{"id":273,"date":"2021-03-03T16:54:44","date_gmt":"2021-03-03T16:54:44","guid":{"rendered":"https:\/\/web.csg.org\/tcs\/?p=273"},"modified":"2021-03-03T16:54:46","modified_gmt":"2021-03-03T16:54:46","slug":"recommendations-on-telehealth-policy","status":"publish","type":"post","link":"https:\/\/web.csg.org\/tcs\/2021\/03\/03\/recommendations-on-telehealth-policy\/","title":{"rendered":"Recommendations on Telehealth Policy"},"content":{"rendered":"\n

From the CSG Healthy States National Task Force 2021 Report<\/em><\/p>\n\n\n\n

View as a PDF<\/a><\/strong><\/p>\n\n\n\n

View the Full Report<\/a><\/strong><\/p>\n\n\n\n

As the COVID-19 global pandemic impacted almost every sector of public policy in early 2020, the four subcommittees working within the CSG Healthy States National Task Force emphasize the role telehealth was playing throughout the health crisis and its importance moving forward. The subcommittees offered the following recommendations on telehealth policy:<\/p>\n\n\n\n

RECOMMENDATION: States consider enacting policies that seek to extend and maintain access to telehealth services.<\/p>\n\n\n\n

RECOMMENDATION: States consider advancing telehealth and telemedicine to meet the needs of rural communities that are often isolated from specialists.<\/p>\n\n\n\n

RECOMMENDATION: States consider helping to ease access to telehealth, including tele-mental health for frontline workers and others who need it during a crisis.<\/p>\n\n\n\n

RECOMMENDATION: States consider utilizing tele-mental health as both a cost-saving and live-saving measure.<\/p>\n\n\n\n

The COVID-19 pandemic caused a disruption to traditional health care delivery, which had a huge impact on demand for telehealth and telemedicine services.<\/p>\n\n\n\n

The research and consulting firm Frost & Sullivan predicted a 64% increase in virtual doctor visits in 2020.<\/p>\n\n\n\n

Analysts at Forrester Research predicted in April such visits could top 1 billion by the end of 2020.<\/p>\n\n\n\n

The Centers for Medicare & Medicaid Services (CMS) reported in July that more than 9 million Medicare beneficiaries used telehealth during the pandemic\u2019s early stages.<\/p>\n\n\n\n

Teladoc Health, the multinational telehealth services provider \u2014 and a private sector partner on the Leveraging Innovation Subcommittee — reported an 85% uptick in revenue for the second quarter of 2020 from the same period in 2019 and a 203% increase in visits.<\/p>\n\n\n\n

This increased usage at a critical time was made possible in large part by the actions of federal agencies and state governments to deploy strategies, relax regulations and provide funding to allow more Americans to access such services.<\/p>\n\n\n\n

At the federal level, CMS moved to<\/p>\n\n\n\n

\u2022          Increase the types of providers who could provide telehealth<\/p>\n\n\n\n

\u2022          Allow them to use different kinds of telehealth modalities, including phone-based services<\/p>\n\n\n\n

\u2022          Update coverage rates to pay the same rate to providers as for in-person visits<\/p>\n\n\n\n

\u2022          Expand the kinds of originating sites for telehealth visits<\/p>\n\n\n\n

At the same time, state governments<\/p>\n\n\n\n

\u2022          Expanded Medicaid coverage of telehealth services<\/p>\n\n\n\n

\u2022          Required private insurance to cover telehealth services<\/p>\n\n\n\n

\u2022          Allowed out-of-state providers to use telehealth to treat their residents5<\/p>\n\n\n\n

While many of these changes were considered temporary and tied to the nationwide public health emergency that was declared in late January, there appeared to be significant support for making many of the new processes permanent. As of July 2020, members of Congress had proposed several bills to continue telehealth freedoms and programs enacted during the pandemic beyond the expiration of the emergency.<\/p>\n\n\n\n

