CONNECT for Health and STAR Acts Poised to Promote Telehealth Adoption

In October of 2019, a bipartisan group introduced new legislation to expand U.S. telehealth services. Spearheaded by U.S. Senators Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.), Ben Cardin (D-Md.), John Thune (R-S.D.), Mark Warner (D-Va.) and Cindy Hyde-Smith (R-Miss.), the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 aims to “improve health outcomes, make it easier for patients to connect with their doctors, and help cut costs for patients and providers.”

Currently, geographic and originating site requirements only permit Medicare beneficiaries to receive telehealth services if they are in certain rural areas and at certain clinical sites. The goal of the new legislation is to overcome these barriers, which are presently perceived to be limiting the use of telehealth services in Medicare. Several provisions from earlier iterations of the act have already been enacted, including advances in covering remote patient monitoring and other virtual services.

The new bill in part seeks to:

• Give the HHS Secretary authority to waive telehealth restrictions if certain criteria are met
• Remove current restrictions related to geography and originating sites, including but not limited to:
  • adding the home as an originating site for mental health services
  • removing geographic restrictions on certain sites for emergency medical services
  • allowing federally qualified health centers (FQHCs) and regional health centers (RHCs) to furnish telehealth services as distant sites
• Expand CMS research efforts to study the impact of broader telehealth model adoption

The current bill has received support from over 100 healthcare agencies, including the American Hospital Association (AHA), the American Medical Association (AMA) and the Health Information and Management Systems Society (HIMSS).

A companion bill was proposed in the House of Representatives in October, as well. Sponsored by Representative Josh Harder (D-Calif.), the Specialty Treatment Access and Referrals (STAR) Act aims to expand adoption of telehealth consultations to enable patients and providers to connect virtually with specialty providers in other locations. The legislation would establish a grant program to help healthcare organizations acquire necessary information-sharing and connectivity infrastructure to support telehealth adoption. While the fate of the two bills is still undetermined, both pieces of legislation have received wide bipartisan support to date.

Earlier this year CMS issued a separate final rule that updates the Medicare Advantage (MA) program beginning in contract year 2020. That final rule (CMS-4185-F) will implement certain provisions of the Bipartisan Budget Act of 2018 that allow MA plans to offer additional telehealth benefits as part of the government-funded basic benefits.

All told, the recent uptick in legislative traction has been seen by many as a clear sign of momentum for ongoing telehealth expansion. As Caregility President and COO Michael Brandofino sees it, “This is long awaited legislation that will have a tremendous impact on changing the point of care. We have based our efforts on driving the fie rights of care and, until now, the ability for caregivers to provide remote telehealth was limited by funding. Many organizations chose to implement these programs even though reimbursement was limited or non-existent in some cases. These new measures and acknowledgement of validity and the benefits to patients from telehealth is a vindication that the early adopters were correct.We see this as a major win for patients and their care givers who will finally have these services covered.”

Providers Expand Telehealth Roadmaps at ATA 2019: Four Things to Know

The American Telemedicine Association (ATA) recently hosted its annual conference and exhibit in New Orleans. Attendees were keenly focused on advancing programs and exploring next-generation telehealth capabilities. Instead of simply shopping for solutions and gaining knowledge, provider organizations attending ATA 2019 were poised to increase their telehealth investments and expand telehealth roadmaps across the entire patient continuum. Four trends emerged during the conference with long-standing impact for all: providers, payers and technology vendors.

Telehealth Interoperability Ahead

ATA 2019 began with the distribution of a comprehensive interoperability white paper to define and describe the value of interoperable telehealth systems, address challenges and discuss standards. As one of the paper’s contributors, I received an inside look into the association’s white paper and its conjoined position with ONC and CMS proposed rules to improve the interoperability of electronic health information.

One of ATA’s goals is to ensure telehealth data remains patient centric and helps connect the dots between healthcare IT systems at large, including the EHR. There is a growing need for telehealth solutions to maintain the integrity of every patient story, despite multiple systems, overlapping platforms and departmental requirements.

This drive for stronger telehealth interoperability is especially critical as providers merge, acquire and consolidate their IT systems. Flexibility to accommodate each organization’s preferred clinical platform was a key vendor requirement cited by nearly every ATA attendee I met and during most exhibit hall conversations.

Telehealth Roadmaps Expand

One of the most important discussions held during ATA 2019 focused on the need to build enterprise-wide telehealth roadmaps. Our strategy sessions lingered late into the evening and long beyond exhibit hall hours.

While each provider organization expressed unique telehealth needs, four questions were commonly asked:

• How can we pull all our telehealth services together and avoid technology silos?
• Where do we need to focus our time and energy when it comes to telehealth?
• What’s required to build an enterprise-wide telehealth strategy across the entire patient care journey?
• Which vendors integrate telehealth into the bigger clinical IT strategy and workflow?

ATA 2019 attendees are moving away from just dabbling in telehealth. They are testing new options and investing in a broader strategy based on a single telehealth platform.

One Telehealth Platform Preferred

No one wants to purchase or implement different telehealth systems to support virtual care. Instead, provider organizations attending this year’s ATA event demanded single telehealth platforms with flexibility to be implemented across all departments and use cases such as tele-ICU, telestroke and e-sitting in patient rooms.

