The American Academy of Pediatrics has issued a policy statement titled “Telehealth: Improving Access to and Quality of Pediatric Health Care.” According to the AAP, the statement “addresses how telehealth and telehealth policy can increase patient access to primary care and subspecialty pediatric expertise, support care coordinated within the medical home, and enhance communication and collaboration among clinicians and other stakeholders, resulting in cost-efficient, equitable, high-quality care.”
The Department of Health and Human Services will be distributing nearly $20 million to strengthen telehealth services in rural and underserved communities across the country. This spending includes about $4 million to help bring primary, acute and behavioral health care directly to patients via telehealth in 11 states, and an additional $4.3 million to help specialists at academic medical centers provide training and support to primary care providers in rural and other underserved areas via “tele-mentoring.”
Funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) will go to 10 Maryland jurisdictions for a one-year pilot program that aims to increase access to telemental health services, including behavioral healthcare and substance use disorder treatment. Providers will receive funding for smartphones and tablets to distribute to patients. The program also addresses the issue of broadband affordability by providing participants with funding for one year of internet access or a wireless carrier plan. Further, providers participating in the MDH pilot program will teach patients and healthcare staff how to use the program’s technology and offer additional technical support to overcome the barriers of digital literacy.
Of the approximately 20% of children in the U.S. experience a mental or behavioral health condition in a given year, only about a fifth of those children receive care from a specialized provider, with children of color less likely to receive adequate services. To address these gaps, HHS is investing $10.7 million in the Pediatric Mental Healthcare Access Program, a program that supports networks of teams providing teleconsultation, training, technical assistance and care coordination for providers to diagnose, treat and refer youth with mental health conditions and substance use disorders.
In a recent survey of almost 100 hospitals and health systems conducted between May and June of 2021, over 80% of respondents reported that telehealth visits comprised 20% or less of their total appointments during the two-month span. The 18% of hospitals that conducted more than 30% of their appointments virtually said they expect a decrease in virtual visits as the country transitions to post-pandemic times. Patient portals were the most common way through which patients participate in virtual care, suggesting that if providers turned their focus to the “digital front door,” it could potentially increase telehealth use overall.
H.R. 4480, “The Telehealth Coverage and Payment Parity Act,” would ensure that all patients, including those covered under ERISA plans, permanently have telehealth coverage. If it becomes law, the bill would:
- Ensure all medically necessary benefits in ERISA plans are covered via telehealth.
- Prohibit restrictions on which conditions can be managed remotely. For example, ERISA plans would not be able to prohibit physicians who provide in-person care from treating patients via telehealth.
- Allow expanded use of telehealth modalities—for example, audio only—in addition to traditional two-way audio-visual technology, where appropriate.
- Require payment parity between telehealth and in-person services for physicians, as well as uniform cost-sharing requirements for patients.
- Enable physicians to offer telehealth services to new and established patients.
During the pandemic, CMS granted coverage of certain audiology and speech-language pathology telehealth services for Medicare beneficiaries, and nearly all state Medicaid programs and many private insurers followed suit. Recent polls and surveys have found that a majority of Americans are open to using telehealth for hearing services, and patients report high levels of satisfaction with telehealth for such services.
Bret Anderson, principal at the Chartis Group, spoke about what virtual care may look like moving into the future of COVID-19 and beyond. Anderson notes that health systems must “view telehealth as a central option in their arsenal of communication and care delivery channels,” utilize hybrid care settings, and create more responsive and flexible systems that can better adapt to events like the COVID-19 pandemic.
Doctor On Demand, Grand Rounds Health, and Medtronic are joining Walmart, Target, Best Buy, State Farm, Genentech, and Accenture–all members of the Black Community Innovation Coalition–to create a “dedicated care concierge and healthcare navigation platform” aimed at reducing barriers to care access and boosting health equity among Black Americans. This effort will take on social determinants of health in an effort to reduce the health disparities experienced by Black Americans.
Sanford Health announced a $350 million gift to create a virtual care centers that will provide accessible care in rural and underserved areas of the Midwest. The virtual care center will serve people from across Sanford Health’s network of hospitals and clinics, expanding opportunities to receive care in our communities as well as our long-term care locations. It will also house innovation, education and research initiatives to advance digital healthcare solutions for the future.
Essentia Health was awarded $981,204 to support the acquisition of remote monitoring devices and video carts with peripheral cameras and stethoscopes/EKGs for care during the pandemic, and to increase wireless broadband coverage at eight clinics to allow for additional space for telehealth patients. The funding came as part of Round 2 of the FCC’s COVID-19 Telehealth Program, which aimed to support providers by providing reimbursement for telehealth technologies during the pandemic.
This article reviews recent changes to coverage and accessibility of mental health telehealth services that affect Minnesotans. Previously, Minnesota had allowed out-of-state providers to offer telehealth services to Minnesota residents due to the COVID-19 state of emergency. This reciprocity is no longer in effect. However, out-of-state psychologists may still be able to serve Minnesotan residents as Minnesota enacted the PsyPact legislation on May 25, 2021. PsyPact allows psychologists licensed in a state with PsyPact legislation to become licensed with PsyPact and offer telehealth services in all PsyPact states.
