As telehealth grows, returning Medicare programs to their original form may be difficult
Friday, May 29, 2020
In another spot of telehealth news, it appears that even seniors are taking a shine to the technology. As many as half of them say they are comfortable using telehealth to get the care they desire. According to a new poll by Morning Consult, those who are using it say it’s been a pleasing experience.
The survey of more than 1,000 seniors shows that a majority (52%) are digging the services provided through the remote-based technology. Only 30% said they’re uncomfortable with the technology.Ninety-one percent of those surveyed said their experience with telehealth was pretty exciting. About 80% (78%) said they would do so again if given the opportunity.
Another 73% of seniors on Medicare Advantage (MA) had their care needs provided either by telehealth or in person, but 27% said they had experienced an interruption with their healthcare.
The poll notes what so many are beginning to ponder — telehealth amid the COVID-19 pandemic is here to stay. The use of it likely means payers, including the federal government, won't be able to return to reduced payment levels for providing care through such channels.
The Centers for Medicare & Medicaid Services (CMS) gave providers greater flexibility for reimbursements from Medicare for telehealth. It announced a rule that lets Medicare Advantage plans discount telehealth for specialty care, among other flexibility with plans through telehealth-provided care.
The CMS rule is meant to encourage these Medicare plans to boost telehealth benefits and increase plan options for rural residents. The finalized rule allows MA plans to cover dermatology, psychiatry, cardiology, ophthalmology, and primary care.
Pushing back telehealth barriers since the start of the pandemic, CMS plans to help seniors access more specialty care. For example, Congress initially passed a $500 billion spending package for an emergency telehealth program to expand coverage for Medicare beneficiaries at the beginning of March.
CMS followed that with saying Medicare will be covering 80 more telehealth services.
For example, seniors accounted for the most significant spike in telehealth usage for all demographics in Massachusetts, where utilization rates jumped from 5% pre-pandemic to 27% in early April.
In the final rule, published in the Federal Register, CMS said it planned to encourage access to telehealth services and maintain the need for in-person care.
"While health plans clearly favored taking into account telehealth access while evaluating network adequacy, providers had more concerns that telehealth services could be used to replace, rather than supplement, in-person healthcare delivery," the rule said. "We explained that it is important and appropriate to account for contracted telehealth providers in evaluating network adequacy consistent with reflecting how MA plans supplement, but do not replace, their in-person networks with telehealth providers."
Virtual visits to a healthcare professional are expected to go from 36 million visits to 200 million visits a year, and from 10,000 visits a week to 300,000 visits a week.
The remaining question now is: will the boom last? It may be too soon for provider organizations to start counting the increased number of telehealth visits, but given the support for the policies, it may be hard for the feds to return to its previous shape.
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