The Senate Health, Education, Labor, and Pensions (HELP) Committee is thinking about what must be retained of the 31 latest changes to telehealth policies once the COVID-19 national public health crisis ends.
The interim modifications to telehealth policies helped to improve access throughout the COVID-19 public health crisis. These modifications were essential to help stop the spread of COVID-19 and make sure that U.S. citizens get quick access to healthcare services. During the COVID-19 emergency, patients have accepted the new procedure and took advantage of virtual consultations and are utilizing remote monitoring applications.
The June 17, 2020 Senate HELP Committee meeting was organized to take a look at which of the latest changes must be fixed or prolonged when the COVID-19 pandemic ends. All committee members backed the idea of making some of the recent changes permanent. HELP Committee Chairman Sen. Lamar Alexander (R-Tenn.) endorsed making two changes permanent: The taking away of restrictions on originating sites and the extension of the types of providers that could be refunded via Medicare and Medicaid for offering virtual consultations.
Sen. Alexander said that the two changes will help healthcare providers attain better patient results, enhance patient experiences, and lower healthcare costs. There is a big support for making these two changes permanent especially with the intensive telehealth experiences at this time of the pandemic. Although it is still early to say if the telehealth modifications have a considerable impact on patient outcomes, they have without doubt helped to better access to medical services.
The University of Virginia (UVA) had 9,000% more virtual consultations from February to May. Ascension Saint Thomas had provided over 30,000 telehealth consultations per month from April to May from just about 50 per year. From April to May, telehealth consultations made up about 45% of all consultations.
The HHS’ Office for Civil Rights declared a Notice of Enforcement discretion for using platforms to provide telehealth services throughout the public health crisis. Besides public-facing platforms, applications that are not typically allowed under HIPAA may be utilized for telehealth. Although the move was needed, it is one modification that needs closer examination moving forward to make sure there is no risk to privacy and security of healthcare information.
The extension of telehealth services has not shown to be a great equalizer since a lot of people do not have the technology to make use of telehealth services. Karen Rheuban, M.D. suggested that Congress must give support to deploy further broadband as necessary to lessen geographic and sociodemographic disparities when accessing care.
There was solid support for continuing to refund telephone consultations to address the underserved population. At Brigham and Women’s Hospital and Massachusetts General Hospital, 60% of telehealth consultations happened over the phone in the last 3 months.
Besides making changes to originating site restrictions permanent, Kvedar, president of the American Telemedicine Association, advised providing the HHS the versatility to add to the list of qualified practitioners and therapy services for telehealth refund, to keep the grant and technical assistance programs, and to pay for infrastructure necessities.
There is a generally held perspective among providers that the choice to keep providing telehealth is mostly reliant on refund rates for telehealth. If the refund is reduced for virtual consultations, that may make providers discontinue providing telehealth in favor of in-person consultations. Sen. Mike Braun (R-Ind) recommended that there must not be pay parity because of the variations in overheads. Sen. Bill Cassidy (R-La.) additionally inquired if reimbursement must be equal when telehealth lowers providers’ overhead expenses.
Though access to telehealth was extended to Medicare and Medicaid patients, modifications must also be extended to the private sector. All harmonization efforts would be a great incentive for adoption and growth.