In a July 2020 issue brief, the U.S. Department of Health & Human Services offered more evidence that CMS was moving toward permanently expanding telehealth coverage under Medicare, arguing that \u201cnew telehealth flexibilities played a critical role in helping to maintain access to primary health care services \u2014 when many beneficiaries and providers were concerned with transmission of COVID-19. Future research could examine whether these flexibilities were effective and if telehealth may have improved access to care and health outcomes among underserved beneficiaries.\u201d<\/p>\n\n\n\n

In early August 2020, President Donald Trump signed an executive order that issued a proposed rule to make permanent Medicare payment of telehealth services for certain health providers. Congress would likely need to approve a more sweeping extension of telehealth policies.<\/p>\n\n\n\n

As of early August 2020, it was unclear what private insurers, many of which followed Medicare\u2019s lead on telehealth coverage, would do once the public health emergency is over. Also, as of August, UnitedHealthcare and Anthem, two of the nation\u2019s biggest insurers, hadn\u2019t decided beyond September or October on whether to extend telehealth policies. Others such as Cigna and the BlueCross plan in North Carolina said they would continue to cover telehealth services at pandemic rates through the end of 2020. Still, some providers expressed concern that insurers could revert back to paying doctors for telehealth visits at a fraction of the cost for office visits. When BlueCross BlueShield of Tennessee announced it was the first major insurer to make telehealth coverage permanent, the company did not say how much it will eventually reimburse for virtual visits.<\/p>\n\n\n\n

Some insurers surveyed as part of a study from the Robert Wood Johnson Foundation and the Urban Institute, argued that while payment parity might make sense during a public health emergency, reimbursement rates should ultimately reflect services rendered, and services delivered over the phone and computer versus in-person can be significantly different. Insurers also commented that there is a risk that telehealth drives up costs and further contributes to overutilization.<\/p>\n\n\n\n

AHIP, the advocacy group representing America\u2019s Health Insurance Plans, which served as a private sector partner to the CSG Healthy States Task Force, advised in a July 2020 policy brief, \u201cState legislatures can encourage the growth of telehealth by allowing health insurance providers to have flexibility in the way in which plans design benefits including \u2026 maintaining cost saving potential of telehealth by not mandating brick-and-mortar payment parity between virtual and in-person visits; telehealth visits do not always require the same level of intensity, same amount of time or the same equipment as in-person visits and thus should not be required to be reimbursed equally.\u201d<\/p>\n\n\n\n

Another important thing to consider when looking at telehealth policy is the return on investment (ROI). Telehealth ROI should consider all the benefits of telehealth, including both quantifiable and nonquantifiable benefits.<\/p>\n\n\n\n

Quantifiable benefits include transportation cost savings, lost wages savings, hospital cost savings and increased revenues to local labs and pharmacies. The Rural Broadband Association also includes nonquantifiable benefits in it\u2019s ROI calculations, including access to specialists, timeliness, comfort, transportation, provider benefits and improved outcomes. Both quantifiable and nonquantifiable benefits should be taken into account when considering telehealth from a return on investment perspective.<\/p>\n","protected":false},"excerpt":{"rendered":"

From the CSG Healthy States National Task Force 2021 Report View as a PDF View the Full Report As the COVID-19 global pandemic impacted almost every sector of public policy in early 2020, the four subcommittees working within the CSG Healthy States National Task Force emphasize the role telehealth was playing throughout the health crisis… Read More »Recommendations on Telehealth Policy<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[3],"tags":[148,138,149,150],"class_list":["post-273","post","type-post","status-publish","format-standard","hentry","category-policy","tag-csg-healthy-states-national-task-force","tag-healthy-states","tag-telehealth","tag-telehealth-policy"],"_links":{"self":[{"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/posts\/273","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/comments?post=273"}],"version-history":[{"count":0,"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/posts\/273\/revisions"}],"wp:attachment":[{"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/media?parent=273"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/categories?post=273"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/web.csg.org\/tcs\/wp-json\/wp\/v2\/tags?post=273"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}