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July 23, 2020

Taking Action Toward Telehealth Reimbursement

For many in healthcare, time is split into two distinct categories: before and after COVID-19. Prior to the pandemic, in-person visits were the norm for most practices. Offices bustled and physicians physically saw numerous patients a day for a variety of needs.

But, as COVID spread at the beginning of 2020, it quickly became clear that physicians needed a way to treat their patients virtually - and they needed it fast. 

After The World Health Organization officially declared the novel coronavirus a pandemic, U.S. providers nationwide began implementing telehealth solutions in order to continue seeing patients despite lockdowns and social distancing orders. Telehealth was seen as a way to triage patients and minimize office foot-traffic to reduce exposure, protect staff and patients and free up appointments for existing or new acute patient situations. And while reimbursement had previously been a challenge to adoption, Congress waived statutory barriers to allow for expanded access to telehealth, providing federal agencies with the flexibility to allow healthcare providers to deliver care virtually.

Many providers across the country used these regulatory flexibilities to scale delivery and provide patients, many for the first time, access to high-quality virtual care, and telehealth adoption soared. In fact, telehealth claims increased by 4,300% year-over-year in March 2020. Questions have not yet been answered, however, about long-term payment models for virtual care. 

Permanent Telehealth Reimbursement Is Needed To Meet Patient And Physician Needs

With so many patients accessing care virtually, expectations for healthcare delivery have shifted. Many patients have grown accustomed to telehealth - and plan to continue using it long after COVID. According to our recent patient survey conducted by Harris Poll over 8 in 10 patients who have used telehealth services since COVID say they love/like it.

Telehealth will no longer be a “plus” or “nice to have” for practices -- it will become a requirement to stay in business. For example, telehealth allowed Updox customer Central Ohio Primary Care, the nation’s largest independent primary care practice, to see 75 percent of their normal patient volume during COVID, when many practices have struggled. Julie Neil, manager of ambulatory applications for Updox customer Washington Regional Health System, said she could see up to 20 percent of the organization’s ambulatory visits continuing with a telehealth option in a post-COVID environment.

Virtual care has the potential to truly transform healthcare through modern ways to maximize patient engagement, improve outcomes and enable more timely, efficient connections between patients and their physicians. But in order to make this a long-term reality, legislators at both the federal and state level need to take immediate action to ensure there are policies in place enabling physicians to be reimbursed for virtual care visits.

Updox recently joined 340 organizations in a letter to Congress urging leaders to make telehealth flexibilities permanent and outlining actions that should be taken immediately to ensure CMS has the authority to continue making telehealth services available once the current health emergency has subsided. Specific requests included:

  • Remove obsolete restrictions on the location of the patient to ensure that all patients can access care at home, and other appropriate locations;
  • Maintain and enhance HHS authority to determine appropriate providers and services for telehealth;
  • Ensure Federally Qualified Health Centers and Rural Health Clinics can furnish telehealth services after the public health emergency; and
  • Make permanent Health and Human Services (HHS) temporary waiver authority for future emergencies.

These are just the first steps. But while providers await federal rulings, some government officials have begun taking necessary steps to cement telehealth expansions on a state level. Several states such as Colorado and Idaho have issued executive orders to help physicians and providers continue the momentum of telehealth adoption and strengthen the capacity of their workforce.

A combination of virtual and in-person care is the way forward to increased patient engagement, improved outcomes and better efficiency. The healthcare industry needs to support physicians and practices through innovation and efficient technologies as well as reimbursement and patient access. Click here to learn more about the future of telehealth.

Topics: Blog, telehealth, telehealth services, telehealth patient engagement, covid-19