Updated Version of CONNECT for Health Act Introduced in Congress Center for Connected Health Policy May 4, 2021 Last week an updated version of the CONNECT for Health Act was introduced in Congress. Last week an updated version of the CONNECT for Health Act was introduced in Congress. The bill, which was first introduced in 2016 but has been repurposed in this newest version to remove restrictions on telehealth for mental health, stroke care and home dialysis in certain circumstances. It also addresses several of the restrictions in Medicare, including geographic limitations, expanding originating sites to include the home, restrictions on federally qualified health centers (FQHCs) and rural health clinics (RHCs) reimbursement and gives the Secretary of Health and Human Services the ability to waive other telehealth restrictions permanently. For more information, see the press release, or read the bill’s summary published by Senator Schatz office. Stay tuned for a deeper dive and further analysis from CCHP next week. Press Release: https://www.schatz.senate.gov/press-releases/schatz-wicker-lead-bipartisan-group-of-50-senators-in-reintroducing-legislation-to-expand-telehealth-access-make-permanent-telehealth-flexibilities-available-during-covid-19-pandemic Summary: https://www.schatz.senate.gov/imo/media/doc/CONNECT%20for%20Health%20Act%20of%202021_Summary.pdf < Previous News Next News >

Telehealth Requires Efforts to Improve Access to Reach Full Potential Mark Melchionna November 29, 2022 New research found that telehealth expansion lacks benefits when efforts to improve access are not present, which may often lead to health disparities. Regions with limited healthcare resources may not benefit from telehealth expansion, prompting the need for efforts to improve access, a new JAMA Network Open study finds. Throughout the recent expansion of telehealth, researchers continuously gained insight into new methods for reaching areas with limited amounts of healthcare resources, highlighting many areas and populations facing limited healthcare resources. The fact and theories about the relationship between telehealth and health disparities led researchers to conduct a cross-sectional study containing 2015 to 2019 American Community Survey data which was linked to national, state, and county-level metrics of healthcare access. Prior to the study, the authors hypothesized that internet access was poor in areas that lacked sufficient access to traditional healthcare resources. Known as healthcare deserts, communities with limited healthcare services such as pharmacies, hospitals, PCPs, and low-cost health centers were reviewed for the study. The data sources included dataQ and GoodRx databases for 60,249 pharmacies, federal information on primary care health professional shortage areas, and geospatial information. Researchers calculated the proportion of populations with internet access and the expected number of healthcare deserts, which represented the population-weighted mean number of deserts in a given region. They also noted statistics for metropolitan status for each state. Among 3,140 counties reviewed in the study, researchers determined that healthcare access and internet service availability corresponded with one another. They found that the states with the largest percentage of households without internet service were Mississippi, Arkansas, Louisiana, New Mexico, West Virginia, and Alabama. The states with the lowest number of households without internet service and the lowest fitted number of healthcare deserts were Washington, New Hampshire, Colorado, Utah, California, and Maryland. Rural areas were more likely to have more health deserts and less internet service availability —78 percent compared to 26 percent of urban counties. Based on these findings, researchers concluded that telehealth expansion may not produce benefits within counties where telehealth is highly needed. Key factors that contribute to rural-urban health disparities in the US may include telehealth expansion without improving internet access as well as clinician shortages. Despite this conclusion, researchers noted limitations, which mainly related to the lack of digital literacy data that may have increased urban-rural disparities, along with the co-occurrence of poor internet and healthcare access across six domains. Previously, however, efforts have been made to support rural communities in obtaining telehealth resources. In September, Equum Medical worked with the National Rural Health Association to provide underserved rural communities with virtual resources. The goal of the collaboration was to assist rural hospitals as they aim to fill gaps in specialty care through tools such as of patient transfer assistance, remote patient monitoring, and help with telehealth implementation. See original article: https://mhealthintelligence.com/news/telehealth-requires-efforts-to-improve-access-to-reach-full-potential < Previous News Next News >

HHS to put $35M toward telehealth for family planning Kat Jercich November 29, 2021 The agency plans to use the funds to award about 60 one-time grants to Title X family planning providers, who must apply by February of next year. The U.S. Department of Health and Human Services announced that it would make $35 million in American Rescue Plan funding available for Title X family planning providers to strengthen their telehealth infrastructure and capacity. Title X family planning clinics help to insure access to a broad range of reproductive health services for low-income or uninsured individuals. "I’ve seen first-hand the critical role that telehealth plays in serving communities, particularly to protect so many families from COVID-19," said HHS Secretary Xavier Becerra in a statement about the grant availability. "As providers transitioned from providing in-person primary care to offering telehealth services, we were able to test, vaccinate, and act as lifelines to communities disproportionately hit by the pandemic," he said. "Increasing our investment and access to telehealth services remains critical." WHY IT MATTERS The Office of Population Affairs funds 71 Title X family planning service grantees and supports hundreds of subrecipients and thousands of service sites around the country. Family planning includes a broad range of services related to reproductive health, including contraception, sexually transmitted infections and pregnancy testing. Although abortion care can be co-located with family planning services, Title X funds cannot be used to pay for it. Although some services require in-person treatment and exams, others can be carried out via telehealth – as evidenced by grantees' use of virtual care to help their patients during the COVID-19 crisis. Still, facilities may not have adequate technology available. "During the global COVID-19 pandemic, family planning programs have accelerated the use of telehealth," said Dr. Rachel Levine, assistant secretary for health, in a statement. "These ARP funds will facilitate the delivery of quality family planning services and reduce access barriers for people living in America who rely on the health care safety net for services," she added. HHS plans to use the funds to award about 60 one-time grants to active Title X grantees. Organizations must apply by February 3, 2022, and notices of awards will be announced before the project start date of May 1, 2022. THE LARGER TREND Even as the government has moved to shore up telehealth infrastructure via funding, the question of virtual care's future continues to hang over Congress. Despite requests from hundreds of advocacy organizations, legislators have so far failed to take action to permanently safeguard telehealth after the end of the COVID-19 public health emergency – what some activists have referred to as "the telehealth cliff." "We recognize there are many unknowns related to the trajectory of the COVID-19 pandemic over the next 12 to 24 months," said American Telemedicine Association CEO Ann Mond Johnson in October. "However, we implore Secretary Becerra to provide as much predictability and certainty as possible to ensure adequate warning before patients are pushed over this looming cliff." ON THE RECORD "The pandemic has laid bare the important role that telehealth can play in our nation’s healthcare service delivery, and we are profoundly grateful for the opportunity to support continued investments in telehealth for the nation’s family planning safety net," said Jessica Swafford Marcella, HHS deputy assistant secretary for population affairs, in a statement. < Previous News Next News >

Healthcare Breaches: 40.7 Million Patients Affected By Dr. Maheu April 5, 2021 There were 758 breaches publicly posted to the Department of Health and Human Services (HHS) breach portal in 2020, affecting 40.7 million patients. However, the breaches listed on the HHS breach portal only reflect breaches affecting 500 or more patients, making it likely that the number of breaches was much higher. Each year Protenus, along with databreaches.net, conducts a breach report to assess the state of healthcare cybersecurity. Their 2021 Breach Barometer examined healthcare breaches occurring in 2020 and compared the findings to 2019 breaches. Read more about previous healthcare breaches on TBHI blogs: Healthcare Data Breach compromised 295,617 patients, Major Healthcare Hack Targets Mental Health Provider and Healthcare Breach: Email Breach Affects Behavioral Health Organization. More details on healthcare breaches, hacking incidents, insider breaches of 2020 are discussed below. Healthcare Breaches in 2020 There were 758 breaches publicly posted to the Department of Health and Human Services (HHS) breach portal in 2020, affecting 40.7 million patients. However, the breaches listed on the HHS breach portal only reflect breaches affecting 500 or more patients, making it likely that the number of breaches was much higher. Through their analysis of 2020 breaches, Protenus determined a 30% increase in healthcare breaches compared to 2019. Hacking Incidents in 2020 The leading cause of 2020 healthcare breaches resulted from hacking incidents representing 62% of reported incidents, with a 42% increase in these types of incidents from the previous year. The 277 hacking incidents compromised the protected health information (PHI) of more than 31 million patients. Part of the reason hacking skyrocketed in the healthcare sector is due to hackers exploiting the COVID pandemic, in some cases posing as government agencies to gain access to sensitive information. The issue was a major cause for concern, with the FBI and HHS warning healthcare organizations against “an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.” Researchers stated, “By making investments to protect patients, health systems, in turn, protect themselves from severe reputational damage, financial penalties, or care disruptions stemming from hacking incidents. Under obligation to do no harm, healthcare organizations must adopt advanced tools capable of preventing hacks and their frightening consequences for patients.” Insider Breaches in 2020 The second most common cause behind healthcare breaches in 2020 was insider breaches. Insider breaches occur when an employee of a healthcare organization accesses PHI without cause. Insider breaches represented 20% of reported incidents, with 111 incidents of insider breaches compromising the PHI of 8.5 million patients. “A zero-tolerance stance on snooping is important, but it will never be enough to prevent innocent mistakes or nefarious hackers,” researchers wrote. “Only by using compliance analytics to calculate the risk score of any anomalous access can organizations surface and prioritize interactions with data that truly warrant attention…. Noncompliance is critically important to identify and prevent, especially when organizations are struggling financially. Compliance incidents are costly because of all that goes into reconciling them. On top of paying penalties, health systems must do damage control,” they added. HIPAA Resources Need assistance with HIPAA compliance? Compliancy Group can help! They help you achieve HIPAA compliance, with Compliance Coaches® guiding you through the entire process. Find out more about the HIPAA Seal of Compliance® and Compliancy Group. Get HIPAA compliant today! Link: https://telehealth.org/healthcare-breaches-2/?utm_source=ActiveCampaign&utm_medium=email&utm_content=New+COVID-19+FCC+Telehealth+Grant+%7C+TBHI+Telehealth+News+4%2F14%2F21&utm_campaign=April+13th+Newsletter&vgo_ee=L60XUD6gIFzXzaAzbkkf6r35hO7C%2FF3J%2FgQB9Uu3XAY%3D < Previous News Next News >

