A recent study aimed to examine the impact of accessibility to a provider via telemedicine on emergency department visit rates in adults who were on home hospice and palliative care. Among the intervention group, the number of emergency department visits and the number of 911 calls decreased from 12 (54.5%) to one (4.5%) post intervention.
Hawai’i UTelehealth, a service run out of the University of Hawaiʻi at Mānoa John A. Burns School of Medicine, was funded by the Federal Communications Commission Connected Care Pilot Program to provide mental health service to rural populations who might experience time constraints, financial burdens and transportation barriers when trying to access services. The online telepsychiatry and telepsychology platform allows individuals to talk to a licensed professional about worries, stress, anxiety, substance use or other concerns at no charge.
A recent study found several barriers to utilizing telehealth for African Americans that were not related to access to technology. While over 90% of participants had the technology to use or access telehealth services, participants had less trust in doctors’ ability to diagnose COVID and less trust in doctor’s ability to treat them using telehealth. The authors summarize that having more Black doctors is key to increasing trust in different forms of health care delivery.
Many legislators in California want the state’s Medicaid program (Medi-Cal) to continue paying for audio-only telehealth appointments at the same rate as for video and in-person visits, a policy that began during the pandemic. From March 1, 2020 to April 30, 2021, Medi-Cal paid for 2.4 million phone appointments. A meta-analysis from the California Health Benefits Review Program reported that telephone visits are generally as effective as in-person visits.
The Federal Communications Commission is providing $57 million in funding for a total of 59 telehealth pilot project sites across the country. Included in these sites are those operated by Catholic Health Initiatives’ pilot project that seeks to expand broadband access to patients in 36 rural sites across Arkansas, Kentucky, Nebraska, Iowa, North Dakota and Minnesota. The aim of the project is to improve connectivity and strengthen chronic care management.
Telehealth visits make up between 60 and 70% of all healthcare services in U.S. tribal communities. However, as many tribal communities are in rural and isolated locations, they face challenges in telehealth delivery. For instance, less than 1% of Apache County, AZ, which is mostly located in the Navajo Nation territory, has access to high-speed internet.
Iowa State University received a $16 million investment from the National Science Foundation (NSF) to join New York City, Salt Lake City and North Carolina State University as a research platform host for NSF’s wireless research platform program. The ISU platform—ARA: Wireless Living Lab for Smart and Connected Rural Communities—has the specific goal of achieving universal and affordable rural broadband.
U.S. Representatives Liz Cheney (R-WY) and Debbie Dingell (D-MI) introduced the Advancing Telehealth Beyond COVID-19 Act of 2021. The bill aims to insure access to telehealth after the pandemic by eliminating geographical restrictions on Medicare coverage for telehealth services, allowing patients to use telehealth from home, allowing audio-only telehealth visits for certain circumstances, expanding the list of providers eligible to use telehealth, and extending coverage for telehealth services at federally qualified health centers (FQHCs) and rural health clinics (RHCs).
Telehealth utilization increased 4000% in the Midwest from May 2019 to May 2020. A report from HCTrends in Wisconsin found that this increase correlated with modest increases in health insurance prices. Additionally, 63% of employers surveyed for the report said telehealth is their primary cost containment strategy this year.
A bipartisan group of Senators reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021. First introduced in 2016, the new bill would permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. It would also allow health centers and rural health clinics to provide telehealth services, and give the Secretary of Health and Human Services permanent authority to waive telehealth restrictions, among other provisions.
The federal government is investing more than $14 million in telehealth programs that integrate behavioral health services into pediatric primary care, dubbed Pediatric Mental Health Care Access (PMHCA) projects. Through PMHCA programs, states or health systems create pediatric mental healthcare teams that can include child and adolescent psychiatrists, licensed mental health professionals and care coordinators.
Recent analysis by Kaiser found that, of the 33.6 million Medicare beneficiaries with a usual source of care whose providers were offering telehealth, 45% had a telehealth appointment between summer and fall of 2020. Additionally, for those Medicare beneficiaries who had a telehealth visit, more than half (56%) used a telephone only.
The AMA authored a report in which they identify several environmental variables (including types of practice, payment arrangements, social determinants of health, clinical use case, and virtual care modality) and value streams (clinical outcomes, quality & safety, access to care, patient/family/caregiver experience, clinician experience, financial and operational impact, and health equity) that affect how a telehealth program generates value.
Senators Steve Daines (R-MT) and Catherine Cortez Masto (D-NV) introduced the Telehealth Expansion Act of 2021 (S 1704). The bill would increase access to telehealth by exempting telehealth visits from meeting deductible requirements in HDHPs. This exemption was a feature of the CARES Act, and the Telehealth Expansion Act of 2021 aims to make it permanent.
Representatives Jason Smith (R-MO) and Josh Gottheimer (D-NJ) introduced the "Permanency for Audio-Only Telehealth Act” (HR 3447). The bill would require Medicare to cover audio-only telehealth services after the COVID-19 public health emergency ends.
The Illinois legislature is considering a bill that would make COVID-19-related expansions to telehealth services permanent through state statute. The bill would prohibit geographic or facility restrictions on telehealth services, allow patients to be treated via telehealth in their home, protect patients from being charged any additional fees by insurance providers for accessing telehealth services, and ensure that patients are not required to prove any sort hardship or access barrier to receive telehealth services.
Upon the mid-pandemic resignation of Sanford’s CEO, Bill Gassen was elevated to the leadership role at a time when the organization was facing an unprecedented set of challenges. In an interview, Gassen discusses his experience and Sanford’s future plans, including a $300 million initiative to transform rural healthcare and expand their virtual strategy.
COPIC, a medical liability carrier, laid out five key points for providers to consider as telehealth becomes more mainstream. These include licensure, out-of-state practice, prescribing laws, liability, and documentation requirements.
A bill that recently arrived on the desk of Iowa Governor Kim Reynolds would create payment parity for telehealth services. If passed, private health carriers in Iowa would have to reimburse telehealth services at the same rate as theri in-person counterparts.
Wisconsin will fund a pilot program to expand internet availability in rural areas through use of SpaceX’s Starlink low Earth orbit satellites that can provide high-speed internet in rural areas where broadband is limited or not available.
Mental health professionals in northern Minnesota describe how telehealth has allowed more people to reach mental health services. The flexibility to be referred to other providers—both in and out of state—has helped people get connected to therapy during the pandemic.
The Marshfield Clinic Health system, which serves a rural area of northwestern Wisconsin, described their experience ramping up telehealth during the COVID-19 pandemic. Marshfield’s director of virtual care, Chris Meyer, also serves as a member of the Program Advisory Council of the Great Plains Telehealth Resource and Assistance Center (gpTRAC).
Jonathan Neufeld and Mary DeVany of gpTRAC will be presenting at the 2021 Minnesota Rural Health Conference. Their workshop, “Moving Telehealth from “Rapid” Implementation to Optimization”, is scheduled for Wednesday, June 23, from 9:15 - 11:15 am. Click here to access registration for the conference, which will take place from June 22 - 23, 2021.
Enrollment for the FCC’s EBB program will begin May 12, 2021. Eligible households will be able to enroll in the Program to receive a monthly discount off the cost of broadband service from an approved provider.
Included in a recent bill to increase health and human services funding by $59 in Iowa is legislation to expand telehealth. The policy component would create payment parity for tele-behavioral health, requiring private insurers to reimburse providers for behavioral mental health services whether delivered in-person or via telehealth.