We may be nearing the edge of the “telemedicine cliff”. This points to the potential sudden disappearance of the benefits of pandemic-era virtual care as the severity of Covid-19 eases across the country.
Once the Covid-19 public health emergency ends, federal policies that allowed telemedicine coverage and waived the requirement for in-person clinician visits for prescriptions will be in jeopardy. It is scheduled to expire on October 15, but is expected to be extended as the Department of Health and Human Services has not provided 60 days’ notice. it said it will issue Once the emergency is completely over. The declaration of emergency has already been extended many times.
We do not know exactly when PHE will end, but it is important that the healthcare industry advocate for extended telemedicine flexibility for at least two years after the end of the emergency.health policy project in Bipartisan Policy Centersaid in an interview. She said her interests need to be expanded, but caution is needed in two key areas: addictive drug prescribing and voice-only visits.
According to Harris, when the pandemic hit, HHS’s telemedicine policy was “basically to turn everything on and remove any guardrails that had been put in place.” HHS has given every provider eligible to bill Medicare the ability to serve virtually. Providers can use popular conferencing platforms such as Zoom and FaceTime for telemedicine appointments. The division also expanded Medicare coverage for voice-only visits and waived the requirement that patients must establish a relationship with a provider before receiving telemedicine services.
All of these benefits are associated with Covid-19 PHE. If the emergency has passed and we are not protected, things will return to the pre-pandemic state. Harris pointed out that most Medicare beneficiaries will lose access to virtual care unless they live in rural areas or enroll in Medicare Advantage.
The Bipartisan Policy Center recently report It details a significant increase in the use of telemedicine since the pandemic. Virtual care, which accounted for less than 1% of his pre-pandemic Medicare claims, peaked at 32% for him in April 2020 and leveled off to 13-17% by July 2021.
Those eligible for Medicare for disability, those with end-stage renal disease, those with multiple chronic conditions, and those dual eligible for both Medicare and Medicaid may use telemedicine. was a much higher cohort. .
This indicates that the flexibility of telemedicine in the pandemic era has “created easier pathways to receive care for people who are struggling to move or who have multiple health problems.” Eliminating such flexibility, she said, could lead to less care-seeking by these populations, which could lead to negative and fatal health consequences. be.
While it’s imperative that the healthcare industry urge Congress to protect the benefits of telemedicine, there are also two important guardrails to advocate, according to Harris.
The first has to do with the fact that some health care providers may be taking advantage of looser pandemic rules on drug prescribing.virtual mental health startups such as cerebrum When peakwas accused this year of indiscriminate prescribing practices for Adderall and ketamine. conducting a survey For cerebral prescriptions.
Harris proposed placing limits on the types of controlled substances that the federal government can prescribe through telemedicine, and recommended that Congress reassess its flexibility for drugs of abuse and addiction potential.
Another concern is audio-only visits. This flexibility was established early in the pandemic as many Americans faced barriers to using video conferencing technology, such as not having a smartphone or having access to broadband.
“However, this is a method that has not been used before and not much is known about its quality of care. Rather, it tries to limit its benefits to those who really have access problems.
She also recommended that audio-only visits be limited to patients who have an existing relationship with the provider.
Photo: Alisa Zahoruiko, Getty Images