Leveraging Telehealth Platforms to Enhance Provider Workflows, Adoption eVisit December 28, 2022 Implementing a telehealth platform can positively impact provider workflows in numerous ways, including easing administrative burdens, thereby leading to greater provider adoption and satisfaction. The pandemic drove telehealth use to new heights. Even though usage appears to be stabilizing, healthcare stakeholders largely agree that telehealth is here to stay, and they are making virtual care a vital part of their care delivery model. Polls conducted by the American Medical Association show that 80 percent of physicians said they were using telehealth tools in 2022, up from 28 percent in 2019 and only 14 percent in 2016. Further, in 2022, about 75 percent of physicians said being able to offer remote care was an important reason to use digital health tools, up from 60 percent in 2016. From the patient perspective, the benefits of telehealth, such as improved healthcare quality and patient experience, have become increasingly apparent. Epic conducted a research study analyzing 35 million telehealth visits between March 1, 2020, and May 31, 2022. They found that "in nearly every specialty studied, most patients who had a telehealth visit did not require an in-person follow-up appointment in that specialty in the next three months." Only two of the 31 specialties — fertility and obstetrics — saw in-person follow-up rates above 50 percent, while genetics, nutrition, endocrinology, and mental health/psychiatry had in-person follow-up rates of 15 percent or less. But, as telehealth is integrated alongside in-person care, provider organizations must ensure they are selecting the right platform for their facility's unique needs and implementing them in a way that addresses — rather than adds to — clinician workflow challenges. KEY TELEHEALTH CAPABILITIES TO IMPROVE PROVIDER WORKFLOWS Amid the rapid rise in the adoption and use of telehealth during the pandemic, providers have faced several challenges in setting up telehealth programs. One of the most significant difficulties is related to the technology available, notes Eric Thrailkill, Venture Partner, Founder of the Telehealth Academy, and Chairman of Project Healthcare at the Nashville Entrepreneur Center. "While these solutions 'worked' per se, they were not designed to help health systems facilitate a hybrid care model with a goal to provide personalized care, regardless of location," he says. "During the shutdowns, almost all provider organizations were completely dedicated to supporting COVID-related patients and/or working through the backlog of previously scheduled appointments. Telehealth, due to the relaxation of certain federal and state regulatory requirements, consisted of phone-based services and two-way video technologies — speed to deploy was the operating mantra." Provider organizations succeeded in rapidly deploying new technologies, but they did not have time to optimize their workflows to account for certain processes — like documentation and revenue cycle — and support overarching population health and chronic care goals. During the pandemic, 'offering telehealth' could simply mean offering a two-way video solution. But now, with a couple of years of experience and data to pull from, providers are able to build robust telehealth programs to pair with in-person care. In short, a telehealth program looks at creating both a personal and efficient experience for the provider and patient before, during, and after the visit. Two-way video technology is just one piece of the puzzle. "Telehealth platforms should contain a virtual triage where location and assignment of a provider could occur," Thrailkill says. "This would also enable an appropriate assessment to ensure higher acuity visits are prioritized over lower acuity visits." For effective triage, relevant care teams must be able to easily coordinate their team and the patients in the virtual waiting room, chat with the patient ahead of, during, and post-visit, access the appointment, and interact with the patients while accurately documenting the encounter in their EHR and scheduling follow-up appointments. The digital experience should be smooth and the UI/UX strong to support adoption and satisfaction. Anything captured by the telehealth platform, say an image or an attachment, must have bidirectional clinical data flows enabled with the EHR to ensure the complete patient picture is captured for the patient's health record and billing and reporting purposes. Additionally, Thrailkill notes that as provider organizations become increasingly focused on addressing social determinants of health needs, they should consider telehealth platforms that can ingest data from multiple sources. Having this data at their fingertips at the point of care can help clinicians provide wraparound care services, including connecting patients with social services and community resources. Not only is a platform's ability to gather data from various sources essential to the success of hybrid care models, but so is seamless data exchange, which helps ensure continuity of care. "Continuity of care is the set of processes whereby the patient and his/her physician-led care team are involved and cooperating over time to achieve the highest level of quality of care," Thrailkill says. "This is difficult, if not impossible, given the fragmentation and healthcare data silos that exist today — both outside and inside provider organizations and health systems." Thus, telehealth platforms should have integration capabilities that provide clinicians with data from prior visits and information from facilities outside the organization where the patient has received care. But Thrailkill also cautions that providers should keep in mind patient rights regarding consent, privacy, and security when developing hybrid care models that leverage telehealth. IMPROVING WORKFLOWS ENHANCES PROVIDER SATISFACTION Selecting the right platform can help healthcare organizations optimize provider workflows, thereby boosting provider adoption and satisfaction. Providers at every level want to practice at "the top of their license," that is, utilize the highest level of their education and experience to deliver care, Thrailkill notes. For physicians, the health system's most expensive clinician, tasks like documentation and prior authorization processes can get in the way of this goal. Prior authorization, in particular, is a critical pain point, as some healthcare payers have complex processes that require much time and effort. "All of these administrative burdens are no doubt contributing to workforce challenges present today across essentially every professional level," Thrailkill says. But by using telehealth platforms with integration capabilities and Fast Healthcare Interoperability Resources (FHIR)-based application programming interface structures, provider organizations can reduce administrative burdens like prior authorization processes through automation and enable them to lean on their medical assistants during the triage process of the telehealth visit. This increases the time available for patient care and optimizes capacity for the clinical team, he adds. Further, when implementing telehealth into hybrid care models, healthcare organizations should take a long-term view rather than regard telemedicine as a replacement for in-person care. "This will challenge the organization to think about the role of medical assistants, nurses, and specialty consult providers — not as follow-on activity, but incorporated into the visit," Thrailkill says. "This will ultimately lead to operational efficiencies and reduce the amount of administrative burden existing in early deployments of telehealth." As noted above, reducing administrative burdens and improving care delivery processes can lead to higher provider satisfaction, engagement levels, and adoption of virtual care across the health system. Incorporating telehealth is not a passing phase, and demand will likely grow in the years ahead. But to ensure its success, provider organizations must select technology that enhances provider workflows, thereby improving satisfaction and adoption. About eVisit eVisit is an enterprise virtual care delivery platform built for health systems and hospitals. It delivers innovative virtual experiences in care navigation, care delivery, and care engagement, improving margins at scale without sacrificing quality or patient and provider satisfaction. eVisit works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue. Based in Phoenix, Ariz., eVisit helps healthcare organizations innovate and succeed in today’s changing healthcare market. See original article: https://mhealthintelligence.com/news/leveraging-telehealth-platforms-to-enhance-provider-workflows-adoption < Previous News Next News >

