(Boston, MA, 01/28/15) Dr. Jason Wasfy (cq) speaks with TeleHealth program manager Benji Meller as ... [+]
Federal lawmakers face a year-end deadline to solidify, or scuttle, an array of covid-era payment changes for telehealth services that include allowing people to stay in their homes to see a doctor or therapist.
Representative Brad Wenstrup and other house members, during a hearing in early March, offered personal experiences on how telehealth, home visits, and remote monitoring helped their patients, relatives, and constituents. Wenstrup, a Republican from Ohio, is also a pediatric surgeon and a retired Army reservist. He told the audience: “Patients are less anxious and heal better when they can be at home.”
Most of the proposals under review focus on how Medicare covers telehealth services. But the rules affect patients on all types of insurance plans because, typically, private insurance and some government programs follow Medicare’s example without congressional action. Virtual health care services like audio-only calls or meeting on-line with specialty doctors – such as an occupational therapist – could end. If passed, the bills would continue to allow rural health clinics and other health centers to offer telehealth services while waiving a requirement for in-person mental health visits.
Telehealth use ballooned in the early months of the Covid-19 pandemic and grew into a popular household term used to describe medical treatment. As a result, its practice has become a popular issue for lawmakers on both sides of the aisle.
Major companies like Amazon
In a U.S. Census Bureau survey from August 2021 to August 2022, Medicare and Medicaid enrollees reported using telehealth visits the most – 26.8% and 28.3%, respectively. The survey of nearly 1.2 million adults also found that Black patients and those earning less than $25,000 reported high rates of telehealth use. Notably, people of color were those likely to use audio-only visits.
Ensuring access to telehealth services “is the best public policy,” said Debbie Curtis, a vice president of McDermott + Consulting, a Washington, D.C-based health care lobbying firm. “It is the best business outcome. It is the best patient outcome.”
Last January, lawmakers – including senators from Mississippi and South Dakota – sent a letter to the Biden administration urging the White House to work quickly with Congress to ensure payments continue for Medicare patients who use telehealth – especially for rural, underserved communities.
Maya Sandalow, a senior policy analyst for the Bipartisan Policy Center, a Washington, D.C. think tank, said lawmakers and policy makers are likely to consider a temporary extension of the payments rather than permanent changes. “Research is still coming out that covers more recent years than the acute effects of the pandemic,” Sandalow said to KFF.org (KFF is an independent source for health policy research, polling, and journalism based in San Francisco). “The center expects to release policy recommendations in the coming month.”
In North Dakota, Sanford Health’s Dr. David Newman said virtual care is often the only way some of his patients in the Western part of the state can get sub-specialty care, such as with behavioral health.
Newman, an endocrinologist and Sanford medical officer of virtual care, said 10% to 20% of his patients are seen virtually during the summer, as compared with about 40% in the winter month because “the weather can be so bad” that roads are impassable. In winters past, Newman would sit around “doing nothing for a day” because patients could not visit him. Now he has a full clinic using telehealth technology.
POSTSCRIPT: I was very excited when I wrote about Amazon’s use of drones (my blog October 23, 2023) to serve rural areas. Dr. Newman is fighting for his patients to be served and cured on a rapid basis. Living in an urban environment one can forget rural challenges. I hope Congress solves the problem and makes healthcare permanently available for rural patients.
