Local: (805)-371-3680 | Toll Free: (800) 240-CHIV
Facebook
Twitter
LinkedIn
YouTube
Chivaroli Insurance Services
  • INSURANCE COVERAGE
    • Healthcare Professional Liability
    • Directors’ & Officers’ Liability
    • Commercial Property
    • Managed Care / Billing / Miscellaneous
    • Employment Practices Liability
    • Difference in Conditions
    • Regulatory Proceedings Errors & Omissions
    • Fiduciary Responsibility
    • Property Terrorism
    • Commercial General Liability
    • Commercial Crime
    • Commercial Automobile
    • Stop Loss Coverage
    • Representations & Warranties
    • Business Owners Package
    • Security & Privacy (Cyber Liability)
    • Workers Compensation
    • Home / Auto / Valuables / Umbrella
  • OTHER SERVICES
    • Credentialing Requests
    • Consulting Services
    • Alternatives
    • Risk Management
    • Wholesale Brokerage
  • RESOURCES
    • Healthcare Resources
    • Insurance Resources
    • Terms & Definitions
  • NEWS
  • ABOUT
  • CONTACT
A women talks to doctor on a telehealth call

Covid Pushed Telehealth into the Mainstream, Proponents Want Virtual Visits to Stay

June 17, 2021Chivaroli InsuranceGeneral Article

By Noam N. Levey | KHN.org

As the covid crisis wanes and life approaches normal across the U.S., health industry leaders and many patient advocates are pushing Congress and the Biden administration to preserve the pandemic-fueled expansion of telehealth that has transformed how millions of Americans see the doctor.

The broad effort reaches across the nation’s diverse health care system, bringing together consumer groups with health insurers, state Medicaid officials, physician organizations and telehealth vendors.

And it represents an emerging consensus that many services that once required an office visit can be provided easily and safely — and often more effectively — through a video chat, a phone call or even an email.

“We’ve seen that telehealth is an extraordinary tool,” said David Holmberg, chief executive of Pittsburgh-based Highmark, a multistate insurer that also operates a major medical system. “It’s convenient for the patient, and it’s convenient for the doctor. … Now we need to make it sustainable and enduring.”

Last fall, a coalition of leading patient groups — including the American Heart Association, the Arthritis Foundation, Susan G. Komen and the advocacy arm of the American Cancer Society — hailed the expansion of telehealth, noting the technology “can and should be used to increase patient access to care.”

But the widespread embrace of telemedicine — arguably the most significant health care shift wrought by the pandemic — is not without skeptics. Even supporters acknowledge the need for safeguards to prevent fraud, preserve quality and ensure that the digital health revolution doesn’t leave behind low-income patients and communities of color with less access to technology — or leave some with only virtual options in place of real physicians.

Some worry that telehealth, like previous medical innovations, may become another billing tool that simply drives up costs, a fear exacerbated by the hundreds of millions of dollars flowing into the burgeoning digital health industry.

Companies offering remote urgent care, virtual primary care and new wearable technologies to monitor patient health are exploding, with the annual global telehealth market expected to top $300 billion by 2026, up nearly fivefold from 2019, according to research company PitchBook.

“I don’t think there’s any debate that there is a value in better access, but if this is just a one-off service that adds another billing option without fitting into patients’ regular care, I don’t know if it will do much for patients’ health,” said Tom Banning, head of the Texas Academy of Family Physicians.

Perhaps the most contentious issue facing politicians, insurers and hospitals is how much a telehealth visit is worth in a system that is already breaking the bank.

While Medicare and other insurers fueled the explosion of telehealth over the past year by paying the same rates as for in-person visits, many are expected to push for lower prices when the federally designated public health crisis ends. At the same time, physicians and hospitals are looking to maintain income.

“Payers are unlikely to give providers carte blanche,” said Dr. Hoangmai Pham, a former senior medical official at health insurance giant Anthem. But Pham noted insurers could reward physicians and hospitals that take greater responsibility for their patients’ overall health with higher rates for telehealth. “There’s an opportunity here,” she said.

For now, tens of millions of Americans have gotten used to meeting their doctor on a laptop or smartphone, and pressure is building on the federal and state governments to loosen rules to preserve virtual visits after the health crisis ends.

