Twenty three healthcare leaders have released their much-anticipated final report, identifying challenges and opportunities for telehealth in the wake of the COVID- 19 pandemic. The Taskforce on Telehealth Policy, convened by the National Committee for Quality Assurance, the Alliance for Connected Care, and the American Telemedicine Association, spent the summer building consensus among its members on a comprehensive set of findings and recommendations.
Taskforce members—representing a broad spectrum of health plans, providers, consumer advocates, and health quality experts from the public, private and non-profit sectors—see the report as a blueprint for how policymakers can harness the rapid expansion of telehealth and create lasting healthcare improvements that prioritize patient safety, quality, and equitable access to care, according to officials from the convening organizations who made the announcement earlier this week.
The Taskforce on Telehealth Policy posted the full report online for public review. Highlights of the report’s key findings and recommendations include:
- Telehealth is the natural evolution of healthcare into the digital age. It is essentially a setting or modality of care, rather than a type of care. As such, it should be held to the same standards and quality measures as in-person care wherever possible and appropriate.
- Early data suggests that telehealth has substituted for a good deal of in-person care during the pandemic without increasing overall costs. Studies show that it can also relieve travel burdens, risks, and care delays, improve behavioral care access, and reduce missed appointments, costly transfers to hospitals and emergency departments and hospital readmissions.
- Policymakers must expand efforts to ensure access to broadband and technology infrastructure to promote equity and not exacerbate care disparities as healthcare moves into the digital age.
- Policymakers should maintain the following specific COVID-19 policy changes:
- Lifting geographic restrictions and limitations on originating sites.
- Allowing telehealth for various types of clinicians and conditions.
- Acknowledging that telehealth visits generally can meet requirements for establishing a clinician/patient relationship.
- Lifting restrictions on telehealth across state lines.
- Full enforcement of the privacy provisions of the Health Insurance Portability and
- Accountability Act (HIPAA) should resume when the current public health emergency ends.
- The ongoing move from fee-for-service to value-based arrangements in healthcare should enhance the ability of patients, payers, and providers to leverage telehealth’s potential.
During the public health emergency, the Centers for Medicare & Medicaid Services (CMS) added 135 services such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, that could be paid when delivered by telehealth. On Aug. 3, the federal agency proposed to permanently allow some of those services to be done by telehealth, including home visits for the evaluation and management of a patient (in the case where the law allows telehealth services in the patient’s home), and certain types of visits for patients with cognitive impairments.
Indeed, throughout the course of the pandemic, hundreds of healthcare organizations have urged Congressional leaders to make telehealth flexibilities created during the COVID-19 pandemic permanent. One letter from 340 industry groups emphasized the importance of providing telehealth services during the crisis—care that would not have been able to be delivered without the loosening of prior restrictions.
Importantly, those groups noted that statutory restrictions within the Social Security Act and that the authorities granted to HHS and CMS through recent coronavirus legislation are limited to the COVID-19 public health emergency period, meaning that “Congress must act to ensure that the Secretary has the appropriate flexibility to assess, transition, and codify any of the recent COVID-19-related telehealth flexibilities and ensure telehealth is regulated the same as in-person services.” Payment-focused telehealth changes are under the authority of Congress rather than HHS and CMS.
“These recommendations were developed through broad consensus and clearly seek to establish telehealth as a permanent modality,” said Ann Mond Johnson, CEO, the American Telemedicine Association. “We heard loud and clear from a range of stakeholders that virtual care must remain an option for patients and providers after the public health emergency is over. Our recommendations provide guidance on aligning standards, quality, payment, and program integrity to make telehealth available to all, including those in underserved and rural communities and our most vulnerable patient populations.”
