In response to the urgent needs and unique challenges presented by the COVID-19 pandemic, regulatory changes across all levels of government unleashed an unprecedented wave of telehealth adoption to deliver care in a manner that protects patients and providers and allows communities to adhere to social distancing measures. Together, patients, provider, and payers created resiliency in health care delivery through telehealth.
The regulatory changes allowing use of telehealth were made by the U.S. Department of Health and Human Services (DHHS) using waiver authority permitted only during the COVID-19 Public Health Emergency (PHE). These regulatory changes allowed for Medicare and Medicaid telehealth, allowed telehealth to be provided outside of rural, health care shortage areas, allowed it to be provided to patients when they are in their place of residence, and provided flexibility on state licensure laws that restrict the provision of telehealth. Once the PHE subsides, regulatory and statutory barriers will prevent telehealth care delivery, leaving the system unable to provide continuous care and care management when the next health care disruption, like a flood, hurricane, or bioterror event, causes extensive displacement.
As we continue to learn and grow from the COVID-19 telehealth adoption experience, we have witnessed a few common takeaways and lessons learned as well as become increasingly aware of the remaining barriers to adoption. Telehealth provided resiliency in health care, it allowed patients to obtain care and providers to deliver it when they were displaced from normal routines. To ensure it is a routine part of health care:
- Congress must act to remove statutory barriers to telehealth. In S. 4375, the “Telehealth Modernization Act of 2020,” in the Senate and H.R. 7663, the “Protecting Access to Post-Covid-19 Telehealth Act,” in the House of Representatives would remove those barriers;
- Lack of reliable and affordable broadband has continued to prevent many patients and providers from utilizing telehealth, as has lack of access to technologies that can support live voice-video communications or provide real-time or regular tracking of a patient’s physiological data. Work by the U.S. Department of Health and Human Services (HHS) and the Federal Communications Commission (FCC) will be essential to address these barriers.
- Workflow and planning are important and there are many lessons on building capability for each and every provider of health care – connected care and telehealth cannot and should not be consolidated into a few national providers. Rather, it must be integrated into provider workflow throughout the health care delivery system. Resources exist to provide roadmaps and assistance to clinical practices and hospitals.
With the right actions, a health care system that seamlessly incorporates the use of connected care to enable improved quality, measurable outcomes, and increased access to health care for consumers will reduce the complexity and costs of health care. When our nation's COVID-19 PHE subsides, continued monitoring for changes and opportunities at all levels of government as well as active engagement with key stakeholders in the creation and implementation of health policy in order to maintain the waivers and temporary health care standards and policies that have been adopted for Medicare, Medicaid, private payers, and professional licensure.
Jody Hoffman is a Senior Partner with Republic Consulting, LLC, where she combines her 20 years of in-depth knowledge in healthcare financing, healthcare delivery systems, and health data and privacy standards with knowledge of legislative and regulatory processes to advise clients on the healthcare sector. Jody works extensively on all aspects of health, including telehealth, reimbursement and coverage policy, health data privacy, and interoperability rules. Jody earlier served on the Clinton/Gore Campaign’s Health Care Advisory Group and served as a health policy advisor for the American Federation of State, County and Municipal Employees (AFSCME).
Request a private consultation with Jody at Poligage.com to discuss issues and developments related to telehealth, or to discuss healthcare policy and regulatory issues such as health policy financing, developments with healthcare policy in the context of a pandemic, and new developments and regulations regarding pharmaceuticals.