Finding Our Way Out of the Pandemic Haze: What Telehealth Tools Are Medicare Providers Allowed to Keep, and Which Must They Leave Behind? Amy J. Dilcher, Kara Du November 30, 2022 During the COVID-19 pandemic, Medicare coverage expanded to include a vast arsenal of tools that help patients access medical services while keeping patients and practitioners safe. Many of these tools involve telehealth services and were made possible by the COVID-19 emergency blanket waivers, which went into effect when the U.S. Department of Health & Human Services (“HHS”) declared a Public Health Emergency (the “PHE”). Some of these tools: Permitted providers to furnish distant site telehealth services; Expanded the use of audio-only telehealth to behavioral health counseling services; and Facilitated the conducting of telehealth appointments by practitioners from their homes while billing from their currently enrolled locations. As a result of these efforts, the use of telehealth and telemedicine exploded in 2020 according to an HHS Study. This growth was no surprise given the unparalleled advantages of conducting a variety of medical appointments from remote locations in a time where limiting one’s exposure to the COVID-19 virus was paramount. Despite the current trend towards relaxing previously stringent regulations on exposure and contact, many providers and patients prefer telehealth services as the primary method of treatment. This post provides an overview of recent developments in the adoption of telehealth tools by providers, the status of Medicare coverage for telemedicine services, the regulatory vision for the ascent out of the PHE, and fraud, waste and abuse considerations as we begin to make our way out of the pandemic haze. When does the PHE current expire? The blanket waivers that expand Medicare coverage of certain telehealth technology are in effect so long as the Secretary of HHS has declared a COVID-19 public health emergency. The first PHE was declared in 2020 and has been renewed every 90 days since then. The latest HHS extension for the PHE is effective through January 11, 2023. The PHE status is very likely to continue to be extended beyond next January given a possible surge in COVID-19 infections in the United States this winter, according to two Biden administration officials. Moreover, in a letter to the state governors, HHS has indicated that they will provide at least a 60-day notice before the current PHE ends (i.e., on or before November 11, 2022) in the event that it does not intend to issue an extension. To date, the agency has not provided that notice. Updates on the status of HHS declarations of public health emergencies are available via the federal government’s PHE tracker. Adoption of Telehealth Tools by Providers Looking towards the future, many providers anticipate keeping some COVID era telehealth tools in their arsenal after the PHE has ended. According to a recent study by the American Medical Association, tele-visit tools ranked highest in provider enthusiasm, provider adoption and improved patient outcomes in comparison to other digital health tools. The vast majority of physicians who have not yet incorporated these tools are seeking to utilize them in the next three years. The Regulatory Vision For the Ascent Out of the PHE CMS has outlined their strategy for assessing which blanket waivers should stay in effect after the last PHE extension expires. The strategy consists of three concurrent phases: Phase1: Evaluating blanket waivers based on the current stage of the PHE as compared to when the waivers were first issued. Phase 2: Keeping tools in place which would be the most helpful in future PHEs, to ensure a rapid response both locally and nationally. Phase 3: Continuing coverage of flexibilities that are aimed at producing high-quality care and health equity. CMS is working with the healthcare industry to holistically prepare our health care system for future PHEs. Medicare Coverage in Advance of Expiration of the PHE Effective as of January 1, 2022, CMS finalized a rule as part of the FY22 Medicare Physician Fee Schedule that expanded Medicare coverage of telehealth for behavioral health services to facilitate greater access and equitable services for those who may not have access to mental health services providers. Most recently, on November 1, 2022, CMS issued the Medicare Physician Fee Schedule (MPFS) 2023 Final Rule (the “2023 Final Rule”), which includes policy revisions and guidance regarding Medicare telehealth services. For example, several services that are temporarily available as telehealth services for the PHE were made available through CY 2023 in order to allow additional time for the collection of data that may support their inclusion as permanent additions to the Medicare Telehealth Services List. CMS also confirmed its intention to implement provisions such as allowing telehealth services to be furnished in any geographic area and in any originating site setting via program instruction or other sub-regulatory guidance to ensure a smooth transition after the end of the PHE. Proposed Legislation to Continue and Expand Medicare Coverage of Telehealth Services The American Hospital Association is one of many groups that urged Congress to expand and make permanent the regulatory flexibilities granted to Medicare telehealth services during the PHE. This strong support in favor of extending and expanding Medicare coverage of telehealth flexibilities was repeated again in a letter sent by 375 organizations to Senate leaders on September 13, 2022. The letter indicates several specific telehealth tools, such as lifting in-person requirements for tele-mental health and waiver of location limitations, that have been among the most integral to bringing needed care to patients in the age of technology. To that end, there are currently several bills in the Senate and House, which would codify much of the progress in telehealth service coverage that providers and industry organizations are seeking. In the Senate, the Telehealth Extension and Evaluation Act was introduced in February of 2022. The bill proposes an extension of and modification to Medicare coverage of four specific telehealth tools. This expansion would continue for two years after the PHE expires. Representatives in the House introduced the Ensuring Telehealth Expansion Act of 2021 in January of 2021. This bill would make Medicare coverage of telehealth flexibilities permanent outside of the PHE. Recently, the Advancing Telehealth Beyond COVID-19 Act of 2022 was passed by the House and is now being reviewed by the Senate. This bill modifies the extension of certain Medicare telehealth flexibilities and provides that some of them continue to apply until December 31, 2024, in the event that the PHE ends before that date. For example, the bill allows beneficiaries to continue to receive telehealth services at any site, regardless of type or location (e.g., the beneficiary’s home), occupational therapists, physical therapists, speech-language pathologists, and audiologists to continue to furnish telehealth services, and federally qualified health centers and rural health clinics to continue to serve as the distant site (i.e., the location of the health care practitioner) for telehealth services. Fraud, Waste and Abuse of Telehealth Services The COVID-19 emergency blanket waivers have been a useful tool for healthcare providers, but the expansion of Medicare coverage of telehealth during the PHE has also presented the opportunity for fraud, waste and abuse. In a recent report (the “Report”) the HHS Office of the Inspector General (“OIG”), identified 1,714 out of 742,000 providers as “high risk” for fraud, waste, or abuse with respect to their billing practices for telehealth services. OIG identified several billing practices that may be indicative of providers it considers to be “high risk” of engaging in Medicare fraud, waste or abuse: Facility fees and telehealth fees are billed for the same visit; The highest, most expensive level of telehealth services is billed every time; Telehealth services are billed for a high number of days in any given year; Medicare fee-for-service and a Medicare Advantage plan are billed for the same service for a high proportion of services; A high average number of hours of telehealth services are billed per visit; Telehealth services are billed for a high number of beneficiaries; and Telehealth services and ordering medical equipment are billed for a high proportion of beneficiaries. Although the “high risk” providers submitted only a small percentage of the total number of claims for telehealth services, the amount of claims associated with these providers represented $127.7 million in Medicare fee-for-service payments. The Report also found that over half of the “high risk” providers were connected with at least one other “high risk” provider. The OIG provided several recommendations to CMS: Strengthen monitoring and targeted oversight of telehealth services; Conduct additional education outreach to providers including training sessions, educational materials, and webinars on appropriate telehealth billing practices; Establish billing modifiers to help providers identify circumstances in which non-physician clinical staff primarily render telehealth services under the supervision of a physician; Identify telehealth companies that bill Medicare by updating the Medicare provider enrollment application or working with the National Uniform Claim Committee to add a taxonomy code that identifies telehealth companies; and Conduct targeted reviews of the “high risk” providers identified in the Report. Final Thoughts The importance of telehealth services cannot be understated. Under the current PHE, providers have had the opportunity to deploy these tools in the emergency context, and at the same time have been able to demonstrate their efficacy and reliability in providing quality medical care to patients who would not otherwise have access to either because of coverage or geographic limitations. Nevertheless, given the rapid growth of the industry in recent years and the amount of Medicare dollars spent on telehealth services, it is prudent for healthcare providers to proactively review their telehealth billing practices and supporting documentation. Doing so will reduce the potential for billing errors and minimize compliance risks while improving quality control and financially protecting their organizations. See original article: https://www.natlawreview.com/article/finding-our-way-out-pandemic-haze-what-telehealth-tools-are-medicare-providers < Previous News Next News >

Telehealth now serves unmet needs, says athenahealth Andrea Fox October 04, 2022 Virtual care is playing a more significant role in filling gaps in delivery, having evolved from pandemic-era visit replacement, according to a new study from the cloud IT developer. Increased telehealth utilization points to wider use as a diagnostic and triage tool, particularly among those with chronic conditions. WHY IT MATTERS New research, based on a Dynata survey of 2,000 U.S. adults that was commissioned by athenahealth conducted in June and July of this year, and data on booked and completed appointments through the athenahealth electronic health record suggest telehealth is now integrated across the care continuum. "Our data shows that after the height of the pandemic, many physicians continue to rely on telehealth, as they see the tremendous value it can provide," said Jessica Sweeney-Platt, vice president of research and editorial strategy at athenahealth, in a statement. The use of telehealth is especially evident among those with chronic conditions. While 24% of those surveyed say their health concern didn't warrant an in-person visit, 23% of respondents indicated their telehealth visits were scheduled check-ins related to chronic conditions, and 9% used telehealth as well for ad hoc care for their conditions. The respondents with chronic conditions reported using telehealth in place of as well as between visits to help manage their conditions, suggesting telehealth is serving a previously unmet need for proactive healthcare. Telehealth has also increased the willingness of patients to seek mental healthcare, with 25% of survey respondents indicating they opted for telehealth sessions to address new mental health conditions. Twenty-three percent shared that they were more likely to ask for mental health support because telehealth was available to them. The findings also revealed patterns of use based on gender and race. The EHR data from January 1, 2019, through April 30, 2022, evaluated in the study showed that in 2021, male providers had 24% lower odds of providing a telehealth visit than their female counterparts. Provider gender also affected patient adoption of telehealth. Patients who worked with a single male provider had 60% lower odds of adoption compared to patients with only a female provider. "Additionally, previous research has shown that female clinicians tend to spend more time with patients, which could further explain higher provider adoption of telehealth among females compared to males, with female providers using telehealth as an additional tool for connecting with patients," said Sweeney-Platt. The research also showed Black and Hispanic patients were more likely to use telehealth services, but less likely to do so with one dedicated provider, suggesting improved access to care but not improved continuity of care. THE LARGER TREND A previous study of 40.7 million commercially-insured adults in the United States – a study of a nationally representative population – published earlier this year found that patients with acute clinical conditions who first sought care via telehealth were more likely to follow up at the emergency room or be admitted to the hospital that those who sought care in person. However, when it came to chronic conditions, follow-up was less likely for those with an initial telehealth visit, finding telehealth comparable to in-person care. The researchers from Johns Hopkins Bloomberg School of Public Health, along with collaborators from Blue Health Intelligence and the Digital Medicine Society compared telehealth and in-person encounters by looking at factors associated with changing patterns of telehealth use beyond the initial months of the pandemic. ON THE RECORD "Our research brings to light the vital role telehealth can play in patient care. Not only does it increase access to care, but it can drive better patient outcomes when used as an extension of in-person visits to provide continuity of care," said Sweeney-Platt in announcing the findings. "Telehealth is now a core tenet of healthcare delivery in the U.S.," said Greg Carey, director of regulatory and government affairs at athenahealth, according to a prepared statement about telehealth fulfilling its promise on the company's website. Correction: The original version of the article indicated that the Dynata survey was of athenaOne network patients. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication. See original article: https://www.healthcareitnews.com/news/telehealth-now-serves-unmet-needs-says-athenahealth < Previous News Next News >

