In telehealth hearing, House committee weighs access against cost

Associates of the U.S. Property Committee on Electricity and Commerce convened Tuesday to explore the long term of digital care. 

Policymakers and stakeholders emphasized the relevance of balancing accessibility to care with addressing problems around fraud and overutilization.   

“Modernizing telehealth plan to satisfy the moment” is a single of lawmakers’ most significant duties, claimed Rep. Doris Matsui, D-Calif.  

“I have claimed right before the genie is out of the bottle about flexibilities and expansion, and I think this,” claimed Rep. Brett Guthrie, R-Ky.

At the exact same time, Guthrie pointed out, broadband accessibility continues to be a limiting factor – both equally in rural and urban environments.   

“We have to have to be certain excellent of care is still offered by the provider, no make any difference the setting,” claimed Guthrie.

The hearing arrived on the heels of the reintroduction of the bipartisan Telehealth Modernization Act in both equally the Property and the Senate, which would safeguard accessibility to protection right after the COVID-19 pandemic.  

Witnesses offered a assortment of approaches for properly addressing the long term of telehealth.

Some, this kind of as Stanford Wellness Treatment Main of Employees Dr. Megan Mahoney, famous that the changeover to telehealth amidst the novel coronavirus pandemic enabled a lot more than 225,000 of the system’s sufferers to comprehensive their 1st online video pay a visit to.  

In many ways, claimed Mahoney, telehealth has strengths of its individual as a modality. 

For illustration, she claimed, “I have discovered a comprehensive medicine assessment can be a lot more simply and properly completed at home,” with tablet bottles near at hand.  

She stressed the relevance of addressing the originating and geographic web site requirements outlined in Portion 1834(m) of the Social Protection Act, which many associates of Congress have signaled their aid for removing.  

Mahoney claimed the limitations inadvertently produce a “donut gap” for Medicare Rate for Assistance sufferers, permitting the health procedure to offer care to all people but them. She urged policymakers to figure out that online video visits and in-person visits need the exact same exertion and healthcare final decision-making by providers, and consequently need to be reimbursed similarly.  

“Telehealth is a device in our toolkit that is largely substitutive, not additive, to in-person care,” she claimed.  

Harvard Healthcare University Affiliate Professor of Wellness Policy and Medication Dr. Ateev Mehrota proposed a a lot more measured method. 

Despite the fact that the have to have for telehealth is unmistakable, claimed Mehrota, procedures need to persuade “higher-benefit” applications for care and discourage “decrease-benefit” kinds.  

He advisable an improve in the use of alternate payment designs, specially for key care providers, physician licensure reciprocity across point out strains, coverage of all varieties of telemedicine for large-risk client populations in which accessibility is probable difficult and protect digital care for the relaxation of the inhabitants “only in which there is proof of benefit or there is persuasive have to have.” He also advocated in opposition to payment parity for telemedicine and in opposition to prolonged-expression protection for audio-only visits.   

“Even though I figure out telephone calls may improve accessibility for disadvantaged populations, I am concerned about a long term with a two-tiered procedure in which the lousy and disadvantaged have cellular phone calls and the rich have online video visits,” claimed Mehrota.

When it arrives to fraud increase – a routinely invoked panic in conversations around telehealth – some industry experts claimed the concern was overblown.  

“The AMA thinks these problems are misplaced offered CMS’ present tools for combating fraud and abuse, the increased skill telehealth expert services supply for documentation and monitoring, and the lack of knowledge to suggest that fraud and abuse or duplication are of distinct concern for telehealth expert services,” claimed Dr. Jack Resneck, a member of the American Healthcare Affiliation Board of Trustees, in ready testimony.

Resneck pointed out that whilst negative actors may use telehealth to defend fraud, they are normally not fraudulently billing for telehealth.   

“Denying sufferers accessibility to telehealth as a consequence of these number of fraudsters isn’t going to address the fraud issues and isn’t going to aid the sufferers,” claimed Resneck.

Rep. Michael Burgess, R-Texas, raised an interesting obstacle: how to be certain telehealth provision by itself isn’t going to come to be extremely burdensome.

Citing a recent examine suggesting industry experts underestimated EHRs’ effects on burnout right after the HITECH Act, Burgess questioned how to pass procedures around digital care and knowledge sharing that never make the circumstance worse. Purchaser Small business Team on Wellness president and CEO Elizabeth Mitchell argued that data siloing would actually make things tougher for clinicians.  

“We have obtained to be certain knowledge is meaningfully shared in a way that is straightforward to use,” she claimed.  

All round, associates of Congress remain bullish on digital care, whilst the aspects of payment parity, fraud avoidance and protection specifics continue to occur as hurdles.

“Providers and sufferers like telehealth, so let’s do our finest not to mess this up,” claimed Rep. Larry Bucshon, R-Ind.  

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
E-mail: [email protected]
Healthcare IT News is a HIMSS Media publication.