On March 31, the Government Accountability Office (GAO) published a report entitled, “Medicaid: CMS Should Assess Effect of Increased Telehealth Use on Beneficiaries' Quality of Care.”
The report states that “GAO's analysis of Centers for Medicare & Medicaid Services (CMS) data in five selected states shows that the number and percentage of services delivered via telehealth and Medicaid beneficiaries receiving them increased exponentially at the beginning of the COVID-19 pandemic in March 2020. From March 2020 through February 2021, 32.5 million services were delivered via telehealth to about 4.9 million beneficiaries in the five states, compared with 2.1 million services to about 455,000 beneficiaries in the 12 months prior to the pandemic.”
The GAO studied CMS data from Arizona, California, Maine, Mississippi, and Missouri.
“CMS does not collect, assess, or report information about any effect delivering services via telehealth has on the quality of care Medicaid beneficiaries receive and has no plans to do so,” the report continues. “Doing so is important, given concerns GAO has raised about the quality of care provided via telehealth. It would also be consistent with how CMS has encouraged states to use data on quality of care to identify disparities in health care and target opportunities for improvement to advance health equity. These efforts could begin with data for quality measures CMS already collects or through other means.”
The GAO says that it conducted this study because in response to the COVID-19 pandemic states expanded their coverage of telehealth in Medicaid. “The CARES Act includes a provision for GAO to report on the federal response to the pandemic,” the report adds. “In addition, GAO was asked to examine the use of Medicaid flexibilities in response to COVID-19. This report describes selected states' telehealth use before and during the pandemic, and experiences with and plans for telehealth. It also evaluates, among other things, CMS's telehealth oversight of quality of services.”
GAO says that it analyzed state-reported data on telehealth use in the states selected partly due to variation in geographic, Medicaid program size, and percentage of population living in rural areas. Additionally, GAO reviewed federal oversight documents, interviewed state and federal Medicaid officials, and assessed CMS oversight against CMS guidance on the use of data to identify health disparities regarding coverage and target improvements.
Finally, GAO recommends that CMS collect and analyze information about the effect delivering services via telehealth has on the quality of care Medicaid beneficiaries receive and also determine any next steps based on the results of the analysis.
The full report can be accessed here.