The COVID-19 public health emergency declared by the Department of Health and Human Services (HHS) expired earlier this month. But that doesn’t mean the deadly respiratory illness has disappeared, warned Deb Houry, MD, MPH, chief medical officer and deputy director for program and science at the Centers for Disease Control and Prevention (CDC).

COVID-19 and the virus that causes it, SARS-CoV-2, still exist, so the CDC’s vaccination efforts will continue. Dr. Houry said physicians will play a key role in continuing to educate their patients and the public about the safety and efficacy of COVID-19 vaccines.

“CDC vaccine safety efforts are not tied to the public health emergency, so they will continue,” Dr. Houry said. “We know that hearing about vaccine safety can instill confidence in communities nationwide. This is where we really look to physicians to be the trusted messenger and share facts.”

Dr. Houry talked about this effort and other changes physicians and patients may experience following the expiration of the public health emergency in a recent episode of “AMA Update.”

COVID-19 is not over

The significance of ending the public health emergency is that it will alter various responses to the pandemic. According to the CDC, the type of data collected and shared by the CDC will change, and COVID-19 at-home tests may no longer be covered by insurers.

Additionally, (HHS) outlined that specific Medicare and Medicaid waivers that helped expand access to care during the pandemic will end.

“The end of the public health emergency is not the end of COVID-19,” Dr. Houry said. “The CDC will continue our commitment to prevent severe illness and death by providing the information needed to protect our nation’s health.”

Physicians should explain to patients that the declaration of a public health emergency is significant because it can trigger certain responses from the government, Dr. Houry said. It also is important for patients to understand that COVID-19 is not spreading as rapidly as it was earlier in the pandemic. According to Dr. Houry, 96% of the population is protected against the worst outcomes of COVID-19 through vaccination or prior infection.

A critical role that physicians can play now is to keep educating and informing patients, particularly about vaccination, she said.

Physicians and other health professionals “are among the most trusted sources when it comes to vaccine uptake,” Dr. Houry noted. “We really encourage all clinicians to talk with patients about their coverage and recommend the COVID-19 vaccines.”

How data collection will change

Physicians and hospitals greatly benefited from the CDC’s collection and distribution of key metrics throughout the COVID-19 pandemic. Now that the public health emergency declaration has expired, COVID-19 case and death data will no longer be highlighted in the COVID Data Tracker. That data, however, became increasingly less reliable as some states opted to stop collecting case data or share test results, the CDC has said.

“We will have changes in data reporting, but we’ll continue to provide timely insights through several different data sources,” Dr. Houry said. “One is our nationwide hospitalization data will be reported on a weekly basis and serve as the primary COVID-19 surveillance metric.”

The percentage of COVID-19-associated deaths each week will be shared by the CDC, as will the weekly number of COVID-19 hospital admissions and patients who visit the emergency department and are diagnosed with COVID-19.

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WASHINGTON (AP) — President Joe Biden informed Congress on Monday that he will end the twin national emergencies for addressing COVID-19 on May 11, as most of the world has returned closer to normalcy nearly three years after they were first declared.

The move to end the national emergency and public health emergency declarations would formally restructure the federal coronavirus response to treat the virus as an endemic threat to public health that can be managed through agencies’ normal authorities.

It comes as lawmakers have already ended elements of the emergencies that kept millions of Americans insured during the pandemic. Combined with the drawdown of most federal COVID-19 relief money, it would also shift the development of vaccines and treatments away from the direct management of the federal government.

Biden’s announcement comes in a statement opposing resolutions being brought to the floor this week by House Republicans to bring the emergency to an immediate end. House Republicans are also gearing up to launch investigations on the federal government’s response to COVID-19.

Then-President Donald Trump’s Health and Human Services Secretary Alex Azar first declared a public health emergency on Jan. 31, 2020, and Trump later declared the COVID-19 pandemic a national emergency that March. The emergencies have been repeatedly extended by Biden since he took office in January 2021, and are set to expire in the coming months. The White House said Biden plans to extend them both briefly to end on May 11.

