CLEVELAND — The public health emergency that congress declared in 2020 is set to expire on January 16. The U.S. Secretary of Health and Human Services has been extending that deadline in 90-day increments, but they haven't issued the latest extension yet.
Among other things, the emergency offers more flexibility to Medicare patients to receive telehealth services.
“That includes the ability of any Medicare fee for service beneficiaries to receive access to reimbursable telehealth encounters, regardless of their geographic and originating site location. There had been really severe restrictions on the ability of Medicare beneficiaries to receive access to virtual care services prior to the pandemic, prior to the public health emergency,” said Kyle Zebley, the vice-president of public policy at the American Telemedicine Association.
The telehealth extension facilitated by the public health emergency eliminates in-person requirements for the online prescription of certain controlled substances. Zebley said that has made it easier for those seeking mental health or substance use disorder assistance to receive those services virtually.
Zebley said the extension has also allowed some frontline healthcare services through federally qualified health centers and rural health clinics to cover and be reimbursed for telehealth services.
Though the PHE has not yet been extended, Zebley is confident that it will be. The ATA is also supporting a bill sponsored and recently introduced by members of the House Ways and Means Committee that seeks to ensure permanent access to telehealth services.
“I think there's every reason to be optimistic that prior to the end of the public health emergency, we won't go off what we're calling the telehealth cliff and that Congress will do the right thing and make sure that this is a permanent benefit for Medicare beneficiaries, which will be a great precedent for other Americans that are relying on telehealth services,” said Zebley.
Telehealth services have exploded during the pandemic.
According to Zebley, there have been up to 38 times more virtual visits now in 2022 compared to the beginning of 2020. And with COVID-19 cases surging due to the omicron variant, experts believe these kinds of visits will remain popular.
“It's about trying to get people the appropriate care as quickly as possible from a provider's perspective,” said Albert Ferreira, the director of telehealth operations at MetroHealth.
At MetroHealth, Ferreira said providers are handling thousands of virtual appointments weekly and over the last couple of weeks, he said there’s been a significant increase as people shift from in-person visits to telehealth likely due to the omicron surge but also because it's easy.
“We're seeing a lot more patients that are more comfortable being at home and having the convenience of being able to talk to their provider from home,” said Ferreira.
He said the impact of the volume on providers largely depends on which department they’re in, like urgent care, which requires more time spent with patients. But overall, he said they’re handling it well.
“We're far more prepared than we were, obviously in 2020. We've adapted to a lot of our processes, you know, the technology components,” said Ferreira. “We're obviously a big enabler for this type of care to take place. But then we also had to adjust our operational procedures, as well as getting our staff comfortable and trained with using these new tools. And I think we've gone a long way in making inroads in those areas.”
University Hospitals is also experiencing a high number of virtual visits from more than 400,000 in 2020 and more than 300,000 in 2021. Compare that to 2019, when there were just 10,000 virtual visits.
“We're finding different ways to reach patients,” said Dr. Brian Zack, the medical director of telehealth at University Hospitals.
Zack said over the holidays wait times were longer than they’d like due to the volume of patients and omicron surge, but overall, telehealth actually helps take the strain off other departments.
“It's given the emergency room more time to see the sicker patients quicker and to really take care of those who need that higher level of care in the most appropriate setting,” said Zack.
He also said it makes it more convenient for patients to access the care they need.
“Our psychiatrists and our psychologists are over 93% virtual. Compliance in the patients, though, is up significantly. No show rate is down over 30%,” said Zack.
So with legislators working to make the telehealth extension permanent, those in the field think it will only make things better for providers and the people they serve.
“We are far better off as a society and as a health care industry by leveraging the tools and technologies that we have available to us and not being afraid of them,” said Ferreira.
“Continuing our ability to be able to see our patients and not force them to come in and travel and miss work will improve things all around. And the support for these bills is really important. It really will enable us to keep people safe, deliver good care and actually keep people from getting sicker and save money overall for the system,” said Zack.
Zebley is encouraging those who utilize telehealth services to call their member of Congress and urge them to act to make the telehealth extension permanent.
“It's clearly the future. It's a growing aspect of our healthcare system, and it's one that's going to help us make the most of our limited resources. So it's been the silver lining of the pandemic. It's been a great opportunity for Americans to have access to care. We can't allow that to go away. We need to make sure that rules and regulations keep up with technology and keep up with the practice of medicine,” said Zebley.
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