Telemedicine boosts access, decreases inequities in Montana Bill Siwicki October 10, 2022 The University of Montana College of Health has expanded its telehealth offerings across many disciplines to reach more people, especially in tribal communities. Montana has unique challenges in providing healthcare to its widely dispersed population of just over 1 million people. THE PROBLEM Out of 56 counties in Montana, 55 are designated as Health Professional Shortage Areas (HPSAs), limiting access to both urgent and routine medical visits. The cost of travel and long distances between healthcare providers and patients are commonly cited reasons for patients to delay or avoid medical care. The use of telehealth technology can improve healthcare access for Montanans living in rural and tribal communities by providing access to primary care and specialty services. Montana also is home to a significant Native American population, which makes up about 7% of residents. Tribal members experience significant health disparities due partly to inequitable healthcare access. "These pre-existing strains have left many rural and tribal communities particularly vulnerable to broad-reaching impacts of the COVID-19 pandemic," said Erica Woodahl, director of the L.S. Skaggs Institute for Health Innovation and a professor at the Skaggs School of Pharmacy at the University of Montana. "Rural and tribal populations have a higher burden of chronic disease and comorbidities known to increase the risk of morbidity and mortality associated with COVID-19," she continued. "Life expectancy of all Americans has decreased during the two years since the pandemic, but no group more than tribal people whose life expectancy has dropped almost seven years." The pandemic also further reduced access to routine care leading to an increase in preventable complications due to chronic conditions, including emergency room visits, hospitalizations and overall healthcare costs, she added. "Additionally, communities without nearby clinics or hospitals have not had adequate access to coronavirus testing or care, leaving rural and tribal patients vulnerable to the spread of COVID-19," she noted. "This increases pre-existing strains on rural healthcare systems due to provider shortages, limited hospital beds and other resource constraints." PROPOSAL In the telemedicine work of the University of Montana College of Health in Missoula, services would be provided through a centralized hub at the university with synchronous and asynchronous telehealth services provided to rural and tribal communities in partnership with clinics, hospitals and pharmacies across the state. The equipment purchased with help from a grant from the FCC telehealth grant program would allow for the expansion of services within UM's College of Health. "While the initial utility of telehealth technologies to improve care for underserved populations focused on immediate provision of clinical services disrupted by the COVID-19 pandemic, benefits to patients will extend beyond the pandemic to address the challenges of providing healthcare to Montanans," explained Shayna Killam, PharmD, a postdoctoral fellow at the Skaggs School of Pharmacy at the University of Montana. "Telehealth technologies provide clinicians with the tools necessary to bridge the gap in healthcare access and offer quality healthcare to Montana patients," she continued. "Services will specifically target patients living in rural and tribal communities with chronic medical conditions and comorbidities." The organization anticipates a broad reach across Montana, leveraging partnerships with clinical training sites and clinical affiliates to provide centralized telehealth services to a wide range of patients. "Programs in UM's College of Health were awarded $684,593 from the FCC," Killam reported. "Funds were used to purchase telehealth equipment and connected medical devices, providing critical and remote services for patients in Montana." Telehealth equipment will be used by faculty, residents and students affiliated with the University of Montana College of Health. Recipients of funding include the following: Skaggs School of Pharmacy (SSOP). Family Medicine Residency of Western Montana (FMRWM). School of Physical Therapy and Rehabilitation Science (UMPT). School of Speech, Language, Hearing and Occupational Sciences (SLHOS). MARKETPLACE There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News published a special report highlighting many of these vendors with detailed descriptions of their products. Click here to read the special report. MEETING THE CHALLENGE Pharmacist-driven programs provide services for community-based chronic disease screening, education and management, including management of diabetes, asthma, cardiovascular risk and mental health through point-of-care testing, medication therapy management visits and consultations with telehealth pharmacists. "Connected medical devices and video conferencing hardware will be used to provide routine and urgent care visits with medical residents and providers affiliated with the FMRWM, including diagnostics and monitoring, chronic disease management, prenatal care and mental health services," Woodahl said. "UMPT programs offer home-based visits and services in end-user sites in rural and tribal communities, including remote evaluations enhanced with telehealth technology, such as vestibular function testing and gait monitoring devices, telepresence robots, and video consults with patients and other healthcare professionals," she added. Clinicians and students in SLHOS will conduct telehealth visits via high-quality video and audio equipment, which facilitate effective evaluation and treatment for articulation and voice disorders. USING FCC AWARD FUNDS The University of Montana College of Health was awarded $684,593 from the FCC telehealth grant fund to purchase telemedicine kits to enable critical, remote telehealth services and to provide internet-connected devices for remote patient monitoring services for underserved, rural and tribal populations within the state. "UM's College of Health has used the FCC telehealth award funds to expand telehealth programs offered by the interprofessional disciplines with an overarching goal of increasing healthcare access and addressing inequities in care," Killam explained. "In addition to providing accessible and equitable healthcare, telehealth technologies will be used to train future health professionals," she continued. "Proactive training of our health professions students has the potential to transform the healthcare landscape in Montana and to overcome the challenges presented by traditional models of care." The equipment purchased has empowered physical therapists to engage in remote monitoring of patients as they complete interventions within their home, said Jennifer Bell, PT, clinical associate professor, school of physical therapy and rehabilitation science. "Oftentimes, patients have difficulty with balance and functional mobility within their home," she noted. "By utilizing technology, we are able to see a patient's home environment and support their ability to move around, minimize the risk of falls and complete a home exercise program." Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/telemedicine-boosts-access-decreases-inequities-montana?utm_source=twitter&utm_medium=social&utm_campaign=womeninhit < Previous News Next News >