“An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans,” the Office of Management and Budget wrote in a Statement of Administration Policy.

More than 1.1 million people in the U.S. have died from COVID-19 since 2020, according to the Centers for Disease Control and Prevention, including about 3,700 last week.

Congress has already blunted the reach of the public health emergency that had the most direct impact on Americans, as political calls to end the declaration intensified. Lawmakers have refused for months to fulfill the Biden administration’s request for billions more dollars to extend free COVID vaccines and testing. And the $1.7 trillion spending package passed last year and signed into law by Biden put an end to a rule that barred states from kicking people off Medicaid, a move that is expected to see millions of people lose their coverage after April 1.

“In some respects, the Biden administration is catching up to what a lot of people in the country have been experiencing,” said Larry Levitt, the executive vice president for health policy at Kaiser Family Foundation. “That said, hundreds of people a day are still dying from COVID.”

Still, some things will change for Americans once the emergency expires, Levitt pointed out.

The costs of COVID-19 vaccines are also expected to skyrocket once the government stops buying them, with Pfizer saying it will charge as much as $130 per dose. Only 15% of Americans have received the recommended, updated booster that has been offered since last fall.

People with private insurance could have some out-of-pocket costs for vaccines, especially if they go to an out-of-network provider, Levitt said. Free at-home COVID tests will also come to an end. And hospitals will not get extra payments for treating COVID patients.

Legislators did extend for another two years telehealth flexibilities that were introduced as COVID-19 hit, leading health care systems around the country to regularly deliver care by smartphone or computer.

The Biden administration had previously considered ending the emergency last year, but held off amid concerns about a potential “winter surge” in cases and to provide adequate time for providers, insurers and patients to prepare for its end.

Officials said the administration would use the next three months to transition the response to conventional methods, warning that an immediate end to the emergency authorities “would sow confusion and chaos into this critical wind-down.”

“To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19,” the administration said. “They do not impose mask mandates or vaccine mandates. They do not restrict school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.”

Case counts have trended downward after a slight bump over the winter holidays, and are significantly below levels seen over the last two winters — though the number of tests performed for the virus and reported to public health officials has sharply decreased.

On Monday, the World Health Organization said the coronavirus remains a global health emergency, even as a key advisory panel for the group found the pandemic may be nearing an “inflexion point” where higher levels of immunity can lower virus-related deaths. China, for example, reported an unprecedented surge in December after lifting most of its COVID-19 restrictions.

Moments before the White House’s announcement, Rep. Tom Cole, R-Okla., accused the president of unnecessarily extending the public health emergency to take action on issues like forgiving some federal student loan debts.

“The country has largely returned to normal,” Cole said Monday, introducing a Republican-backed bill calling for an end to the health emergency. “Everyday Americans have returned to work and to school with no restrictions on their activities. It is time that the government acknowledges this reality: the pandemic is over.”

The House was scheduled to vote Tuesday on legislation that would terminate the public health emergency.

The bill’s author, Rep. Brett Guthrie, R-Ky., said he still hopes the House will proceed with a vote. He said he was surprised by the White House move, but thinks the legislation may have played a role in prompting the administration to act.

“I think we should go forward,” he said late Monday as lawmakers returned to the Capitol. “If for some reason they don’t do it on May the 11th, the vehicle is still there for Congress to take back its authority.”

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By Mark Melchionna

January 18, 2023 – A recent study published in JAMA Network Open found that among nonelderly cancer patients, the expansion of telehealth oncology services may have helped lessen challenges related to travel, including time and money.

In the US, cancer is a common cause of death. Although it most commonly affects those older than 65, many young patients also battle this condition. According to the Centers for Disease Control and Prevention (CDC), there were a total of 161,594 patients between 15 and 64 who died of cancer in the US in 2020.

