Next, we outline what changes have been made to telehealth policy and implementation by the federal government, state governments, commercial insurers and health systems in response to the COVID-19 emergency, as well as what gaps remain. Importantly, most states are newly allowing both FFS and managed care Medicaid beneficiaries to access services from their home, and most are directing Medicaid plans to allow for reimbursement for some telephone evaluations. First Choice SafeLink Phone Program First Choice by Select Health of South Carolina is proud to be working with SafeLink Wireless (PDF) to offer the Lifeline program at no cost to you! CCHP finds only 6 states (CA, DE, GA, HI, MN, NM) that required payment parity prior to COVID-19, while a KFF analysis of telehealth laws suggests an additional 4 states followed payment parity as well (AR, CO, KY, NJ). With new telehealth flexibility and relaxation of privacy laws in response to COVID-19, some of these financial hurdles may be lessened. The Peterson-KFF Health System Tracker analyzed a sample of health benefit claims from the IBM MarketScan Commercial Claims and Encounters Database; among enrollees in large employer health plans with an outpatient service, 2.4% had utilized at least one telehealth service in 2018 (up from 0.8% in 2016). * Telemedicine isn’t a replacement for your Primary Care Provider (PCP). The Cleveland Clinic, University of Washington (UW), NYU Langone, Oregon Health Sciences University (OHSU), Intermountain Health Care, Medical University of South Carolina (MUSC), and Rush University Medical Center are all advising patients with suspected coronavirus to start by using a virtual visit or online screening, rather than presenting to an emergency room for testing. Opens in a new window. This complexity in the regulatory framework for telemedicine creates challenges for patients in knowing what services are covered, and for providers in knowing what regulations to abide by. The Physicians at FCPP have been serving the needs of the Orange County area and beyond. In response to COVID-19, CMS has advised plans that they may waive or reduce cost sharing for telehealth services, as long as plans do this uniformly for all similarly situated enrollees. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. Many states are newly allowing FQHCs and RHCs to serve as distant site providers, and expanding which professions qualify as eligible to provide telehealth services through Medicaid. Organizations. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. Telehealth virtual visits available for CA, FL, GA, ME, NM, PA, TN, WA . Actions to rapidly expand telemedicine could come with tradeoffs, including concerns over privacy and quality of care. KFF is tracking other state Medicaid actions to address COVID-19, found here. The federal government dictates several facets of telehealth policy, including nationwide patient privacy laws (e.g. That has an impact on cost for people and their employers,” Okigwe said in a previous report. Meredith Freed 2. Use of “virtual visits” via phone or videoconference can address non-urgent care or routine management of medical or psychiatric conditions, while online or app-based questionnaires can facilitate COVID-19 screening to determine the need for in-person care. Telemedicine can also enable remote interactions and consultations between providers. With the continued spread of the coronavirus that causes COVID-19, FirstHealth is committed to providing telemedicine options that allow providers to give people the care they need from the comfort and safety of their own home. If and when the regulatory environment around telehealth and HIPAA becomes more stringent, however, providers will need to decide whether to invest in more robust telemedicine platforms to continue to provide these services. Avenues to consider to further expand telemedicine access include: There are potential trade-offs in loosening regulations on telemedicine, including privacy issues and quality of care. 2. First Choice Health Covers the Cost of Telehealth and Virtual Care Services for Employers via 98point6 Amid COVID-19 Crisis PR Newswire • March 25, … , Fertility and family planning services have seen a surge during COVID, says Peter Nieves, chief operating officer of WINFertility. Others participate in “compacts” that allow providers in participating states an expedited process to practice in other compact states. , As clinicians seek new ways to serve patients and stem the rapid spread of the novel coronavirus in the United States, policymakers and insurers have looked to telemedicine or telehealth to provide care to patients in their homes. Health systems have rapidly adapted to implement new telehealth programs or ramp up existing ones. Coronavirus testing codes follow: 1. This is in line with the Centers for Disease Control and Prevention (CDC) encouragement that those who are mildly ill should call their doctors before seeking in-person care. And even when regulations are temporarily lifted to facilitate telemedicine, health systems and patients will have their own challenges in implementing and accessing these services. This requires significant financial and workforce investment, which may be more difficult for smaller or less-resourced practices. On a state level, many state governments have focused on expanding telehealth in their Medicaid programs, as well relaxing state-level restrictions around provider licensing, online prescribing and written consent. For FirstHealth On the Go, download the app on your Android or Apple device or get st… In 2019, large employers projected that healthcare costs were going to rise by 5% for the sixth year in a row, according to a survey by the Business Group on Health. U0001:CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel. HIPAA), federal prescribing laws for controlled substances, grant funding for telehealth initiatives and Medicare coverage of telehealth. YES, THERE’S AN APP FOR THAT…to lessen the risk of exposure