The intersection of remote patient monitoring and AI Bill Siwicki October 25, 2022 Robin Farmanfarmaian, a Silicon Valley AI entrepreneur and author, explains how artificial intelligence can boost the efficacy of RPM and help democratize healthcare. Robin Farmanfarmaian is a Silicon Valley-based entrepreneur working in technology and artificial intelligence. She has been involved with more than 20 early-stage biotech and healthcare startups, including ones working on medical devices and digital health. With more than 180 speaking engagements in 15 countries, she has educated audiences on many aspects of technology intersecting healthcare, including artificial intelligence and the shift in healthcare delivery to the patient's home. She has written four books, including "The Patient as CEO: How Technology Empowers the Healthcare Consumer" and, most recently, "How AI Can Democratize Healthcare: The Rise in Digital Care." Healthcare IT News spoke with Farmanfarmaian to discuss where AI is impacting remote patient monitoring today and how AI can democratize healthcare. Q. Where is remote patient monitoring today? Where do you see RPM five and 10 years from now? A. Remote patient monitoring is still in the first five years of adoption and integration into the healthcare system, and the pandemic accelerated this trend by illustrating the need and value of RPM. There are many clinical-grade devices now that patients can buy or use to measure and monitor various vital signs, including EKG, heart rate, heart rate variability, blood pressure and blood oxygen level. The Centers for Medicare and Medicaid Services is one of the organizations that sets the standard of care in the U.S. healthcare system, and CMS launched CPT codes for remote physiological monitoring more than four years ago. CMS has expanded coverage and specificity over the past few years with additional and updated CPT codes. In 2022, CMS launched CPT codes for remote therapeutic monitoring (RTM). These codes cover RTM for respiratory and musculoskeletal (MSK) conditions, such as remote physical therapy and COPD inhaler tracking. Considering that most of healthcare happens in a patient's daily life, not the occasional clinic visit, this is a big step forward toward helping patients use their treatments in the best possible way on a daily basis. Many mainstream corporations have launched their own wearables that have cleared the FDA, blurring the lines between healthcare companies and consumer-facing tech companies. Apple, Amazon, Google and Samsung are some of the giants that can shift consumer habits on a national scale, and they all have launched mainstream wearables. For instance, the Apple Watch has outsold the entire Swiss watch industry multiple years in a row, and the device has an EKG monitor that has cleared the FDA for use with people over the age of 22 and with no history of arrhythmia. This trend is great news because many people may already be tracking something about their health, whether that's blood pressure monitoring, continuous glucose monitoring or even a simple accelerometer for step count. That makes it significantly more likely a patient will continue to use the device if their healthcare professional recommends it and has access to the data. In 10 years, remote patient monitoring will be mainstream, and likely reimbursed by all the major payers. We're already seeing that RPM has the ability to catch hospital readmissions days before they happen. The healthcare industry is experiencing a revolution in vital-sign measurement devices, with many companies innovating on ways to collect vital signs. New innovations include taking vital signs using a smartwatch, using just a smartphone or laptop camera, breathalyzer devices for standard vital signs like BP and Sp02, sensors in clothing, epidermal sensors and subcutaneous sensors. Within 10 years, tracking vital signs will be done in ways that are more seamless and effortless for the patient, such as subcutaneous sensors that last five years. Eversense already has an FDA-cleared implantable sensor for continuous glucose monitoring that passively records glucose levels 24/7. Q. How did artificial intelligence first come into the picture with RPM? What was the connection? A. Some of these new FDA-cleared devices measure vital signs continuously, which means they are collecting thousands of data points a day on each patient. BiolntelliSense has a medical-grade rechargeable sensor that sticks to the chest and passively measures more than 20 vital signs, recording 1,440 measurements a day. Humans don't have the ability to analyze and interpret thousands of data points every day for every patient – which is why these clinical-grade wearables and sensors have an AI software component to manage, monitor, analyze and interpret the thousands of daily data points per patient. The AI software typically flags or alerts the healthcare team and patient when the vital signs are outside predetermined ranges, personalized to the individual. While it is still early in this trend, there are examples of new innovations that only exist because of continuous, personalized data collection. January AI uses the previous three days of data from a continuous glucose monitor, combined with vital-sign data, to predict glucose response in real time to individual foods, educating the patient at the point of the decision-making. This helps manage diabetes in a more personalized and predictive way, instead of the standard reactive way diabetes is currently treated. But January AI isn't just for people with diabetes. They work with athletes, people with pre-diabetes or metabolic syndrome, and people who just want to be as healthy as they can be. This education in real time doesn't just assume the standard diet for diabetes is right for every individual or that there is any one healthy diet that works for everyone. People don't react the same way to food as others, or even to themselves. Everyone has a unique glucose response to food based on many factors, including that day's activity level, sleep, amount of fiber, stress, weight, age and many more data points. AI-based software, combined with RPM, allows personalized care 24/7. Q. Today, how does AI work with RPM to improve patient care and outcomes? A. When RPM is used for serious conditions, it can be the difference between life and death. VitalConnect ran a study on their single-lead EKG VitalPatch and was able to predict hospital readmission for cardiac patients 6.5 days in advance. Alacrity Care is working on RPM for oncology that combines vital signs taken with FDA-cleared devices including the Omron blood pressure watch and the Oxitone pulse-oximeter watch with a daily oncology practitioner check-in and blood labs taken in the home. This is to catch serious, life-threatening problems such as neutropenia, sepsis and cytokine storm days before a patient with cancer is in serious medical trouble. Catching these three conditions early can be the difference between life and death. New AI-based software tools are clearing the FDA, including one earlier this year for TytoCare that analyzes lung sounds for the patient and the remote clinician using a connected stethoscope in the home. There are other companies working on sensors in clothing that are covered by Medicare. SirenCare has socks available by prescription that monitor the temperature on the bottom of the foot. For patients with diabetes, a hotspot on the bottom of the foot could lead to a skin ulcer, which could eventually lead to an amputation if the wound doesn't heal. With access to the continuous data, the software can alert the patient and clinician when there is a problem so it can be treated before the skin breaks. The promise and goal of RPM is to keep patients safely in their homes and catch problems early, before they become serious or emergency issues. Q. You have a new book out with Michael Ferro, "How AI Can Democratize Healthcare." How does that theme fit in with the combination of AI and RPM? A. When dealing with AI, life begins at 1 billion data points. There are some major problems with traditional healthcare datasets that exist today to train software. Most healthcare data is locked into silos, whether that is the EHR, faxes, the payer or in clinical notes. In fact, when I get lab results from my physician through the hospital's patient portal, it is uploaded as a scanned fax and saved as a PDF that is not machine readable, and sometimes, not even human readable. While we are seeing interoperability move forward, there is still a long way to go. The typical healthcare data is collected on people at one point in time, such as their annual physical or if they are hospitalized. Frequently, that means the data doesn't include an individual's baseline, taken in their daily environment. It also means that most of the clinical-grade vital-sign data is on people who are already sick enough to be in a hospital. By shifting the data collection to the patient's daily life, RPM has the ability to collect clinical-grade data when people are in all stages of health and at all ages. When collected continuously in machine-readable databases, once RPM is more fully adopted, those databases have the ability to dwarf EHR data from a hospital or health system. That is the type of training data that can give healthcare a much deeper look and understanding of normal vital signs across ages, genders and genetics. RPM helps democratize healthcare in a way never before possible. Many people don't live within easy access to a doctor or clinic. Trying to get to a clinic during their open hours can be next to impossible for some people due to many factors – from not being able to take off work, school, finding transportation, distance, childcare and other barriers, to traveling to a physical clinic. Even for established patients, specialist doctors are frequently booked out one to three months in advance, which gives a medical problem time to advance and potentially get much worse. That, in turn, lowers the odds of a successful outcome when and if that patient is ever seen and treated by a healthcare professional. Instead of trying to physically get to a clinic, RPM can be used to determine when someone needs to see a healthcare professional and can make a virtual care visit much more effective. The best healthcare is the healthcare that actually gets done. RPM enables passive healthcare in someone's daily environment, 24/7. Twitter: @SiwickiHealthIT Email the writer: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication. See original article: https://www.healthcareitnews.com/news/intersection-remote-patient-monitoring-and-ai?utm_source=twitter&utm_medium=social&utm_campaign=womeninhit < Previous News Next News >

Principal Deputy Inspector General Grimm on Telehealth By Christi A. Grimm, HHS-OIG Principal Deputy Inspector General February 26, 2021 It has been just over a year into the COVID-19 pandemic and we remember the over 500,000 Americans who have lost their lives due to COVID-19. That figure is a stark reminder of the critical mission of the Department of Health and Human Services. Challenges in responding to the pandemic have been many, thorny and unprecedented. Consequential decisions often were made quickly to respond to the emergency and provide relief in the way of funding, supplies, and reductions in regulatory and procedural burden. This quick response and scope of relief make oversight, enforcement, transparency, program integrity, and accountability all the more important. It has been just over a year into the COVID-19 pandemic and we remember the over 500,000 Americans who have lost their lives due to COVID-19. That figure is a stark reminder of the critical mission of the Department of Health and Human Services. Challenges in responding to the pandemic have been many, thorny and unprecedented. Consequential decisions often were made quickly to respond to the emergency and provide relief in the way of funding, supplies, and reductions in regulatory and procedural burden. This quick response and scope of relief make oversight, enforcement, transparency, program integrity, and accountability all the more important. Early in the pandemic, OIG, along with many others, recognized the value of expanding options for accessing health care services. Telehealth is a prime example. Where telehealth and other remote access technologies were once a matter of convenience, the public health emergency made them a matter of safety for many beneficiaries. In some cases, health care providers needed regulatory flexibility to provide safe and effective care remotely during the ongoing pandemic. In March 2020, we issued policy statements and FAQs in support of increased telehealth flexibilities. A year later, there is a robust national conversation about expanding coverage for telehealth services based on the experience providers and patients have had during the pandemic. For most, telehealth expansion is viewed positively, offering opportunities to increase access to services, decrease burdens for both patients and providers, and enable better care, including enhanced mental health care. A 2019 OIG study found that telehealth can be an important tool to improve patient access to behavioral health services. And as we observed in recent rulemaking, OIG recognizes the promise that telehealth and other digital health technologies have for improving care coordination and health outcomes. It is important that new policies and technologies with potential to improve care and enhance convenience achieve these goals and are not compromised by fraud, abuse, or misuse. OIG is conducting significant oversight work assessing telehealth services during the public health emergency. Once complete, these reviews will provide objective findings and recommendations that can further inform policymakers and other stakeholders considering what telehealth flexibilities should be permanent. This work can help ensure the potential benefits of telehealth are realized for patients, providers, and HHS programs. We anticipate the first work products to be published later this year. We are aware of concerns raised regarding enforcement actions related to "telefraud" schemes, and it is important to distinguish those schemes from telehealth fraud. In the last few years, OIG has conducted several large investigations of fraud schemes that inappropriately leveraged the reach of telemarketing schemes in combination with unscrupulous doctors conducting sham remote visits to increase the size and scale of the perpetrator's criminal operations. In many cases, the criminals did not bill for the sham telehealth visit. Instead, the perpetrators billed fraudulently for other items or services, like durable medical equipment or genetic tests. We will continue to vigilantly pursue these "telefraud" schemes and monitor the evolution of scams that may relate to telehealth. As our work and the national conversation continues, OIG believes there is a shared goal: ensuring that telehealth delivers quality, convenient care for patients and is not compromised by fraud. As we continue our COVID-19 oversight and enforcement work, we look forward to providing objective, independent information to stakeholders and policymakers. < Previous News Next News >