Today’s users want to document clinical information, conduct video calls, check clinician schedules and perform all other telehealth functions within the same system despite varying clinical workflows and patient care scenarios. And preferably, the single system is embedded in the EHR so physicians can easily camera into a room and achieve optimal clinical efficiency.

Favorable Reimbursement Celebrated

Recent developments in the expansion of payer reimbursements for telehealth services were a huge buzz at ATA 2019. Good news raises all ships. Everyone involved with delivering telehealth services benefits when reimbursement improves.

For example, CMS recently approved a plan to eliminate geographical restrictions on telehealth access and telemedicine services in Medicare Advantage (MA) plans by 2020. The CMS plan also enables those in urban areas to use connected health technology, which gives MA members more locations to access care, including their own home according to the April 9, 2019 CMS news announcement.

Most attendees I met with agreed: As CMS and other payers improve reimbursement capabilities for telehealth, more consumers and clinicians will use virtual care as the most cost-effective and efficient care delivery method for specific patient populations.

Looking Ahead to ATA 2020: Specialization and Focus

Virtual care programs are expanding, telehealth is on the rise and provider organizations are figuring out how to make it all happen. Telehealth plans are now integrated into every clinical initiative with hefty investments ahead.

While attendance is smaller than at HIMSS or other general conferences, better questions are asked at ATA. And attendees are ready to buy and implement. Educational sessions and exhibitors are laser focused on next-generation telehealth solutions. Finally, attendees are well informed and know what they are looking for.

To borrow the phrase from a famous retailer, “An educated ATA attendee is our best telehealth customer.”

Learn more about how Yorktel’s Telehealth Consultancy services can help you build your roadmap today!

Veterans’ Access to Telemedicine Across State Lines Clears Major Hurdle

As the nation prepares to honor veterans and thank them for their services to the United States this Friday, it is important to laud the VA’s efforts to expand its use of telemedicine services.

Last Thursday the House Committee on Veterans’ Affairs passed a bill to remove restrictions on the ability of VA providers to practice telemedicine across state lines. The passing of Veterans E-Health and Telemedicine Support Act of 2017 (H.R. 2123) will allow veterans to receive telemedicine treatment from any location, including their home or a community center, rather than mandate they travel to a VA facility to receive treatment in person. The bill is vital to the VA’s “Anywhere to Anywhere VA Health Care” program that was announced back in August.

Phil Roe, MD (R-Tenn.), chairman House Veterans’ Affairs Committee stated that “H.R. 2123 would give the VA Secretary the legislative authority to allow VA providers to practice telemedicine across state lines. Specifically, it would authorize a VA licensed healthcare provider to practice telemedicine in any state, regardless of whether or not the patient or provider is located on federal government property.”

Why is this bill so important?

Today, the medical industry is regulated on a state by state basis. Greg Sobodkin of Health Data Management points out that, under current law, VA physicians can only waive state licensing requirements and provide telemedicine treatment across state lines if both the veteran and the doctor are located in a federally owned facility. The VETS Act will remove these barriers and allow VA health professionals to practice telemedicine across state lines, provided that they are qualified and practice within the scope of their authorized federal duties.

This may be the tipping point the medical industry and nation needs to begin loosening the restrictions for providing medical services across state lines. There is an acute shortage of qualified doctors in many regions of the country. Medical costs are soaring. Telemedicine can bring the benefit of having the right doctor at the right place and at the right time. It will result in better care at a lower cost.

This is great news for veterans and the telemedicine industry in general.

The VA is one of the largest healthcare networks in the world and has been an early pioneer in telemedicine as well as one of the world’s largest users of the technology. Now, it is taking the lead on the regulatory front to tear down the barriers that have hindered the adoption and growth of new telemedicine applications that benefit us all.

In 2016, VA providers saw 702,000 patients via telemedicine in 2.17 million episodes of care – and nearly half of those who received telemedicine care lived in rural areas. Telemedicine has been responsible for a 31 percent decrease in VA hospital admissions and a 59 percent decrease in VA bed days of care. Around 90 percent of veterans who received care through telemedicine reported satisfaction with the online platform.

And then there is the very human side to all of this.

Michael Shores, director of regulation policy and management in the VA secretary’s office, wrote that the rule could “eliminate veteran suicide and provide access to mental healthcare … the VA’s number one clinical priority, and this proposed rule-making would improve VA’s ability to reach its most vulnerable beneficiaries.”

Strong Industry Support

So far, the bill has received overwhelming support from states, provider organizations and health IT groups, including: the American Telemedicine Association, American Medical Informatics Association, Federal Trade Commission, Health IT Now, the American Academy of Family Physicians, the College of Healthcare Information Management Executives (CHIME), Teladoc, Oracle, the American Psychological Association, the Brain Injury Association of America, the National Association of Social Workers and the University of Pittsburgh Center for Military Medicine Research.

Yorktel understands the VA’s commitment to providing the best care for our veterans.

We have been working with the VA on their Tele-ICU initiative for the past four years. We provide the telemedicine video conferencing systems, infrastructure and support that allows them to instantly bring the right medical specialist into the ICU room when they are needed. These systems are in over 500 ICU rooms and they are saving lives.

Yes, we are proud, and extend our most heartfelt gratitude to the men and women who serve in our nation’s armed forces.