Two North Dakota health care systems are getting grants through the second round of the Federal Communications Commission’s COVID-19 Telehealth Program. McKenzie County Healthcare Systems in Watford City, is getting just under $200,000 for telehealth equipment and connectivity, and South Dakota-based Sanford Health, which has a hospital in Bismarck, is getting about $968,000 for connectivity and security work.
A new study conducted by researchers from the University of Minnesota School of Public Health, Harvard Medical School and the university’s T.H. Chan School of Public Health and athenahealth found that telehealth visits may provide better infection control than in-person visits. The study found that people who visited their doctor’s office after someone infected with the flu had visited were much more likely to come down with the flu themselves, a factor that would not be an issue with telemedicine visits.
Telehealth provider SOC Telemed is expanding its partnership with Iowa-based health system UnityPoint Health by broadening its telepsychiatry services from three hospitals to an additional four hospitals. SOC Telemed and UnityPoint first implemented SOC Telemed’s Telemed IQ platform and telepsychiatry solution three years ago, and in that time decreased the average length of a mental health visit by 11.87 hours and saved over $1.7 million in annual boarding costs.
As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Manatt Health has developed a federal and comprehensive 50-state tracker for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic. Linked here is the executive summary, which outlines federal developments from the past two weeks, new state-level developments, and older federal developments.
During the COVID-19 pandemic, a high proportion of FQHCs’ telehealth visits were conducted via audio-only. This article discusses measures that providers can take to ensure that audio-only visits are safe, secure, and HIPAA-compliant.
Lawmakers in North Dakota are beginning to look into determining a consistent payment model for telemedicine services across the state. This will create clarity for insurers, allow telehealth to become more commonplace, and ultimately create greater access to telehealth care for rural residents.
Recent research conducted by Zoom found that 72% of survey respondents want to attend healthcare appointments both virtually and in-person post-pandemic. In an interview with Heidi West, head of healthcare at Zoom, West discussed the results of this survey and what a hybrid approach to health care might look like in the future. West maintains that telehealth is a necessary care option to improve accessibility to care, though she acknowledges that issues facing universal telehealth access include broadband accessibility and reimbursement policies.
Members of the Pro-Choice Caucus introduced a resolution asking for a reconsideration of policies governing access to abortion-inducing drug mifepristone. The FDA Commissioner stated that the agency would look into permanently lifting restrictions on telehealth abortions. The proposed resolution aims to ensure that any policy changes regarding tele-abortions are “equitable and based on science.”
Rep. Cindy Axne (IA-03) announced her support for two bipartisan bills—the Telehealth Modernization Act and the CONNECT for Health Act—to preserve telehealth options for Iowans beyond COVID-19. The bills would remove geographic site requirements, allow beneficiaries to use telehealth from their own homes, ensure reimbursement for telehealth services provided by health centers and rural health clinics, and improve the process for covering additional telehealth services.
US Reps. Dean Phillips (D-MN) and Steve Chabot (R-OH) reintroduced The Telehealth Coverage and Payment Parity Act (HR 4480) after it failed in 2020. The bill would require payers to cover telehealth services, including cost-sharing requirements such as deductibles, at the same as in-person services; prohibit restrictions on which conditions can be managed virtually; eliminate location-based restrictions on providers and guarantee that all medically necessary benefits in ERISA plans are covered by telehealth. It would also expand the definition of a “qualifying telecommunications system,” or telehealth platform, to include the telephone, internet communications, streaming media communications “and such other systems as specified by the Secretary of Health and Human Services.”
The Biden-Harris Administration announced on Thursday, Aug. 12 that it will make up to $500 million available in grants to help rural healthcare facilities, tribes and communities expand access to COVID-19 vaccines, healthcare services and nutrition assistance. Applicants can apply for two types of assistance: Recovery Grants and Impact Grants. Recovery Grants are available to help public bodies, nonprofit organizations and tribes provide immediate COVID relief to support rural hospitals, healthcare clinics and local communities. Applications will be accepted until funds run out. Impact Grants are meant to help regional partnerships, public bodies, nonprofits and tribes solve regional rural healthcare issues and build stronger and more sustainable systems in response to the pandemic. Impact Grant applications are required to be submitted to local USDA Rural Development State Offices by 4 p.m. on Oct. 12, 2021.
Though telemedicine has been beneficial for connecting remote patients to care, however, not all patients and providers in rural parts of the state may be able to take advantage of telehealth technologies. For instance, Dr. Amy Slagle, a family physician at the Menominee Tribal Clinic in Keshena, shared they don’t typically use telehealth because their service in Northeast Wisconsin is inconsistent and because many patients do not own smartphones.
Though telehealth claims have been declining in recent months, telehealth visits increased drastically across all U.S. states during the pandemic. California experienced a 1,860% percent growth in telehealth utilization, followed by Massachusetts, Oregon, Hawaii and Vermont. Even states with the least growth still more than doubled their use, with North Dakota bringing up the rear at 218%. Wyoming, Mississippi, Iowa and Arizona were also on the low end of the range.