This Week Health

We have a bunch of data on Telehealth. Why don't we use it? Perhaps its time to stop saying telehealth like it's one thing and examine the different components to see what is working and what isn't. Just a thought.

Transcript

Today in health, it telehealth expansion. How about we make a data-driven decision? Just thought my name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health instead of channels, dedicated to keeping health it staff current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health

Gordian dynamics, Quill health. nuance, Canon medical, and current health. Check them out at this week. health.com/today. All right. Two things going on today. Let's see both related to telehealth. Tell how stakeholder letters to the Senate. So the honorable Charles Schumer and the honorable Mitch McConnell, both received a letter.

Today. And I don't know if it was today. Let's Term to 13th. Thank you for your continued leadership and expanding access to virtual care during the COVID-19 public health emergency PAG. This access has been transformational patients now expect and often prefer telehealth as a key component of our healthcare system. And providers have been able to reach many patients.

That previously had access barriers through virtual care. I agree. These opportunities were made possible by the flexibilities and waivers under the current PAG. However, the end of the COVID-19 PHG period, the clock begins to tick. On the current 151 day statutory extension of tele-health waivers.

While we appreciate these temporary extensions. The short-term nature continues to introduce significant uncertainty into our healthcare systems. Providers must weigh the cost of investing in techno technological and. Clinical infrastructure required. To maintain tele-health programs at scale against the uncertainty of when these telehealth policies may add further patients who utilize telehealth as part of their care plan faced the possibility of a forced return to in-person care. This is particularly concerning for those utilizing tele-health to reach experts at long distances, for access to mental and behavioral health practitioners, and those receiving ongoing remote care.

For chronic conditions. All right. Can we give you a little bit more? Virtual care is now fundamental part of the us healthcare And it will improve patient access to high quality care and strengthened continuity of care. Well, beyond the COVID 19 pandemic. Well, many of the most compelling clinical use cases for virtual care.

Our only, now emerging more communities than ever have experienced the powerful impact tele-health had in bridging gaps in care tele-health is helping to address the crisis level mental health, primary care, and other workforce shortages, many underserved communities that historically have had limited access to care.

May now. Uh, beam in additional support beam in additional support. That's what it says for their workforce, as well as top. Specialists to help save lives and treat critically ill patients. Unfortunately. Without statutory certainty for remote care. The hard work of building infrastructure, trust and relationships with these communities is beginning to stall.

Okay. As such, we are the Senate to act this fall to ensure a certainty for telehealth services as demonstrated by the house, which passed the advancing tele-health beyond COVID-19 act. Uh, tele-health is an overwhelmingly bipartisan issue. The Senate should act to pass a two year extension on these important tele-health policies while continuing to push for a permanent extension.

Okay. So you have that letter that went to the members of Congress. It was signed by a ton of people. Let's see. Here we go. Um, Yeah, it was a bunch of health systems and then a bunch of Americans, right? So American academy of filling the blank, allergy asthma and immunology, home care medicine, hospice care neurology.

Uh, PAs physician medicine, you get the picture of American college of emergency physicians. American college. Have you got at American heart association?

Uh, medical association so forth and so on. All the way down the line, you have Amwell in there, you would hope that ammo would be inherited. Hope that all the Teladoc should be in here as well. I'm sure they are. There's a hundred plus type organizations that have signed onto this. As, um,

Yeah, yeah. About a hundred or so that are in this. So not a surprise. Teladoc is in here as well as a, just a whole bunch of health systems. Okay, so you got that letter. The second thing we have here is a healthcare innovation group.com. Has H S O. G report puts telehealth expansion under the microscope.

And this is going to be my point by the way. Dana dis Data-driven decision-making. Easier said than done, but data driven. Decision-making. We now have a bunch of data. Maybe it's not. You know, we don't have enough of a time history. But we have a bunch of data. So that, that's what this is talking about.

Uh, let's see two recent reports from the us department of health and human services of the office of inspector general. Examine the explosion in the use of tele-health during the pandemic to help policymakers balance concerns. About issues such as access, quality of care costs. Health equity and program integrity. All right. So listen to those issues.

Such as access. Tell out the screen at access quality of care. Um, actually that needs to be measured a little bit. But a cost definitely cost less. And then health equity. So reaching out to those communities, but then it also says, and program integrity, as they consider extending widespread access to telehealth, the centers, uh, CMS is evaluating the continuation of telehealth services that were temporarily added during

lehealth services from March,:y room. So again, peak March,:

We're used by beneficiaries enrolled in Medicare fee for service and total Medicare paid over $5 billion for these services, 76 times more than what it paid for. Tele-health in the prior year. Uh, let me give you some of the data in brief beneficiaries in urban areas are more likely to use. Um, then rural areas.

Which is probably just per capita. A dually eligible, Hispanic, younger, and female beneficiaries were also more likely than others to use. Tele-health also one fifth of beneficiaries. You certain audio Tel only tele-health services. The vast majority of these beneficiaries use them exclusively older beneficiaries, more likely to use certain audio only services as we're dually eligible and Hispanic beneficiaries.

Uh, this goes, that OIG has additional evaluations and audits underway, examining telehealth and Medicare. To help further inform program policies and oversight. So that's what they're doing. They're doing the research. And I've been saying this for a long time. Actually. I've been saying this. During the middle of the pandemic. I said, this is going to give us the data. We need to see exactly where telehealth benefits the patient, where it improves quality of care and where it,

It improves access, but also where it's open to fraud where it's open to abuse and those kinds of things. All right. So cause on Congress has extended the temporary tele-health expansion. For five months after the public health emergency ends. If that deadline comes to, um, Comes before longterm telehealth policies have been enacted. OIG recommends that CMS should seek additional authority from Congress to temporarily continue access to telehealth services in urban areas.

And from the beneficiary's home.

This will ensure that beneficiaries enrolled in Medicare fee for service can continue to receive services via telehealth, regardless of geographic location, or ability to travel to a healthcare facility to receive care while policymakers deliberate. And develop more permanent policies for telehealth as CMS development.

Uh, develop proposals for long-term policies on tele-health. Oh, I G said. It should carefully consider the impact of tele-health flexibilities on beneficiary access to care health equity. Quality cost and program integrity. And my silhouette for this again, is so simple, which is data driven. Decision-making don't talk about, tele-health like, it's one thing we know better. It's not one thing it's, um, it's a bunch of different things. It is, uh, it is, uh,

You know, care, care provider to care provider it's telestroke it's it's, uh, it's console it's, it's all those kinds of things. It's um, primary care it's direct to a patient. It is, um, uh, mental health, behavioral health. Uh, kinds of services. Um, it is, uh, caring for chronic conditions. It is remote patient monitoring. It is a lot of different things and the reality is it doesn't work in all the areas. It doesn't work effectively in all the areas. We can't treat it as one thing. We should look at it in the subsections that it is, we should have used the data to determine where it, where does it improve access?

Uh, improve access. Uh, where does it improve health equity? Where does it improve quality? Where does it increase fruit costs? And where, um, where is it open to fraud and abuse? Uh, and we should, we should be. I judicious and how we write these programs and not just, you know, categorically signing a letter that says, Hey, you should, you should spend, continue to spend this money on tele-health because it's, it's important.

Um, and it's just too broad. It's too broad of a category and needs to be broken down. We need to look at the data and we need to make decisions based on. The data. Seems like it makes sense to me. I don't know. Maybe, maybe I'm off base who knows, you know how to reach me bill at this week, health.com. Let me know what you think.

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