Closing 2022 with New Telehealth G-Codes for HHAs, Uncertainty for Telehealth Startups, Plus State & Federal Telehealth Developments (and much more!) CCHP December 13, 2022 New G-Code Reporting Requirements for HHAs under CY 2023 CMS PPS Rule The Centers for Medicare and Medicaid Services (CMS) has finalized new G-codes to report use of telecommunications technology under the home health benefit for Home Health Agencies (HHAs) under their finalized Calendar Year (CY) 2023 Home Health Prospective Payment System (PPS) Rate Update. HHAs are asked to voluntarily start reporting on January 1, 2023, and the requirement to report would kick in July 2023. CMS notes that in 2020 the home health benefit was temporarily altered due to COVID-19 (and made permanent in 2021) requiring any provision of remote patient monitoring or other services furnished via a telecommunications system to be included in the plan of care. The telecommunication service, however is not allowed to substitute for a home visit ordered by the plan of care or for purposes of eligibility or payment. Reporting of the new G-codes will allow CMS to analyze the characteristics of beneficiaries utilizing services remotely and have a broader understanding of the social determinants that affect who benefits most from these services. The codes HHAs will be asked to submit are detailed in a Medicare Learning Network (MLN) document, and include: G0320: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring) For more details on the G-codes and reporting expectations, see the full MLN Guidance and the full text of the finalized CY 2023 Home Health PPS Rate Rule. Falling Investment for Telehealth Startups A recent article in Politico [subscription required] brings to light the stark decrease in investment in telehealth companies in 2022 (compared to 2021), as the pandemic subsides and a recession likely kicks in. In fact, while telehealth funding for digital health in the US peaked in 2021 with $11 billion dollars, that has fallen to only $3 billion by the third quarter of 2022. The effects of this slow down in capital is bound to ripple across the industry. As a result, many startups are laying off workers and focusing on just a few key offerings. Adding to the uncertainty of the future for these companies is how telehealth policies will impact them moving forward as state and federal governments shift from pandemic era temporary policies to often stricter permanent telehealth requirements with greater oversight. Cerebral, a digital mental health company, for example is currently under federal investigation for over-prescribing ADHD medication. This is the type of occurrence other telehealth companies may take note of and may shape the way they think about the future of their products and services in order to avoid such situations. Additionally, consumer demand has shifted post-pandemic. While consumers were enthusiastic about utilizing telehealth for most forms of healthcare in order to avoid crowded doctors’ offices and hospitals at the height of the pandemic, they now prefer to use it for check-ins with their doctors, mental health visits and addiction treatment, according a survey by the American Medical Association. This necessitates a shift for many telehealth start-ups, and according to Megan Zweig, COO of Rock Health, many companies are struggling with this. For more information, read the full Politico article [subscription required]. World Health Organization Telemedicine Implementation Guidance In November the World Health Organization (WHO) released a telemedicine implementation guide based on knowledge and learnings the WHO has gathered since releasing their first report on telemedicine in 2010. The set of recommendations within the new guide is aimed at optimizing the implementation of telemedicine services by providing an overview of key planning, implementation and maintenance processes to inform an investment plan and support countries across different stages in developing telehealth solutions. The guide contains three phases to developing a successful telehealth program, including (1) a situational assessment; (2) planning the implementation; and (3) monitoring and evaluation, and continuous improvement. There are a total of eleven steps within the three phases, including tasks such as performing a landscape analysis, establishing standard operating procedures, developing a budget and determining monitoring and evaluation goals, as well as an adaptive management plan for improvement. Several case studies from different countries, including India, Cabo Verde, Indonesia, Qatar and Mali are also provided in the annex section of the document. Download the full telemedicine implementation document from the WHO’s website for all the detailed steps outlined in their recommended procedures for telemedicine implementation. See full article: https://mailchi.mp/cchpca/closing-2022-with-new-telehealth-g-codes-for-hhas-uncertainty-for-telehealth-startups-plus-state-federal-telehealth-developments-and-much-more < Previous News Next News >

State Telehealth Laws and Reimbursement Policies Report, Fall 2022 CCHP October 2022 The Center for Connected Health Policy’s (CCHP) Fall 2022 Summary Report of the state telehealth laws and Medicaid program policies is now available as well as updated information on our online Policy Finder tool. The most current information in the online tool may be exported for each state into a PDF document. The following is a summary of the current status of telehealth policy in the states given these new updates. CCHP provides these bi-annual summary reports in the Spring and Fall each year to provide a snapshot of the progress made in the past six months. CCHP is committed to providing timely policy information that is easy for users to navigate and understand through our Policy Finder. The information for this summary report covers updates in state telehealth policy made between July and early September 2022. Read the executive summary While this Executive Summary provides an overview of findings, it must be stressed that there are nuances in many of the telehealth policies. To fully understand a specific policy and all its intricacies, the full language of it must be read utilizing CCHP’s telehealth Policy Finder. For further information, visit cchpca.org. We hope you find the report useful, and welcome your feedback and questions. You can direct your inquiries to Amy Durbin, Policy Advisor or Christine Calouro, Policy Associate at info@cchpca.org . A special thank you to CCHP Policy Associate Veronica Collins for her invaluable contributions to this report. INTRODUCTION The Center for Connected Health Policy’s (CCHP) Fall 2022 analysis and summary of telehealth policies are based on information contained in its online Policy Finder. The Summary Report provides highlights on certain aspects of telehealth policy and the changes that have taken place between now and the previous edition, Spring 2022. The research for this edition of the Summary was conducted between July and early September 2022. This summary offers the reader an overview of telehealth policy trends throughout the nation. For detailed information by state, see CCHP’s telehealth Policy Finder which breaks down policy for all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands. Please note that many states continue to keep their temporary telehealth COVID-19 emergency policies siloed from their permanent telehealth policies. These temporary policies are not included in this summary, although they are listed under each state in the online Policy Finder under the COVID-19 category. In instances where the state has made policies permanent, or extended policies for multiple years, CCHP has incorporated those policies into this report. See full report: https://www.cchpca.org/resources/state-telehealth-laws-and-reimbursement-policies-report-fall-2022/ < Previous News Next News >

How Does a Telemedicine Pain Program Work in Rural American with Multi-Vulnerable Patient Populations? Dax Trujillo, MD July 20, 2022 In April 2017 Summit Healthcare started a multi-disciplinary program to treat patients with chronic and acute pain in the White Mountains of Arizona. Our patient service area is HRSA-designated as having a shortage of providers and medically underserved. The area is the size of Rhode Island and includes Native American reservations and other vulnerable populations. Many of our patients live in a high poverty area which makes access to care challenging. In order to provide multi-disciplinary services that include interventional procedures, monitored medication management and cognitive behavior therapy, we needed to create a hybrid program. Our program incorporates in-person, video/audio and telephone visits. By using three different modes of care delivery we were able to reach and follow more patients with better outcomes. Since April 1, 2017 we have had over 900 patients participate in our telemedicine pain program. The visits include virtual appointments for medical management, behavioral therapy, and general wellness checks after an in-person visit; virtual check-ins for procedure or testing follow-ups and eVisits via email communication to answer questions and/or review prescription issues or re-ordering. Due to the rurality of the service area we estimate that patients were saved from having to travel 66,144 miles to a physician’s office. This was a significant relief to patients with limited means to transportation, knowing that their weekly, monthly in-patient visits were reduced to quarterly in-patient visits. Patient satisfaction has been high due to the reduction of travel time and costs. Simultaneously, the patient perceived they were being more closely monitored and their pain issues addressed in a timely manner. Another benefit is that more than one professional can join a telemedicine visit with the patient which allows a more holistic and comprehensive visit for better value based care of the patient. By providing virtual visits as part of the entire treatment program, we have saved thousands of dollars in chronic pain treatment costs. Through evidence-based research we know that patients are achieving better healthcare outcomes in this hybrid program by incorporating telemedicine technology. Our program has had overall success with addressing pain but there are some risks involved that must be addressed within your institution to provide a platform that is HIPPA compliant and protects critical sensitive health information. Providing a secure platform must be a top priority when delivering pain treatment virtually due to the sensitive nature of the disease/treatments with this patient population. While most patients do well with the hybrid program we do have patients for whom it is not appropriate. Due to our location, a subset of patients do not have access to broadband internet service so we cannot perform visits via video or sometimes audio. Other patients have expressed a preference for in-person visits while another group prefers all visits to be virtual. Patients needing neuraxial interventions or surgeries will need to be seen in-person. Each patient has their own unique circumstances so having a hybrid pain treatment program with various care delivery options allows us to reach more patients previously not being treated for their chronic pain issues. In the future we will purchase a remote patient monitoring platform/equipment that can be used with our chronic pain patients to better track their vitals, physical and mental health. This will also allow us to manage medications and behavioral issues related to pain and opioid addiction, both of which are prevalent in our service area. Our hospital system is also developing a hospital at home program which will incorporate the telemedicine pain program for patients with co-morbidities. The future of healthcare access is using hybrid delivery of care systems that include telemedicine, to improve accessibility and outcomes for chronic pain patients. For original article: https://southwesttrc.org/blog/2022/how-does-telemedicine-pain-program-work-rural-american-multi-vulnerable-patient < Previous News Next News >

