COVID-19 Pandemic Accelerates Telehealth Adoption: New Regulatory Changes

COVID-19 Pandemic Accelerates Telehealth Adoption: New Regulatory Changes

After over a decade of limited Telehealth use, the regulatory nudge to innovate patient care delivery is finally here. The Public Health Emergency (PHE), due to COVID-19, has presented the healthcare industry with the opportunity to utilize and receive payment for the use of Telehealth technology, streamlining care delivery, and increasing access to care, all the while ensuring the safety of both patients and providers. What may have taken the industry another 10 years of regulatory red tape has now been made available within the last 10 weeks. A safe and convenient patient experience is extremely important now more than ever and should be a priority for every organization.

The PHE has delivered what consumers have been championing for quite some time – access to providers via modern technologies. Telehealth delivers safe, effective, and convenient care accessible to patients, no matter their location, age, or condition.

Telehealth is proving to deliver high value for both providers and patients

  • More than 79 percent of patients say that scheduling telemedicine follow-up visits is more convenient than arranging in-person visits according to Massachusetts General Hospital
  • Over 40 percent of Millennials say that telemedicine is “extremely or very important” when picking a physician

This support by patients and consumers has only increased during the PHE. So much so that Google has added new features in Search and Maps that will highlight telehealth options and services provided by health professionals, increasing transparency for consumers on the available services offered by their provider.1

With in-office patient volumes decreasing (in some cases, dramatically so), it is important to form a telehealth execution plan and strategy in order to maintain your business and provide care for your patients. Is your organization maximizing and adjusting to the opportunities that these new laws have brought about? How is your organization adapting to this new normal?

Regulatory Changes Must-Knows

CMS is leading the way in regulatory and reimbursement changes.2 Nevertheless, private insurers are following the trend, continuing to open up access to Telehealth services across the country.3

Similarly, a CMS toolkit was recently published to enable states to accelerate the use of Telehealth in Medicaid and CHIP; reinforcing the nudge for care delivery innovation.4

Although Telehealth reimbursement and regulatory requirements are expected to continue to shift, your organizations have the opportunity to safely engage with patients remotely right now.

Consider the following regulatory changes that help make the most of Telehealth program(s) and services:

1. Telehealth services can be provided by more than just physicians.

Service must be provided by a qualified provider to Medicare beneficiaries (subject to state law):

DETAIL

BUSINESS IMPACT

  • Physicians
  • Advanced Practice Providers
    1. Nurse practitioners (NPs)
    2. Physician assistants (PAs)
    3. Nurse-midwives
    4. Clinical nurse specialists (CNSs)
    5. Certified registered nurse anesthetists (CRNAs)
  • Clinical psychologists (CPs) and clinical social workers (CSWs)
  • Registered dietitians or nutrition professional
  • Enable qualified health providers to practice at the top of their license, and billing abilities
  • Leverage APPs to deliver Telehealth services for missed routine or evaluation & management appointments due to the PHE
  • Promote and deliver preventive care protocols, in an effort to keep your facility capacity manageable

2. Telehealth services can be provided to any Medicare patient and are no longer restricted by the patient or provider location.

DETAIL

BUSINESS IMPACT

  • Patient Geography: Patient can be located anywhere, no longer required to reside in a qualifying rural area
  • Patient Physical Location: Patient can receive care anywhere, including home and does not have to be in a qualifying healthcare facility (“originating site”)
  • Provider Location: Service is by one of ten eligible professionals and can conduct services from outside the office or health care facility
  • Improve on patient retention and reduce system leakage
  • Attract new patients to a practice
  • Improve provider satisfaction and safety while continuing to provide care and bill for services

3. Telehealth visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.

DETAIL

BUSINESS IMPACT

  • The regulatory changes permit the use of CPT telehealth modifier 95, to allow providers who bill for Medicare telehealth services at the level of what would have been an office visit (POS 11 at the non-facility rate)
  • 80+ services are able to be delivered via Telehealth.5
  • Continue to accrue and generate revenue despite the impact to in-office visits volume
  • Reserve in-office/facility visits for high severity or critical patient care

4. Virtual Check-ins can be billed for by qualified health providers and can be provided via secure text messaging.

DETAIL

BUSINESS IMPACT

  • Virtual Check-ins – A brief communications between provider and existing patient, 5-10 minute interaction (HCPCS codes G2010)
  • A Virtual Check-in can also be billed for reviewing an image or recording. (HCPCS code G2012)
  • Virtual Check-ins are not on CMS’s list of telehealth services and can be provided by telephone and/or secure text messaging only
  • Seek reimbursement for quick patient interactions that were likely overlooked prior to the PHE
  • Enable office staff to send pertinent care information or reminders to a patient population
  • Communicate with patients in the manner they prefer

Read more here on why Telehealth isn’t enough and why you need a virtual care strategy.

Seamless care experience can only happen if nurses, physicians, patients, and the entire care community are connected and collaborating. Explore how TigerConnect helps healthcare teams get the right information to the right people, at the right time to make virtual care and patient engagement a sustainable reality.

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Sources:

  1. https://techcrunch.com/2020/04/10/google-starts-highlighting-virtual-care-options-in-search-and-maps/
  2. https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
  3. https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/
  4. https://www.cms.gov/newsroom/press-releases/trump-administration-releases-covid-19-telehealth-toolkit-accelerate-state-use-telehealth-medicaid
  5. https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes

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