and Tony Cardenas (D-CA) launched the Permanency for Audio-Only Telehealth Act that might require CMS to proceed reimbursing suppliers for audio-only telehealth even after the general public well being emergency ends.
The American Psychological Affiliation is one in every of many organizations that assist the invoice.
“Permitting sufferers to obtain psychological well being providers by audio-only phone is a matter of well being fairness for underserved populations, and APA applauds this necessary equalizer,” mentioned APA CEO Arthur C. Evans Jr., PhD. “This invoice will enable sufferers to obtain providers at dwelling irrespective of the place they dwell − whether or not in rural, city or suburban communities.”
Even with out the invoice, HHS expects to increase the general public well being emergency by the tip of 2021, in keeping with a letter it lately despatched to governors.
Twitter: @HackettMallory
E mail the author: mhackett@himss.org