To gather information regarding the time, travel, and costs nonelderly patients saved when they obtained cancer care through telehealth, researchers conducted an economic evaluation of cost savings related to completed telehealth visits from April 1, 2020, to June 30, 2021. All data came from a single National Cancer Institute-Designated comprehensive cancer center. Researchers defined nonelderly as those who fell between 18 and 65 years of age.

The total study population included 11,688 patients who participated in a total of 25,486 telehealth visits. Of these visits, 4,525 were new, and 20,971 were follow-ups. The median age of patients engaging in telehealth visits was 55, and 15,663 visits included women. About 18,360 visits included Hispanic non-White patients.

The main measure that researchers used when evaluating data was patient cost savings from telehealth. They assessed two sets of costs: costs of travel and the potential loss of productivity due to the medical visit. They defined costs of travel as the roundtrip distance saved from car travel and potential loss of productivity as the income missed from roundtrip travel and the loss of income from in-person clinic visits.

The cost models of the study show that the estimated mean total cost savings ranged from $147.4 at $0.56 per mile to $186.1 at $0.82 per mile.

However, these cost savings differed between new or established and follow-up visits. Among new or established visits, the mean total cost savings per visit fell between $176.6 at $0.56 per mile and $222.8 at $0.82 per mile. For follow-up visits, these figures fell between $141.1 at $0.56 per mile and $178.1 at $0.82 per mile.

Based on these findings, researchers concluded that telehealth did help save patient time and travel costs.

“Expansion of telehealth oncology services may be an effective strategy to reduce the financial burden among patients with cancer,” they wrote.

However, the study also has certain limitations, including being conducted retrospectively within a tertiary referral center, the assumptions of patient employment rates and incomes, potentially affecting savings from lost productivity, and the inclusion of telehealth visits that only occurred through synchronous videoconference.

Researchers also noted that if long-term oncologic outcomes are similar between in-person and virtual care, further evaluation of costs may be necessary.

This is not the first study to establish a link between virtual care and healthcare costs.

A report from Cigna published in January 2022 found that virtual care lowered healthcare costs by about $100 per visit. Aside from financial benefits, the study also found that telehealth improved access to healthcare for Cigna members.

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Advocates for telehealth kept pressing Congress to ensure access for virtual care, and it appears lawmakers got the message.

Lawmakers are working on final approval of the $1.7 trillion federal spending bill before the government is slated to shut down at the end of the week. Senate leaders included a provision to extend telehealth waivers for healthcare providers through 2024.

The news was music to the ears of Kyle Zebley, senior vice president of public policy for the American Telemedicine Association.

With the possible exception of the federal government expanding virtual care shortly after the arrival of COVID-19, “This is the biggest federal success the telehealth community has had, arguably ever,” Zebley told Chief Healthcare Executive in an interview Wednesday morning.

“It’s a real bipartisan example of the stunning levels of support we have built up over the years,” Zebley said.

The Senate approved the omnibus spending package Thursday, and the House passed it Friday. President Biden is expected to sign it Friday.

Advocates are grateful for the two-year telehealth extension, and are looking for longer-lasting reforms down the road.

“It is a sign that we’re on the road to permanency,” Zebley said.

Racing the clock

Healthcare groups emphasized that extending telehealth access was near the top of their list of priorities before Congress adjourns for the year. It wasn’t just an arbitrary deadline. 

A new Congress will take office in January. If lawmakers didn’t approve the telehealth measure, the legislative process would have to begin anew in 2023, with a new bill being introduced and requiring several steps to clear both the House and Senate, or get inserted into another spending package.

The House of Representatives overwhelmingly approved a bill in July to extend telehealth coverage through 2024. The House passed it with a 416-12 vote, an unusually wide margin in the highly charged partisan environment in Washington.

The measure also had strong support in the Senate, but health advocates said Senate passage wouldn’t be a lock because of the short amount of time left in the congressional session.

Health systems were given waivers to extend telehealth services early in the COVID-19 pandemic, which was a necessity since many providers had curbed in-person services in the first few months of the pandemic.