Maximizing Telemedicine Benefits Elizabeth A. Krupinski, Southwest Telehealth Resource Center August 2021 First and foremost, the key to a successful telemedicine program is planning and figuring out exactly what role you expect telemedicine to play and how it fits in the mission and goals of your practice or institution. The United States and the world have seen a dramatic increase in the use of telemedicine since the inception of the COVID-19 public health emergency due in most part to stay at home restrictions for both providers and patients. Prior to this, telemedicine was used in a wide variety of clinical and related patient care applications for at least 30 years, and had been seeing steady but not exponential growth. In many cases programs were initiated quite rapidly using readily available and often low-cost equipment and tools, unless there was already an existing program and platform in place. Further, the use of telemedicine was facilitated at the state and federal levels but widespread waivers and measures being put into place to reduce barriers that were previously in place such as changes in reimbursements, requirements regarding patient and provider locations, cross-state licensure and privacy/security requirements. Those of us in the field for a long time are hopeful that many of these measures will stay in place, but there are clearly some that will or already have expired. We are additionally hopeful that even though in-person practices are clearly coming back full-tilt, that everyone has seen and/or experienced the benefits of telemedicine and will continue to use it to some degree as feasible and appropriate with their patients. As this occurs, however, providers will be faced with new challenges as they take their initial telemedicine set-ups and transition to this new hybrid world of services. As noted, some things will still be allowed (e.g., certain billing codes) but others will likely return to pre-COVID status (e.g., not being able to use non-HIPAA-compliant devices and software platforms). In addition to finding the best software for future telemedicine applications, there are other things to consider when trying to maximize telemedicine benefits. From my perspective, although the technology is critical, telemedicine success has very little to do with the technology and everything to do with the people and the environment within which they practice. Thus, in order to maximize telemedicine these are the elements one should consider and focus on in addition to carefully selecting the most appropriate technology for your practice and providers. First and foremost, the key to a successful telemedicine program is planning and figuring out exactly what role you expect telemedicine to play and how it fits in the mission and goals of your practice or institution. The use cases need to be clearly defined and must match an identified need. Then the who, what, where, why and when must be carefully delineated. Who needs to be involved (e.g., providers, billing, scheduling, IT, legal, administration), what clinical tasks can be accomplished via telemedicine, where will the technology and/or providers be located (e.g., clinic, home) and where will the patients be (e.g., primary care provider office, home, work, school), why will telemedicine be offered as an option (e.g., lack of sub-specialty providers, patients need to travel long distances, no show rates are too high) and when will telemedicine be offered (e.g., certain days/times, any opening in the schedule)? All of this can be accomplished by plotting out in a workflow diagram what the current practice is and how it needs to be adjusted in order to integrate telemedicine into that workflow. Again, the expectation is that although some practices might remain essentially virtual, the majority are going to evolve into a hybrid practice – but such a hybrid will not happen overnight or automatically. Workflow integration is going to be just as critical as integrating telemedicine technologies into a practice – it really is all about the people, setting expectations and establishing standard operating procedures and protocols for everyone that is going to be involved. Another thing that can be done to maximize a telemedicine practice is to properly train everyone on standard operating procedures and protocols, especially the providers who will be interacting with the patients. To date there are very few training programs that incorporate formally telemedicine as part of the curriculum. A number of programs are increasingly exposing trainees to telemedicine if offered at their institution, but typically as an elective or chance encounter in the clinic. There are however a number of organizations that are working on developing and promoting telemedicine competencies and the Association of American Medical Colleges (AAMC) recently developed a set of Core Competencies. Although specific to medical college trainees, they are comprehensive enough to cover nearly every other specialty/profession in many respects. Very briefly, the AAMC Telehealth Competencies consist of three domains, each with a set of explicit skills that increase in complexity and responsibility across three stages of practice: entering residency, entering practice and experienced faculty physician. The skills from each prior stage of training should carry over to the next phase as the provider becomes more expert and acquires additional skill sets. The six domains are: patient safety and appropriate use of telehealth; access and equity in telehealth; communication via telehealth; data collection and assessment via telehealth; technology for telehealth; and ethical practices and legal requirements for telehealth. Patient safety and appropriate use of telehealth includes 4 skill sets ranging from being able to explain to patients are caregivers the benefits and limitations of telemedicine to knowing when a patient is at risk and how/when to escalate care (e.g., convert to in-person) during an encounter. Access and equity in telehealth has 3 skill sets including knowing your biases and implications when considering healthcare, how telehealth can mitigate or amplify access to care gaps, and taking into account all potential cultural, social, physical and other factors when considering telemedicine. Communication via telehealth has 3 skills covering establishing rapport with patients, creating the right environment (e.g., lighting, sound) and knowing how to incorporate a patient’s social support into an encounter. Data collection and assessment via telehealth covers how to obtain a patient history, how to conduct an appropriate remote exam, and how to deal with patient-generated data. Technology for telehealth does not expect everyone to be an engineer or IT expert, but they should be able to explain equipment requirements for a visit, explain limitations and minimum requirements, and explain risks of technology failure and how to respond to them. Similarly, ethical practices and legal requirements for telehealth does not expect everyone to be a lawyer but should be able to describe local legal and privacy regulations, define components of informed consent, understand ethical challenges and professional requirements, and assess potential conflicts of interest (e.g., interest in commercial products/services). Many of these skills can be acquired by those already in practice by attending the wide variety of courses and webinars available for telemedicine skill building. It is also highly recommended that before engaging with patients for the first time via telemedicine to engage in some simulated practice sessions – from start to finish practicing each skill and developing your “style” for interacting with patients via this virtual medium. Finally, in order to maximize benefits you need to assess your program. This does not require a degree in statistics or setting up a complex experimental study. It really requires just two things – a set of metrics and a process. There are lots of metrics available and most have been studied in a wide variety of clinical applications so a good lit review will always help get you started. It is important to keep in mind that the things you measure need to reflect your goals/mission for using telemedicine and the bottom line of making a profit is not always the most appropriate metric to use. There are lots of relevant metrics and as a good starting place the article by Shore et al. “A lexicon of assessment and outcome measures for telemental health” is a great place to get some ideas. Although developed for the telemental health community the metrics provided apply quite well to nearly any specialty or practice. The metrics include such things as patient/provider satisfaction, no shows, symptom outcomes, completion of treatment, wait times, number of services, cultural access, cost avoidance and patient safety. Once you decide on metrics that are appropriate for your practice (recommend starting with 2-3 then add more as your practice grows) there is a very easy, straight-forward process for getting to outcomes. First, consider a given measure an indicator – these are concrete activities, products etc. that can be measured readily (e.g., from the patient record). For example, you could measure A1C levels in patients as a function of being enrolled in a telenutrition program. The next step is to set performance targets – these are concrete goals that are time limited and based on the indicator metrics. For example, you would like to see a 25% reduction in A1C levels in at least 50% of patients enrolled in the telenutrition course at 6 months post-baseline. Finally, you will have quantifiable outcomes (without fancy statistics) at the end of your set time period – if you meet your 25% reduction goal in 50% of patients great. If not, then maybe reassess the program or whether your goals were realistic. In any case, you now have concrete outcomes of your program demonstrating its benefits that you can provide to funders, administration, your care team and even patients and the community. In order to maximize telemedicine benefits you need to get the word out about its availability and its effectiveness! < Previous News Next News >

What You Need to Know About the Telehealth Extension and Evaluation Act Dr. Maheu February 24, 2022 The Telehealth Extension and Evaluation Act was introduced on February 7, 2022, to ensure a continuation of public access to telehealth after the end of a public health emergency. If passed, it will allow time to gather data concerning virtual care utilization and prevent a sudden drop-off in access to care, also known as the telehealth cliff. What is the Telehealth Extension and Evaluation Act? The Telehealth Extension and Evaluation Act establishes a two-year extension for certain coronavirus-related telehealth waivers. It will extend geographic and site restrictions waivers and allow Medicare beneficiaries to access telehealth from various locations. It also provides flexibility for prescribing drugs via telehealth and extends flexible Medicare payment plans for Rural Health Centers (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs). The bill follows an advocacy letter signed by 336 organizations, co-led by the American Telemedicine Association (ATA) and others, urging Congressional leaders to continue the current telehealth waivers and pass permanent, evidence-based telehealth legislation for implementation in 2024. Key Takeaways for the Telehealth Industry The telehealth industry should be aware of the critical points of the Telehealth Extension and Evaluation Act. Extension of Medicare Payment for Telehealth Services. The CARES ACT allowed the Centers for Medicare and Medicaid Services (CMS) to waive specific Medicare coverage and payment limitations, allowing Medicare beneficiaries to receive telehealth care at home. If the Telehealth Extension and Evaluation passes, it will extend certain telehealth coverage waivers on originating site and geographic location limitations, expand the list of telehealth providers, and increase the availability of audio-only telehealth services to Medicare beneficiaries for two years after the public health emergency ends. Telemedicine Drug Prescribing. The Ryan Haight Act prohibits the prescribing of medicine without an in-person visit. Federal law allowed DEA registered practitioners to prescribe to patients without in-person visits during the pandemic. See TBHI’s previous article Telehealth Opioids, and Ryan Haight Act Update, for more information. The proposed legislation would extend this flexibility two years after the public health emergency. Extension of FQHCs and RHCs. Before the pandemic, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) could only provide telehealth services to patients near their locations. The CARES Act allowed these facilities to provide care to patients in distant areas, a practice the legislation would continue for two years after the public health emergency expires. Extension for CAHs. The 2020 Hospitals Without Walls program allowed hospitals to provide telehealth care during a public health emergency. The proposed legislation would add Critical Access Hospitals (CAHs) as distant site providers of telehealth services to continue offering off-site care. Restrictions for Certain DMEs and Lab Tests. The legislation would require an ordering physician to conduct an in-person examination of a patient no more than 12 months before ordering specific high-cost lab tests and Durable Medical Equipment (DME) products via telehealth. It would also instruct Medicare Administrative Contractors to audit practitioners and clinicians who do 90% or more of their orders of DME and lab tests via telehealth. This would continue for two years after the health emergency ends. It is meant to reduce instances of fraud and abuse. NPI Number for Telehealth Billing. Healthcare providers need a national provider identifier (NPI) number to bill Medicare directly. Under certain conditions, Medicare pays for services billed by physicians but performed by non-physician staff acting under the physician’s supervision. This practice is known as “incident to” billing. The proposed legislation requires all practitioners to obtain an NPI number to receive Medicare payment for telehealth services two years after the public health emergency. Your Advocacy Is Needed The pandemic has caused an increased reliance on the telehealth industry. If passed, the Telehealth Extension and Evaluation Act will ensure that patients can continue to access the virtual care they need. Contact your elected officials at the federal level to ask them to support this crucial bill. https://telehealth.org/what-you-need-to-know-about-the-telehealth-extension-and-evaluation-act/?smclient=f760e669-8538-11ec-83c8-18cf24ce389f&smconv=5bc4c379-a4c1-484f-a411-33ec93777504&smlid=9&utm_source=salesmanago&utm_medium=email&utm_campaign=default < Previous News Next News >