to coronavirus (COVID-19) while continuing to provide you with quality health care, First Choice is offering virtual visits. If your doctor provides phone or video appointments, follow their instructions. With expanding use of telemedicine in clinical settings, health systems need to decide which providers they will divert to phone lines and/or video visits and how to manage their patient flow, while still ensuring enough staff to manage in-person care. Health Plans. A number of gaps remain in ensuring access to telemedicine during the COVID-19 pandemic. Hawaii is the only state to require malpractice carriers to offer telemedicine coverage, and insurance premiums may be higher if covering telemedicine. Employers including Walt Disney Company and Costco cinched the 51-100 spots on Glassdoor’s annual “Best Places to Work” awards. Normally, clinicians must be licensed to practice in states where they offer telemedicine services, and states regulate which health professionals are credentialed to practice in their state. Laurie Sobel Follow @laurie_sobel on Twitter Figure 3: Who Regulates Telemedicine in Health Plans? Clinicians must ensure their malpractice or liability insurance covers telemedicine, and if needed, that it covers services provided across state lines. As health systems and smaller practices implement or ramp up use of telemedicine in response to this crisis, there are many provider facing and patient facing considerations to address. Many states have relaxed telemedicine written consent, licensing, and online prescribing laws, while expanding coverage in Medicaid and fully-insured private plans. “Helping employers rediscover the excellent care available to them locally is a great way for FCH to have an impact on the health of our communities.”, Associate editor, During the current outbreak, many telemedicine platforms are experiencing high volumes of patients trying to access care online which has resulted in IT crashes and long wait times to obtain a virtual appointment in some systems. Loosening enforcement of HIPAA will likely not impact state level regulations, meaning states would need to lift or loosen their own health information laws. Telemedicine growth has been limited by lack of uniform coverage policies across insurers and states, and hurdles to establishing telemedicine in health systems (e.g. For patients who are now turning to telemedicine visits rather than their usual source of in-person care, clinicians in some states may face legal barriers to online prescribing medications if they do not already have a pre-existing relationship with the patient. AK, AZ, AR, DE, HI, IA, KS, KY, LA, MD, MS, MT, OH, OK, SD). While use of telemedicine in the U.S. had been minimal prior to COVID-19, interest in and implementation of telemedicine has expanded rapidly during the crisis, as policymakers, insurers and health systems have looked for ways to deliver care to patients in their homes to limit transmission of the novel coronavirus. With all these factors in mind, it will be up to policymakers, payors, and providers to determine if the changes made to telehealth policy in light of COVID-19 outweigh the potential concerns, if they should remain permanently, and if telemedicine helps enable accessible, quality health care. Implementing new telemedicine initiatives in response to COVID-19 oftentimes requires a redesign of longstanding clinical care models. Therefore, patients may not be able to talk to their usual providers, if restricted to certain telehealth platforms by their insurance provider. While studies show some interest in telehealth among older individuals, concerns include perceived poorer quality of care, privacy issues and difficulty using technology. While use of telehealth has opened the door for patients to maintain access to care during this public health crisis, ensuring quality of care of telehealth visits is still important. Our Rising Star Awards nomination deadline has been extended. Changes to state level regulations in response to COVID-19 are described next. There are some inherent differences to evaluating patients remotely from their homes compared to in-person. high startup costs, workflow reconfiguration, clinician buy-in, patient interest). Many insurers are reducing or eliminating cost sharing for telemedicine, for a limited period of time. Additionally, CMS is temporarily waiving the Medicare requirement that providers be licensed in the state they are delivering telemedicine services when practicing across state lines, if a list of conditions are met. However, many health systems did not have existing telemedicine infrastructure, and many providers are novices to providing care through telemedicine. The isolation that comes with being separated from a communal workplace has made many employees question how dedicated they are to their employers, and people feel emboldened to speak out when managers and co-workers aren’t peering over their shoulders. Planning to build or develop a telemedicine app in 2021? Meanwhile, many commercial insurers have voluntarily addressed telemedicine in their response to COVID-19, focusing on reducing or eliminating cost sharing, broadening coverage of telemedicine and expanding in-network telemedicine providers. home) and modalities (e.g. First Choice will cover all medically necessary services required to facilitate testing and treatment of COVID-19 for its eligible members, in accordance with federal and state guidance. Meanwhile an estimated 15% of physicians had used telemedicine to facilitate interactions with their patients. 