Advocates expected the telehealth legislation would have to be included in a broader spending package, and healthcare groups sought to get it into the omnibus bill, even as the end of the year rapidly approaches.

“For something like this, everybody that’s been fighting to get something included in a massive package like this … It’s a race against time,” Zebley said.

The telehealth waivers are largely tied to the federal government’s COVID-19 public health emergency, generating uncertainty as to how long those waivers would be in effect. The emergency looks to stay in place through the early months of 2023, healthcare advocates say, but it’s difficult to predict how long it will last. Health systems warned of an impending cliff for telehealth.

Congress and President Biden approved a safety net early last year by allowing telehealth waivers to continue for about five months after the end of the emergency designation.

But health systems pressed lawmakers for a longer period to continue telehealth, which has become a valuable service for providers and for patients, particularly those who don’t live near a practice or hospital.

Key provisions

The spending package includes a two-year delay in implementing the Medicare telemental health in-person requirement, a key issue for behavioral health providers. Healthcare leaders have said telemedicine is a critical way to expand mental health services, particularly with the shortage of clinicians.

It also includes a two-year extension to offer telehealth in High Deductible Health Plans, the American Telemedicine Association said.

The spending package would also provide a two-year extension for hospital-at-home programs, another top issue for health systems. More hospitals have been launching home-based acute care programs. Across the nation, 259 hospitals in 37 states are offering acute care at home, according to federal data.

Home hospital programs are “one of the most innovative test programs that has come out during the pandemic,” Zebley said. “That’s included and it’s a huge victory.”

In addition, audio-only telehealth services would be covered, which Zebley said is important in communities where video telehealth services aren’t widely available.

However, the spending package didn’t include a provision healthcare advocates had sought.

Telemedicine advocates had pushed for an extension of the waiver for the remote prescription of certain controlled substances, including some medications for substance use disorder. But that provision didn’t make the final cut.

The remote prescription waiver is tied to the public health emergency, so that waiver could end shortly after the emergency designation is phased out.

“There’s a big outlier … I’m very concerned about what happens when the public health emergency ends for that community,” Zebley said.

The spending package directs the Drug Enforcement Administration to develop regulations specifying when telemedicine may be used for remote prescriptions of certain substances. And health groups will continue pushing for a more permanent solution, Zebley said.

Looking ahead

Assuming Congress gets the spending package done, health groups are looking forward to pressing ahead with permanent telehealth reforms.

There will be a new Congress, with Republicans holding a narrow majority in the House and Democrats holding a slim edge in the Senate. Zebley said he’s optimistic that there will continue to be strong support for telehealth across party lines, and healthcare groups will be pushing for legislation to craft lasting coverage for telehealth.

“We’re one of those rare issues that had extraordinary support in the Trump administration, which carried over into the Biden administration,” Zebley said.

This wasn’t a new, last-minute effort to wedge telehealth expansion into a big spending package, Zebley said. Telehealth advocates have been pressing Congress for years, building credibility and support with lawmakers. Health groups spoke “with one voice in support of telehealth … which is no small thing,” Zebley said.

“Getting everyone on the same page is also important,” Zebley said.

Telehealth usage soared early in the COVID-19 pandemic, and while use of telehealth has dipped from peak levels, many patients like having virtual options. More than one in three Americans (37%) used telehealth at some point in 2021, according to the Centers for Disease Control and Prevention.

With broad usage of virtual care, strong legislative support and a two-year extension, Zebley said advocates can work with lawmakers on crafting thoughtful legislation to continue telehealth services.

“Even in a divided Congress, even during a divided time, even as we gear up for the 2024 election, this continues to be an issue that garners bipartisan support,” Zebley said.

“I think the vast majority of these programs are on the road to permanency,” he said. “I’m very optimistic.”

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Two House members said that congress is trying to expand Medicare’s virtual flexibilities beyond the public health emergency, NextGov reported Dec. 14. 