“I don’t want to go back,” said Suzy Brantley, a 67-year-old Texan who works at an accounting firm outside Dallas.

Brantley has been going to the same medical practice for more than 15 years. “I love them there,” she said. But when the practice closed its doors last spring, requiring virtual visits, Brantley found she enjoyed the more convenient way to do routine business like refill a prescription.

“You don’t have to leave work to go to the doctor,” she said. “I can just step into the break room for a few minutes and use my phone. … I love it.”

She’s far from alone. In a nationwide poll last year, 8 in 10 Americans who had used telehealth said they “liked it” or “loved it.” Nearly the same share said they were likely to continue using it after the pandemic, according to the survey by the Harris Poll.

Just a year ago, telehealth — or telemedicine, as it’s also called — was largely a curiosity. Patient and physician wariness and strict rules about how doctors could bill had squelched widespread use.

Fearing fraud and overuse, the federal government tightly restricted the kind of video and audio visits that could be billed to Medicare, limiting use mainly to rural areas and to visits in which a doctor was in an office or hospital, rather than working remotely.

“There was a fear that if there was the slightest opening in the Medicare payment system, people would find a way to abuse it,” said Sean Cavanaugh, who oversaw Medicare during the Obama administration.

That changed suddenly in spring 2020 as pandemic lockdowns shuttered physician offices. Almost overnight, doctors were forced to pivot to virtual care to maintain contact with patients and keep money flowing.

The Trump administration moved quickly to facilitate the shift. The Medicare agency dramatically expanded the kind of services that could be provided virtually. Officials added 140 telehealth services to the list of what Medicare would pay for during the pandemic, including emergency visits, eye exams, speech and hearing therapy, and nursing home care.

Critically, Medicare raised fees for virtual visits to match those for in-office exams, a move followed by state Medicaid programs and many commercial insurers.

The surge was explosive. While fewer than 1% of primary care visits in Medicare occurred virtually in January 2020, by April nearly half did, according to data compiled by the Medicare Payment Advisory Commission.

At UnitedHealth Group, the nation’s largest health insurer, the number of covered telehealth visits increased nearly thirtyfold, rising from 1.2 million visits in 2019 to 34 million last year. Other insurers reported as much as an eightyfold increase.

“Very quickly, it became clear that we could deliver very good care to our patients via televisit,” said Dr. Manish Naik, chief medical information officer at Austin Regional Clinic in central Texas.

The medical group not only helped its primary care physicians pivot to telehealth, but it also built a virtual urgent care system that allows patients to connect by video with on-call doctors 24 hours a day, a model used by large medical systems such as Kaiser Permanente.

Other systems are moving beyond televisits to expand use of remote monitoring tools in people’s homes that track vital signs of patients with chronic illnesses such as diabetes.

Perhaps nowhere has telehealth proved more transformational than in mental health services and treatment for patients addicted to drugs.

“Telehealth has been a godsend,” said Ellen Bemis, chief executive of AMHC, a network of behavioral health clinics in rural northern Maine. Bemis said the clinics are already seeing patients adhere better to their medications as they remain in better contact virtually.

“I hope we never go back,” she said.

In Alaska, health officials feel the same way. “What we’ve seen through covid was amazing,” said state Medicaid director Albert Wall, noting a major decline in patients missing appointments.

Whether these changes endure depends largely on Congress and the Biden administration, which hasn’t indicated whether it will make permanent the looser telehealth rules rolled out last year. The rules will sunset when the public health emergency ends, likely at the end of this year.

The uncertainty is fueling an urgent effort by physicians, hospitals, patient advocates and others to persuade government officials not to reimpose the strict limitations.

Democrats and Republicans in Congress have introduced bills to cement the changes. In statehouses, advocates for expanding telehealth have introduced more than 650 bills, according to the Alliance for Connected Care, a telehealth lobbying coalition.

“We’ve seen the potential of telehealth,” said Dr. Christopher Crow, chief executive of Texas-based Catalyst Health Network, which helps primary care physicians manage their practices. “Now, we have to make sure we realize it before everyone starts shifting back to the exam rooms.”