2021 - First Choice Health FCH Providers portal provides access to benefits and eligibility, status of claims and payments, payor search, provider update form, and more. The Federation of State Medical Boards is tracking these updates, and finds that currently 49 states have issued waivers regarding licensure requirements during the COVID-19 emergency. What will happen when patients finally feel comfortable returning to their healthcare providers’ offices? Similarly, utilization of telemedicine by traditional Medicare and Medicaid and beneficiaries enrolled in managed care plans had been trending upward, but remained low. Serving local communities since 2015. Coverage and reimbursement of telemedicine is still far from uniform between payors, and most changes to telehealth policy are temporary. For some plans this applies only to telehealth visits related to COVID-19, while for others this applies to any health indication. Health systems will need to decide whether to invest in telemedicine infrastructure for long-term use, or if they are looking for shorter term, potentially cheaper, solutions solely to respond to this acute crisis. In a 2019 study by Definitive Healthcare, many outpatient practices reported not investing in telehealth due to these financial barriers. The waiver does the following: lifts the requirement that beneficiaries must live in rural areas in order to receive telehealth services, meaning beneficiaries in any geographic area could receive telehealth services; allows the patient’s home to qualify as an “originating site” from which they can access telehealth visits; allows telehealth visits to be delivered via smartphone with real-time audio/video interactive capabilities in lieu of other equipment; and removes the requirement that providers of telehealth services have treated the beneficiary in the last three years. Importantly, these expanded telehealth services under Medicare are not limited to COVID-19 related services, rather they are available to patients regardless of diagnosis and can be used for regular office visits, mental health counseling, and preventive health screenings. We are pleased to inform you that with effect from July 1, 2020, the ATH website address (URL) for First Choice users will be changed as follows. These members now have access to on-demand primary care and EAP services through telemedicine. Costs included hiring programmers to create a telemedicine platform, ideally one that integrates into an existing electronic health record, protects patient privacy, and can charge for visits if needed. On-demand pay is the future of payroll processing, says Amy Cohen, director of total rewards at Noodles & Company. In some states, this applies only to Medicaid beneficiaries, but in others this applies to all telehealth encounters regardless of payor. Alternatively, health systems could contract with existing telemedicine platforms to provide these services. A separate provision in the CARES Act allows federally qualified health centers (FQHCs) and rural health clinics (RHCs) to serve as “distant site” providers, and provide telehealth services to Medicare beneficiaries during the COVID-19 emergency period (Figure 5). For purposes of Medicaid, telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This means some telemedicine platforms may need to hire more clinicians in order to keep up with demand. Share on Facebook. Filling the need for trusted information on national health issues, Gabriela Weigel, , and Some states (e.g. Partner with First Choice Telehealth Solutions and watch your providers quickly transform patient care to a new level of performance. Many telemedicine platforms use an online health questionnaire to establish that relationship, but in at least 15 states, this method is considered inadequate. (Figure 2). Contact Our Office for a Telehealth Appointment With a Primary Health Care Provider or for Behavioral Health . Subscribe to our email list Here! Other modifications to telehealth availability in response to the COVID-19 emergency include allowing both home health agencies and hospice providers to provide some services via telehealth, and allowing certain required face-to-face visits between providers and home dialysis and hospice patients to be conducted via telehealth. In addition to HIPAA, many states have their own laws and regulations to protect patient health information. Okigwe also anticipates a greater focus on providing more direct-to-employer health services. To make an appointment to virtually see one of our providers using the app, call: 860-528-1359. The federal government, some states, and some health insurance carriers are trying to enable more telemedicine visits to be permitted and paid for. In China, telemedicine platform JD Health saw a tenfold increase in their services during the outbreak and is now providing nearly 2 million online visits per month. They also offer telemedicine programs that address behavioral health, weight loss and substance abuse. While a limited telemedicine assessment may be adequate to determine if a patient needs to present to an emergency room/urgent care or for testing, there are the limitations of telemedicine care for this purpose. Importantly, states also are in charge of deciding which telehealth services will be covered by their Medicaid program, and most states also have laws governing reimbursement for telemedicine in full-insured private plans. To Schedule a Telehealth Appointment Call: (910) 364-0970. This program currently awards a total of $8.7 million a year for telehealth technologies used in rural areas and medically underserved areas. First Choice providers are now using telemedicine to evaluate and treat patients. Telemedicine allows health care professionals to evaluate, diagnose and treat patients at a distance using technology. About First Choice Telehealth; Meet Our Team; Contact Us; Media; First Choice Blog; The Details. ... ©2018 BY FIRST CHOICE COMMUNITY HEALTH CENTERS. The same year, the Colorado city of Arvada contracted with Paladina Health to restructure its benefit offerings to be self-insured. Nearly 130,000 Americans were hospitalized with COVID-19 as of midnight on Monday and the country had reported 22.5 million infections and 376,188 deaths.” Medical personnel across the country are overwhelmed, which makes telemedicine a logical and safe choice for obtaining health care. 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