“Unfortunately, it took a global pandemic for us to realize the larger benefits of telehealth and really introduce telehealth into traditional Medicare,” said Cathy McMorris Rodgers, R-Wash., House Energy and Commerce Committee ranking member.

Lawmakers are trying to transition beyond the public health emergency and create a more permanent direction for telehealth, which was used by 38 percent of Americans in the past 12 months, according to CDC data. 

“We want to delink the telehealth flexibilities from the COVID-19 public health emergency. We want to make sure that patients remain in control of their doctor visit decisions and that it’s the patient that is deciding whether or not to utilize telehealth services or if they prefer to see a provider in person,” Ms. Rodgers said. “We’re also having broader conversations about the guardrails on the program to make sure that we are cutting down on the potential waste, fraud and abuse, which we will see in any program, but we need to create a permanent structure around telehealth. Right now, we’re working more on a short term bridge policy, to give us some time to consider what those guardrails would be and where the maximum efficiencies will be.”

As of now, Medicare telehealth flexibilities will end 151 days after the PHE expires, which has been extended past January 11, 2023.  

House members have voted on a bill to expand telemedicine coverage under Medicare for two years, but the Senate has not taken up this bill. 

Mike Thompson, D-Calif., co-chair of the House Ways and Means Committee and member of the Congressional Telehealth Caucus, also introduced a bill to expand telehealth permanently, but it has been lingering. 

“It is a bipartisan issue and it’s an important issue,” Mr. Thompson told NextGov. “Congress is a strange place and there are any number of bills right now that you and I … would agree should be passed, but for a number of very complicated reasons, they’re lingering, this being one. Now, there was some rumor that the Senate was inclined to do it, but only wanted to do it for one year. And we’re waiting to see what the final package comes down to.”

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In anticipation of critical telehealth flexibilities expiring on Dec. 31, US Representatives Michelle Steel (CA-48), Brad Schneider (IL-10), and Susie Lee (NV-3), along with a bipartisan group of 30 Congress members, sent a letter requesting that House leadership include two pieces of legislation that extend some flexibilities in a year-end package.

When the COVID-19 pandemic began, patients and providers turned to telehealth in droves to maintain care. According to the Centers for Disease Control and Prevention (CDC), there was a 154 percent increase in telehealth visits when comparing data from the last week of March 2020 with that of March 2019.

This uptake of telehealth was likely associated with the withdrawal of regulatory restrictions in response to the limitations placed on in-person care during the public health emergency.

As part of the CARES Act of 2020, Congress passed reforms that expanded access to telehealth services. For instance, prior to the CARES Act, Americans with high-deductible health plans (HDHPs) coupled with health savings accounts (HSAs) had to reach the minimum deductible before they qualified for telehealth coverage.

However, Section 3701 of the CARES Act eliminated this requirement initially through Dec. 31, 2021. The provision was later extended through the Consolidated Appropriations Act, 2022.

This led to wider coverage of telehealth services as health plans and employers were able to expand access to virtual care services for individuals with HDHP-HSAs pre-deductible. According to the representatives, increased access has led to many benefits for patients, particularly those without access to transportation services and those who reside far away from clinical locations.

“Access to telehealth has also provided a significant portion of the U.S. workforce relief at a time when household costs are rising. Telehealth has allowed families to avoid taking time off from work to travel to and from appointments, and timely care has helped prevent costly visits to urgent care or the emergency room. Unfortunately, those with a high deductible may decide to skip critical preventative services – including primary care and behavioral health services – if the deductible is not waived, often leading to poor health outcomes and more costly care down the line,” the letter states.

Due to the increasingly apparent benefits of telehealth, the US representatives are requesting that House leadership include the Primary and Virtual Care Affordability Act and the Telehealth Expansion Act in the end-of-the-year package. The Telehealth Expansion Act would make the telehealth flexibility permanent for people with HDHP-HSAs. The Primary and Virtual Care Affordability Act would both extend the flexibility and allow insurance providers to cover primary care services pre-deductible.