Major physician groups are pushing to maintain equal reimbursement for telehealth and in-person visits.

Dr. Susan Bailey, president of the American Medical Association, said Medicare should continue to allow patients to receive virtual care in their homes and in all areas of the country, not just rural areas.

The association is also pushing for Medicare to keep reimbursing doctors for consulting with patients by phone, a move Bailey said would ensure that patients without broadband internet service aren’t left behind.

The push for more billable services has raised concerns about fraud, especially as physicians and hospitals develop more efficient systems to see patients remotely. “Overuse is absolutely a concern,” said Dr. Von Nguyen, chief medical officer at Blue Cross Blue Shield of North Carolina. “Once these systems are in place, I suspect, the risk will be greater.”

Nevertheless, many insurers and state Medicaid programs, two groups that typically look more skeptically at services that can drive up costs, are backing telehealth expansion.

And despite initial fraud concerns, nearly a dozen Medicaid and insurance industry officials interviewed for this article noted that thus far they’ve seen little evidence of widespread misuse.

“There is fraud in traditional medical care, too,” said Dr. Donna O’Shea, a senior executive at UnitedHealth Group.

Several insurance officials said telehealth could ultimately save money by routing some medical care from high-cost doctors’ offices and hospitals to lower-priced virtual visits, particularly for urgent care.

And some insurance companies — including Harvard Pilgrim Health Care in New England and Priority Health in Michigan — are marketing health plans with lower premiums that steer patients to virtual care.

“We see this being a long-term change,” said Dr. Michael Sherman, Harvard Pilgrim’s chief medical officer.

Sherman said the health plan is even exploring whether to help low-income patients get internet access to expand telehealth further. “We have proven to ourselves that this works,” he said.

KHN correspondent Rachana Pradhan and digital producer Hannah Norman contributed to this report.

Chivaroli Insurance
Previous post In the Race to Fix Primary Care, Companies Bet on a Subscription Model Next post Insurance Carriers Unlikely to Stop Vicious Ransomware Cycle

Sign up for News Updates

* = required field

Categories

  • Article Archives
  • General Article
  • Private
  • Uncategorized

Archives

  • March 2023
  • February 2023
  • January 2023
  • December 2022
  • October 2022
  • September 2022
  • August 2022
  • July 2022
  • June 2022
  • May 2022
  • April 2022
  • March 2022
  • February 2022
  • January 2022
  • November 2021
  • September 2021
  • August 2021
  • July 2021
  • June 2021
  • May 2021
  • April 2021
  • March 2021
  • February 2021
  • January 2021
  • November 2020
  • October 2020
  • September 2020
  • August 2020
  • July 2020
  • June 2020
  • May 2020
  • April 2020
  • March 2020
  • February 2020
  • January 2020
  • August 2019
  • July 2019
  • June 2019
  • March 2019
  • February 2019
  • January 2019
  • December 2018
  • November 2018
  • August 2018
  • July 2018
  • June 2018
  • May 2018
  • April 2018
  • March 2018
  • February 2018
  • December 2017
  • November 2017
  • October 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • November 2016
  • October 2016
  • September 2016
  • August 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • April 2015
  • February 2015
  • January 2015
  • December 2014
  • November 2014
  • October 2014
  • September 2014
  • August 2014
  • July 2014
  • June 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014

Chivaroli and Associates Insurance Services is a full-service brokerage firm specializing in the custom-design and placement of insurance and alternative risk funding solutions for your healthcare organization.

Facebook
Twitter
LinkedIn
YouTube

Contact Us Today

Address:
200 North Westlake Blvd., Suite 101
Westlake Village, CA 91362
Phone:
805-371-3680
E-mail:
mail@chivarolitr.wpengine.com

Resources

Health Care
Insurance
Terms & Definitions
News
About

Policies

Cookie Policy
Disclaimer

Recent News

  • Passwords Remain a Top Cybersecurity Weakness
  • Lawmakers Seek New Limits to Travel Nurse Costs
  • Experts Predict Healthcare M&A Will Accelerate in 2023
  • Surveys Indicate a Persistent Hard Insurance Market
© 2023 All rights reserved. Powered By Insurance Agency Website by Stratosphere