Telehealth QA – Is it all it’s QAcked up to be? Trudy Bearden, PA-C, MPAS February 16, 2022 In hopes of sparking renewed commitment to applying improvement science to telehealth, we offer this Telehealth QI and QA Miniseries. Today is the fourth in the series. Require expertise and excellence in telehealth service delivery. Expertise with telehealth requires deliberate practice which builds on or modifies existing skills, usually with the help and guidance of a coach or teacher with targeted feedback on what to improve and how to improve those skills. Send staff through telehealth training either internally or externally. The California Telehealth Resource Center Telehealth Course Finder is a great place to start for external telehealth trainings. Provide peer review of telehealth sessions by inviting a trusted clinician to join a telehealth visit – with patient permission. Debrief after the session to provide feedback and to discuss what went well, what did not go well and what changes can be made to improve Implement written triage protocols that are easily accessible by all staff to clarify which patients or patient issues are appropriate for telehealth and which need to be seen in person. Make a commitment to exceptional service delivery. Solicit and act on patient and staff feedback. Consider including a patient partner or advisor in these efforts. Below are some sample staff and clinician satisfaction survey questions. Some institutions may already incorporate some of these into their existing patient feedback systems (e.g., Press Ganey) so check to see if they are before duplicating efforts. Sometimes it’s best to collect feedback simply and in real time by asking, “How was your visit? What could have gone better?” Read full article here: https://southwesttrc.org/blog/2022/telehealth-qa-it-all-it-s-qacked-be < Previous News Next News >

Review of Veterans Health Administration’s Use of Telehealth During Pandemic Center for Connected Health Policy April 2021 Veteran’s Affairs Office of the Inspector General (OIG) assessed the Veterans Health Administration’s virtual primary care response to the COVID-19 pandemic. From February 7 to June 16, 2020, the Veteran’s Affairs Office of the Inspector General (OIG) assessed the Veterans Health Administration’s virtual primary care response to the COVID-19 pandemic, based upon reviewing primary care encounter data, interviews with VHA leaders, and use of primary care provider questionnaires. In its report, the OIG found that face-to-face primary care visits decreased by 75% and contact by telephone represented 81% of all primary care encounters. In regards to VA Video Connect (VVC), providers stated that not only were there technical complications related to specifically scheduling VVC visits, but many patients didn’t have internet access or the appropriate equipment needed for video calls. The OIG identified the need for additional training and support for veterans and test visits with patients and staff to walk through the process before the visit. In addition, the OIG recommended the Under Secretary for Health evaluate veteran access to reliable internet connectivity necessary for use of VVC and take appropriate action. Department of Veterans Affairs, Office of Inspector General: https://www.va.gov/oig/ Veterans Health Administration: https://www.va.gov/health/ < Previous News Next News >

New Nationwide Poll Shows an Increased Popularity for Telehealth Services Center for Connected Health Policy June 2021 Expansion of telehealth is welcomed by most Americans. The American Psychiatric Association (APA) completed a new national public opinion poll finding that expansion of telehealth is welcomed by most Americans. Nearly 4 in 10 reported having used telehealth services, nearly 6 in 10 said they would use telehealth for mental health services, and more than 1 in 3 said they prefer telehealth. In addition, more individuals seem to have used telehealth via video (69%) than via phone (38%). Perception of the quality of telehealth appears to have improved as well, at 45% up from 40% last year. The results came from a recent online survey of 1,000 adults – additional information on the poll and its findings can be accessed on the APA website - https://www.psychiatry.org/newsroom/news-releases/New-Nationwide-Poll-Shows-an-Increased-Popularity-for-Telehealth-Services. < Previous News Next News >

AMA survey shows widespread enthusiasm for telehealth American Medical Association March 23, 2022 CHICAGO — An American Medical Association (AMA) survey released today shows physicians have enthusiastically embraced telehealth and expect to use it even more in the future. Nearly 85% of physician respondents indicated they are currently using telehealth to care for patients, and nearly 70% report their organization is motivated to continue using telehealth in their practice. Many physicians foresee providing telehealth services for chronic disease management and ongoing medical management, care coordination, mental/behavioral health, and specialty care. The survey comes as Congress recently extended the availability of telehealth for Medicare patients beyond the current COVID-19 public health emergency. Additional action by Congress will be needed to permanently provide access to Medicare telehealth services. As physicians and practices plan to expand telehealth services, they say widespread adoption hinges on preventing a return to the previous lack of insurance coverage and little to no payer reimbursement. Payers, both public and private, should continue to evaluate and improve policies, coverage, and payment rates for services provided via telehealth. “Physicians view telehealth as providing quality care to their patients, and policymakers and payers have come to the same conclusion. Patients will benefit immensely from this new era of improved access to care,” said AMA President Gerald E. Harmon, M.D. “This survey shows adoption of the technology is widespread as is the demand for continued access. It is critical that Congress takes action and makes permanent telehealth access for Medicare patients.” Physicians strongly support that telehealth via audio-only/telephone remains covered in the future to ensure equitable access. That coverage has been permitted during the public health emergency and extended for several months afterward. According to the survey, 95% of physicians report patients are primarily located at their home at the time of the virtual visit. Allowing patients to be in their home is a key component of making telehealth more accessible. Before the pandemic, Medicare patients needed to be physically located in a rural area to access telehealth services, shutting out urban and suburban patients from receiving the same benefits of virtual care. Before the pandemic, rural patients needed to travel to an “originating site,” essentially another health care facility, outside of their home to access telehealth services. The temporary extension in the omnibus will allow patients with Medicare to receive telehealth services anywhere they are located, including in their home. The AMA will continue to urge Congress to make permanent this and other policies that have offered coverage and convenience to patients. Fewer than half of respondents report being able to access all of their telehealth platforms via their electronic health records, and more than 75% report that their support technology does not automatically collect and deliver patient-reported data. Improving interoperability between platforms and support technology would improve and streamline telehealth services. Physicians perceive technology, digital literacy, and broadband internet access to be the top three patient barriers to using telehealth. In addition, only 8% of physician respondents said they were using remote patient monitoring at this time. The AMA will advocate for patient populations and communities with limited access to telehealth service, including but not limited to, supporting increased funding and planning for telehealth infrastructure such as broadband and internet-connected devices. Read the survey here. To learn more about the results, register for an AMA Telehealth Immersion Program webinar at 10 a.m. ET March 31. Media Contact: Jack Deutsch ph: (202) 789-7442 jack.deutsch@ama-assn.org About the American Medical Association The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care. < Previous News Next News >

Congress' last-minute $1.7 trillion omnibus package: 8 healthcare takeaways Molly Gamble December 20, 2022 Lawmakers rolled out a roughly $1.7 trillion year-end spending bill Dec. 20 to fund the U.S. government through most of 2023, tacking on proposals to extend telehealth and hospital-at-home flexibilities while leaving out other healthcare asks. Lawmakers have until the end of Dec. 23 to clear the 2023 Omnibus Appropriations bill or federal funds are set to run out, bringing key agencies and programs to a halt. The package consists of all 12 annual appropriations bills Congress must pass and would fund the government through the remainder of fiscal 2023, which runs through September. Eight healthcare- and hospital-specific notes out of the 4,155-page bill: 1. The legislation curbs a scheduled cut of nearly 4.5 percent to the Medicare physician fee schedule that was set to take effect in 2023, narrowing the cut to 2 percentage points in the year ahead with a scheduled cut of 3.25 percentage points in 2024. The American Medical Association, which lobbied against the cuts, said it is "extremely disappointed and dismayed" with the cuts that made it to the bill. 2. While physicians did not get the relief they sought with complete aversion of fee schedule payment cuts, the spending bill would avert the 4 percent Statutory Pay-As-You-Go reduction, which would have amounted to cuts of approximately $36 billion, from taking effect in 2023. 3. The legislation extends incentives under the alternative payment model, which were set to expire this year, but reduces the amount from 5 percent to 3.5 percent. The incentive is designed to offset losses in revenue physicians may incur as they move from fee-for-service to participation in value-based care models. 4. The package extends Medicare telehealth flexibilities through 2024. The deadline for these flexibilities has been tied to 151 days after the end of the COVID-19 public health emergency, meaning the precise date was unclear as HHS has continued to renew the PHE in 90-day increments. Under the legislation, providers would be able to lean on flexibilities guaranteed throughout 2024. 5. The package extends acute hospital care at home waivers and flexibilities for two years through 2024. Similar to telehealth flexibilities, the deadline for hospital care at home waivers was tied to the status of the PHE. CMS has approved more than 250 hospitals to participate in the acute hospital care at home program. 6. The legislation extends the low-volume hospital payment adjustment and Medicare-dependent hospital programs through fiscal year 2024, or Sept. 30, 2024. 7. The legislation includes $118.7 billion — a 22 percent increase — for VA medical care. Other healthcare end medical allotments include $47.5 billion for the National Institutes of Health (a 5.6 percent increase); $9.2 billion for the CDC; $1.5 billion for NIH's second-year Advanced Research Projects Agency for Health and $950 million for the Biomedical Advanced Research and Development Authority, according to Senate Appropriations Committee Chairman Patrick Leahy. 8. The American Hospital Association expressed satisfaction with a number of measures in the legislation, including the extension of telehealth, hospital-at-home and programs to help rural hospitals, but signaled toward the work that remains to garner funding for hospitals. "In the new year, we will continue to advocate for Congress and the administration to take action to address patient discharge backlogs, support our current workforce and increase the pipeline into the future, hold commercial health insurers accountable for policies that compromise patient safety and add burden to care providers, and strengthen hospitals that care for a disproportionate number of patients covered by government programs or are uninsured, to name a few of our priorities," association President and CEO Rick Pollack said in a statement shared with Becker's. See original article: https://www.beckershospitalreview.com/finance/congress-last-minute-1-7-trillion-omnibus-package-8-healthcare-takeaways.html < Previous News Next News >