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Medicare Telehealth Pre and Post-COVID-19

By
Sophia Albanese Orcid logo ,
Sophia Albanese
Amar Gupta Orcid logo ,
Amar Gupta
Ilina Shah Orcid logo ,
Ilina Shah
Joanna Mitri Orcid logo
Joanna Mitri

Abstract

ABSTRACT The COVID-19 pandemic led to temporary relaxations for telehealth with respect to physician licensure, geographic location, and eligible sites for reimbursement. Earlier policies had impacted the rate of adoption of telehealth and retarded the ability to derive full benefits related to cost, access to care, and quality of care. This aspect is analyzed using 2018 Medicare fee-for-service codes and rates for 10 telemedicine services. Based on the analysis of these data, additional research, and literature review, this report describes how interstate practices can be better leveraged to achieve maximum potential for direct and indirect savings that can accrue through such pragmatic approaches for certain services. The interstate collaborations proposed in this report provide examples of broader telehealth policies that could foster increasing access to quality health care for Medicare beneficiaries and can potentially be used as insight to assist federal and state agencies as they review the continuation, cessation, or modifications of relaxations granted due to the COVID-19 pandemic.

References

1.
Cia. Field listing: current health expenditure -The World Factbook -Central Intelligence Agency. 2020;
2.
Who. World Health Statistics 2020 visual summary. 2020;
3.
Bell M, Larson D, Weems J, Kosiak D, Mickalowski K, Kilawee L. Geographic restrictions for Medicare telehealth reimbursement. National Rural Health Association. 2011;
4.
Nord G, Rising KL, Band RA, Carr BG, Hollander JE. On-demand synchronous audio video telemedicine visits are cost effective. The American Journal of Emergency Medicine. 2019;37(5):890–4.
5.
Adler-Milstein J, Kvedar J, Bates DW. Telehealth Among US Hospitals: Several Factors, Including State Reimbursement And Licensure Policies, Influence Adoption. Health Affairs. 2014;33(2):207–15.
6.
Fact sheet: telehealth. 2020;
7.
Dayaratna K, Larkin P, Shea O, J. Reforming American medical licensure. Harv J Law Public Policy. 2019;(1):253–78.
8.
Gupta A, Sao D. The constitutionality of current legal barriers to telemedicine in the United States: analysis and future directions of its relationship to national and international health care reform. Health Matrix Clevel. 2011;(2):385–442.
9.
Lum HD, Nearing K, Pimentel CB, Levy CR, Hung WW. Anywhere to Anywhere: Use of Telehealth to Increase Health Care Access for Older, Rural Veterans. Public Policy & Aging Report. 2019;30(1):12–8.
10.
Centers M, Services M. Fact sheet. Physician Fee Schedule Search. 2020;
11.
Albanese S, Gupta A, Shah I, Mitri J. Medicare Telehealth Pre and Post-COVID-19. Telehealth and Medicine Today. 2021;
12.
Centers M, Services M. Telehealth services. Medicare learning network booklet. 2020;
13.
Nicoletti B. Facility versus non-facility in the Physician Fee Schedule. CodingIntel. 2019;
14.
Centers M, Services M. 2018;
15.
High healthcare costs in Alaska. 2018;
16.
Clif G. Health care costs in Alaska: facts, causes, consequences, and remedies. Alaska Common Ground.
17.
Centers M, Services M. Medicare enrollment dashboard. CMS, Office of Enterprise Data & Analytics (OEDA). 2020;
18.
Kimbol A. Whatever you do, don’t get sick at night. Health Law Perspectives. 2008;
19.
R A. Night Shift Work and Weight Gain among Female Filipino Nurses. Journal of Obesity and Overweight. 2018;4(1).
20.
Caruso CC, Baldwin CM, Berger A, Chasens ER, Edmonson JC, Gobel BH, et al. Policy brief: Nurse fatigue, sleep, and health, and ensuring patient and public safety. Nursing Outlook. 2019;67(5):615–9.
21.
Gupta A, Seshasai S. Toward the 24-hour knowledge factory. Social Science Research Network. 2004;
22.
Gupta A, Sando S, Parthasarathy S, Quan SF. Information Technology Conduit as a Portal to Circumvent the Graveyard Shift. Journal of Clinical Sleep Medicine. 2010;06(02):113–6.
23.
Emory cares for ICU patients remotely, turning ’night into day. 2018;
24.
Foland M. The perfect storm: the present and developing crisis in Alaska health care access. 2018;
25.
Albanese S, Gupta A, Shah I, Mitri J. Medicare Telehealth Pre and Post-COVID-19. Telehealth and Medicine Today. 2021;
26.
Connolly B, Paulson L. Expanded telehealth helps communities address opioid use disorder during pandemic. 2020;
27.
Smith A, Thomas E, Snoswell C, Haydon H, Mehrotra A, Clemensen J. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020;(5):309–13.
28.
Mathews A, Evans M. Hospitals use telemedicine to minimize contact with virus patients. Wall Street Journal. 2020;
29.
Klevens R, Edwards J, Richards C, Horan T, Gaynes R, Pollock D. Estimating health care-associated infections and deaths in U.S. hospitals. Public Health Rep. 2002;(2):160–6.
30.
Weber DJ, Rutala WA, Miller MB, Huslage K, Sickbert-Bennett E. Role of hospital surfaces in the transmission of emerging health care-associated pathogens: Norovirus, Clostridium difficile, and Acinetobacter species. American Journal of Infection Control. 2010;38(5):S25–33.
