Electronic Health Reporter

By Jay Eisenstock, principal, JE Consulting and WEDI board chair.

Virtual visits help providers increase productivity by adding revenue and reducing travel to different clinical settings. However, despite these obvious advantages, 2019 saw an abysmally low utilization rate of less than 10%. Things have monumentally changed. As a local physician characterized telehealth today, convenience is the new quality. Love it or hate it, telehealth is here to stay.

The primary care collaborative conducts a weekly survey of physicians, nurse practitioners, and physician assistants working in primary care on how their practices are responding to the COVID-19 outbreak. Over 80% of respondents indicate their patients accept telehealth visits and nearly half of the respondents plan to continue using telehealth after the COVID-19 crisis is controlled.

Prior to the pandemic, telehealth was seen as convenient and time efficient for patients.  It also showed promise for providing access to care for various underserved populations. Today we’ve gone beyond convenience as telehealth has become a necessity for both patients and providers. Increased utilization has been made possible by the relaxation of rules and requirements by both government and commercial health plans. Notably, the use of telehealth had been restricted by design.

Health plans wanted to control how and where telehealth was offered along with who could provide the service. For the duration of the COVID-19 health emergency, most health plans are allowing telehealth to be used in place of in-person encounters. Many are waiving patient cost share and paying providers the same rate as an in-person visit.

Medicare has made the following changes effective during the COVID-19 health emergency: telehealth can be used with both new and established patients, telehealth via telephone will be reimbursed, and providers are allowed to treat patients across state lines. In addition, the Centers for Medicare and Medicaid Services (CMS) is waiving HIPAA violation penalties for utilizing technologies such as FaceTime or Skype.

The genie is out of the bottle – so what will happen after the COVID-19 crisis has abated? The primary care collaborative also reported that nearly three-quarters of respondents have some patients who are unable to access telehealth due to the lack of a computer and/or internet connection.

According to a 2019 Pew Research Center report more than 90% of seniors have cellphones, but less than 40% have smartphones with video capabilities. For telehealth to continue to be a viable option for seniors, and many people in underserved populations, health plans should continue to allow the use of telephone-based encounters.

In the United States we are experiencing an ever-increasing shortage of physicians. According to a report from the Association of Medical colleges, by 2032 there will be 47,0000 to 122,000 fewer physicians both in primary and specialty care. Telehealth is often considered a remedy to address the physician shortfall and to better serve the needs of patients across the country. Health plans should continue to allow telehealth treatment across state lines.

When it comes to privacy and security, the HIPAA mandates must again be enforced.  The protection of personal health information is a right most consumers will demand.

Finally, providers can make a case for payment parity between in-person and telehealth encounters. Research shows that telehealth can reduce medical costs, increase care quality and improve patient satisfaction.