Telehealth Expansion: COVID-19’s Silver Lining
by: Catherine Saar
Telemedicine was already on the rise before the current COVID-19 crisis and is quickly becoming the standard of care for many. It is often a faster, easier, and more cost-effective way to treat minor complaints and address routine health needs. In a recent post from the American Academy of Family Physicians, one provider shared, “If there is a silver lining in this crisis, it is that barriers to care have been removed. Previous barriers to telehealth have been insurance payment limitations, Drug Enforcement Administration restrictions on addiction care, and the lack of experience that many clinicians and patients had with this modality.”
In our work we have found that many community health center (CHC) leaders seem to agree that telehealth expansion may be the silver lining to the COVID-19 pandemic. So many CHCs have been hoping to offer and to be reimbursed for telemedicine for years as a way to expand access to care for those who are remote, and/or who cannot easily travel to physical sites for any number of reasons. Now, almost overnight, regulations are changing, and telehealth implementation is going full force in all sectors of health care.
Of course, trying to implement a major program so quickly can create short term challenges around accurate interpretation of new policies, figuring out coding, billing, establishing workflows, and obtaining equipment and training.
Jonathan Neufeld, PhD, the Director/Principal Investigator for Great Plains Telehealth Resource & Assistance Center Program, joined one of our recent virtual events to provide insights on telehealth expansion. Some of his key points included:
Pay Attention to Varying Definitions of Telehealth
For Medicare, definitions of “Telehealth,” “eVisits,” and “Telephone E/M” all vary and require different billing codes. Knowing the codes and associated reimbursement rates is important.
Billing and Reimbursement are Complicated
While regulations are shifting, reimbursement still varies by payer, so it is important to understand policies for Medicare, as well as each commercial plan and Medicaid, which varies by state. Payers are changing and adapting to an evolving situation, so keeping up to date is essential. Even since our recent session, new guidance has been released by CMS.
Implications and Strategies to Consider During this Pandemic and Beyond:
- Telehealth regulations and practice will likely NOT return to their previous state, and the new state is not completely defined
- Equipment costs have the potential to be lower than expected; time/complexity costs will be buried in the general chaos of the coronavirus response
- Care pathways or “channels” will multiply (phone, text, photo, video) along with billing codes (CCM, eVisits, RPM, intra-practice, etc.)
- Communication to patients about the availability of services via telehealth will be important
There is much speculation that organizations that can embrace telehealth will realize many unforeseen benefits, both for providers and for patients, including improving access to quality care for all. If that outcome can be realized, and is hastened by the COVID-19 pandemic, that could indeed be quite a silver lining.
Resources to Explore
-Covid-19: a remote assessment in primary care (BMJ open access journal)
-Why the Telemedicine Physical is Better Than You Think (Jud Hollander, MD, Jefferson Health)
Workflows for Federally Qualified Health Centers
-Workflow and Guides (Center for Care Innovations)
-Telehealth: Getting a new workflow started during COVID-19 (HITEQ Center downloadable resource)
Webinars about telehealth technology
-Webinar Series: Telehealth Technology 101 with Dan Kurywchak (Center for Care Innovations)
-www.matrc.org/ (click on COVID-19 link)
-www.telehealthquickstart.org (Presentations with tips and other resources)