Enhancing the Telehealth Footprint and Avoiding the Telehealth Cliff

It’s been a year since the outbreak of the COVID-19 pandemic and ever since – the healthcare industry will never be the same. In 2020 telehealth adoption soared and quickly became a footprint for delivering care. As we begin the shift to a post-pandemic era, will the telehealth footprint that opened the door to digital innovation continue to prevail or become just a memory?

Recent studies indicate physicians and consumers intend to use virtual care in both the short term and the foreseeable future. With more than half of consumers electing to use telehealth and a resounding 92% of providers continuing to offer video visits post-pandemic. Following this shift, CMS found that between mid-March and October of 2020, 24.5 million Medicare beneficiaries used virtual care.

We believe telehealth is here to stay, yet we are close to the cliff of spiraling downward where we will be making the benefit harder than it needs to be.  While we know that telemedicine can never replace in-person care, we need to look at defining what quality telehealth looks like and designing the benefit properly to secure its use as a seamless integration into value-based care. Especially now that telehealth is a powerful clinical tool expanding access to care and choices for Americans. 

Telehealth Legislation

In January 2021, a bipartisan group of U.S. representatives re-introduced a bill aimed at expanding access to telehealth beyond the pandemic – the Protecting Access to Post-COVID19 Telehealth Act of 2021. This bill would: 

  • Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establish the patient’s home as an eligible distant site.
  • Authorize CMS to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency (PHE).
  • Make permanent the disaster waiver authority, enabling the U.S. Department of Health and Human Services (HHS) to expand telehealth in Medicare during all future emergencies and disasters.
  • Require a study on the use of telehealth during COVID, including its costs, uptake rates, measurable health outcomes and racial and geographic disparities.

This bill addresses most of the priorities listed in a letter to Congress by the American Telemed Organization (ATA) and 339 other healthcare organizations.  As it stands, it has yet to move to the House and Senate.

In June of this year, the Federal Communications Commission (FCC) awarded $31 million in funding to 32 healthcare organizations as part of its $100 million Connected Care Pilot Program. The program covers 85% of the eligible costs necessary to provide telehealth services to low-income and veteran patients. To date, the program has awarded more than $57 million to 59 projects in 30+ states with awarded projects addressing critical health issues such as maternal health, chronic disease, mental health conditions and opioid dependency.

With state of emergency declarations expiring or being lifted, there is great concern that patients will be left with reduced access without permanent telehealth policy changes. On July 26th, a letter was submitted to Congress on behalf of over 400 organizations, urging the need to make regulatory flexibilities granted by Congress permanent.  Critical areas addressed include:

  • Removing the obsolete restriction of geographic limitation on originating sites and allowing beneficiaries to receive virtual care in their homes.
  • Ensuring that HHS and CMS maintain the authority to add/remove eligible telehealth services via a predictable regulatory process that gives patients and providers transparency and clarity.
  • Ensuring Federally Qualified Health Centers (FQHCs), Critical Access Hospitals (CAHs), and Rural Health Clinic (RHCs) can offer virtual services post-COVID and provide appropriate reimbursement.
  • Rejecting arbitrary restrictions that would require an in-person visit prior to a telehealth visit for mental health services.

From a legislative front, more than 300 bills have been introduced nationwide regarding telehealth policies.  The telehealth legislative footprint is definitely here to stay, but challenges remain such as patient and provider access regardless of geographic location, provider reimbursements, cross-state licensing barriers, payment parity and multi-channel telemedicine delivery.

Transforming Care Delivery

The consumer-provider relationships remain vital and for an effective telehealth model, it is important to establish a seamless holistic continuum of care.  An array of healthcare stakeholders, from payers to providers to drug developers are increasingly joining forces to expand access to telehealth. In CB Insights report, more than 80 companies have moved forward with the vision of transforming care delivery.  At Emids, we call these vision drivers. These drivers demonstrate the expanding breadth of services that telehealth technology can provide and that stakeholders need to enhance in their virtual care journey.  We provide strategic, operational and/or technical expertise and partner with our clients to help them build an effective telehealth model. The drivers we work through are to:

  • Improve the consumer and provider experience: Having seamless care coordination regardless of the care setting (outpatient, inpatient, home) with enhanced automated processes to foster positive consumer perception and continuous training/education. 
  • Leverage technology: Integrating platforms and reducing provider burn-out by automating processes, providing asynchronous and synchronous modalities while installing technical safeguards. It also means having the right data assets to provide meaningful insights to the organization, and ultimately the provider and consumer.
  • Optimize communication: Providing mechanisms for all stakeholders to connect, updating policies to include patient safety and quality components related to virtual/telehealth, and developing real-time analytics to gauge consumer and provider satisfaction.
  • Manage Reimbursement: Incorporating reimbursement models to promote virtual care adoption and ways to easily capture billing codes for faster reimbursement.

The next phase of telehealth is already in progress, shifting to the hospital at home, telehealth automation, enhanced remote patient monitoring and melding into value-based care programs. Telehealth has become embedded in care practices, consumers’ lifestyles and has eased the burden of providing and receiving care. Private payers are on a trajectory to continue addressing disparities in care by enabling virtual care policies that support providers and patients, with CMS continuing to introduce legislation. But if that isn’t convincing enough, perhaps seeing how tech giants like Amazon are expanding telehealth services nationwide will make us realize that it is the right thing to do and that the telehealth footprint is most definitely here to stay.

Download our 2021 Outlook Report for more on this and understanding how leveraging digital tools, operational changes and collaboration with new entities is fundamental to transforming care services and improving clinical outcomes.

About the Author

Sophia Batallas, MSN, RN, is a Principal with Emids.  She has over 25 years of experience working in large healthcare systems, healthcare IT consulting, and is a highly resourceful leader that serves as a change agent to promote clinician adoption of new technology and possesses the ability to translate multifaceted processes and regulations into successful strategic roadmaps for systems and stakeholders. One of Sophia’s biggest passions is the ability to effectively guide leaders and mentor new hires in looking at technology as a way to not only improve the consumer and provider experience, but to enhance clinical outcomes and operational processes.

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