31.
Krishnan S. Telemedicine: decreasing barriers and increasing access to healthcare. Altarum Health Care Value Hub. 2017;
32.
Globalmed. Telemedicine in corrections: cost-effective, safer way to provide timely healthcare to prison inmates. 2015;
33.
Russo JE, McCool RR, Davies L. VA Telemedicine: An Analysis of Cost and Time Savings. Telemedicine and e-Health. 2016;22(3):209–15.
34.
Inrix. 2017;
35.
Finkelstein JB, Cahill D, Young K, Humphrey K, Campbell J, Schumann C, et al. Telemedicine for Pediatric Urological Postoperative Care is Safe, Convenient and Economical. Journal of Urology. 2020;204(1):144–8.
36.
Huilgol Y, Joshi A, Carr B, Hollander J. Giving urban health care access issues the attention they deserve in telemedicine reimbursement policies. Health Affairs Blog.
37.
Patterson BM, Draeger RW, Olsson EC, Spang JT, Lin FC, Kamath GV. A Regional Assessment of Medicaid Access to Outpatient Orthopaedic Care: The Influence of Population Density and Proximity to Academic Medical Centers on Patient Access. Journal of Bone and Joint Surgery. 2014;96(18):e156.
38.
Harvey JB, Valenta S, Simpson K, Lyles M, McElligott J. Utilization of Outpatient Telehealth Services in Parity and Nonparity States 2010–2015. Telemedicine and e-Health. 2019;25(2):132–6.
39.
Cullen K. Maintaining local preference while increasing vendor competition. SourceSuite.
40.
Mitchell S, Lavecchia O. Local purchasing preferences. Institute for Local Self-Reliance.
41.
Alaska’s Department of Administration. Alaska Bidder Preference AS 36.30. 2013;
42.
Position paper. Local preference in public procurement. 2015;
43.
8AD;
44.
Medicare, Gov.
45.
COVID-19: 2019 novel coronavirus disease. Public Health Emergency. 2020;
46.
Centers For Medicare M, Services. Medicare telehealth frequently asked questions (FAQs). 2020;
47.
Post-COVID telehealth priorities letter to Congress. 2020;
48.
Wicklund E. House to debate extending CARES Act telehealth coverage indefinitely. mHealthIntelligence. 2020;
49.
O’donnell J, Alltucker K. Telehealth can be lifesaving amid COVID-19, yet as virus rages, insurance companies look to scale back. USA Today. 8AD;
50.
Eberly LA, Khatana SAM, Nathan AS, Snider C, Julien HM, Deleener ME, et al. Telemedicine Outpatient Cardiovascular Care During the COVID-19 Pandemic. Circulation. 2020;142(5):510–2.
51.
Velasquez D, Mehrotra A. Ensuring the growth of telehealth during COVID-19 does not exacerbate disparities in care. Health Affairs. 2020;
52.
Nouri S, Khoong E, Lyles C, Karliner L. Addressing equity in telemedicine for chronic disease management during the Covid-19 pandemic. NEJM Catalyst. 2020;
53.
Eliminating barriers to virtual care: implementing portable medical licensure. The American Journal of Managed Care. 2019;26(1):20–2.
54.
Mataxen PA. Licensure barriers to telehealth nursing practice. Nursing. 2019;49(11):67–8.
55.
Weigel G, Ramaswamy A, Sobel L, Salganicoff A, Cubanski J, Freed M. Opportunities and barriers for telemedicine in the U.S. during the COVID-19 emergency and beyond. 2020;
56.
Interstate Medical Licensure Compact The IMLC. 10AD;
57.
Marino B, Prasad R, Gupta A. A case for federal regulation of telemedicine in the wake of the Affordable Care Act. Sci Tech L Rev. 2015;(2):274–357.
58.
Usa, Gov. Foreign nationals driving in the U.S. 2020;
59.
Virtual care in Canada: discussion paper. 2019;
60.
Breen KJ. National registration scheme at 5 years: not what it promised. Australian Health Review. 2016;40(6):674.
61.
Breen KJ. National registration legislative proposals need more work and more time. Medical Journal of Australia. 2009;191(8):464–5.
62.
Saleh N. Top disciplinary actions taken by medical boards. MDLinx. 2019;
63.
Robins D. Georgia board licenses doctors other states won’t. Atlanta Journal-Constitution. 2014;(4).
64.
Fauber J, Wynn M, Fiore K. Prescription for secrecy. Journal Sentinel Online. 2018;
65.
Dehlendorf CE. Physicians Disciplined for Sex-Related Offenses. JAMA. 1998;279(23):1883.
66.
Sao D, Gupta A, Gantz DA. Interoperable Electronic Health Care Record: A Case for Adoption of a National Standard to Stem the Ongoing Health Care Crisis. Journal of Legal Medicine. 2013;34(1):55–90.
67.
Royal K. Who owns patient medical records? J Urg Care Med Available from.
68.
Terry K. Patient records: the struggle for ownership. Med Econ. 2015;(23):22–8.
69.
Hhs, Gov. Notification of enforcement discretion for telehealth remote communications during the COVID-19. 2020;
70.
Potorac K. Possible solutions to the harmonization of federal and state privacy laws for health information exchanges. 2014;
71.
Hhs, Gov. Preemption of state law. 2020;
72.
MELLO MM, ADLER‐MILSTEIN J, DING KL, SAVAGE L. Legal Barriers to the Growth of Health Information Exchange—Boulders or Pebbles? The Milbank Quarterly. 2018;96(1):110–43.
73.
Remarks by President Trump, Vice President Pence, and Members of the Coronavirus Task Force in press briefing. The White House. 2020;

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