This letter is part of a larger effort among healthcare stakeholders to ensure that expanded access to telehealth is solidified.

Another letter written by the Connected Health Initiative (CHI) requested that Congress extend the safe harbor for telehealth coverage by HDHPs.

In the letter, CHI noted its support for removing restrictions impeding telehealth access among Medicare beneficiaries. It also emphasized the upcoming telehealth deadline Americans with HDHPs will face at the end of 2022.

Due to this, CHI requested that Congress extend the safe harbor for HDHPs to cover telehealth with first-dollar coverage. This would also allow them to maintain HDHP status.

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Remote patient monitoring is a more advanced method for healthcare centers to examine their patients. Although remote patient monitoring is not the latest technology but its need has increased tremendously in COVID-19 days because these days, no one was allowed going outside of their houses or living places, then doctors and all other great healthcare centers had to make a lot of positive changes in RPM to make it better for patients as well as for themselves. Nowadays, the United States is leading all the countries to use this impressive technology, but there are also some other advanced countries that are getting benefits from RPM.

According to the Centers for Disease Control and Prevention (CDC), the US spends almost $3.5 trillion on the treatment of chronic diseases. That is almost 90% of total annual healthcare expenditures. Chronic diseases are very complicated and need special attention to cure. That is where RPM comes into play because, with the help of RPM, healthcare centers can keep an eye on their patients all the time. RPM is very different and beneficial from traditional treatment methods. In this article, we will discuss some of the benefits of Remote Patient Monitoring, how and why it is working better than other traditional treatment methods.

1- Patients are more visible to healthcare centers

RPM is considered the most effective method to treat a patient because, with this technology, a doctor can observe his patient’s condition at each and every moment, whenever he wants. But in traditional treatment, if a patient has to meet his doctor, he has to physically travel to his doctor, which is sometimes very difficult. So, RPM is more effective in every way with respect to traditional treatment methods.

2- RPM is Cheaper than Traditional Treatments

Another important benefit of RPM is it reduces a lot of our expenses as compared to traditional treatment methods. Suppose in traditional treatment a patient has to pay for traveling, rent, childcare, and other expenses. A patient does not have to pay for these extra expenses if he chooses RPM for his treatment. This is why nowadays surveys always show the first priority of patients is telehealth facilities over other traditional methods.

3- No Barriers

If you ask for the biggest benefit that RPM provides, most of the doctors, as well as patients, go for no barriers. Let me explain how. In traditional treatment, a patient has to reach his doctor physically, which is very difficult for those who are living in rural areas where the system of transportation is also not good. If the condition of a patient is severe, they may die before reaching the hospital. These traditional treatment methods are very disgusting. But the arrival of RPM makes it very easy to contact doctors whenever and wherever you want.

4- Easy to connect

Remote patient monitoring is very comfortable for patients as they feel more connected to their medical staff or health givers. In traditional treatment in the hospitals, a doctor only comes once a day to visit the patient and then disappears, but in RPM you are always connected with the caregiving staff, which is very beneficial. Due to this facility, patients feel much better and more confident than other patients and feel free to connect with their doctors.

5- Extends the reach of the Physician

Remote patient monitoring is beneficial because it extends the reach of doctors worldwide. It means you can contact any doctor in the world as a patient if you want to take a consultation with him. In COVID-19, patients always connect with their doctors through RPM and this is the only reason why RPM is so famous now. In traditional treatment, a patient has to move out of his country if he wants to visit a doctor outside of his country, which is very difficult, but RPM makes it look so easy to connect healthcare centers worldwide.

6- Creates a good relation

Look when patients visit the doctors at their clinics, sometimes they are shy and do not explain their entire condition and problems, which could be fatal for their health in the future. But when they leave, they feel that they should tell their doctors what they have not said. This is where RPM is also more effective than traditional treatment as the condition of the patient is reached to the doctors through an electronic medical records system automatically, which is a very big advantage.

Sum up:

In this article, our motto was to find the benefits of RPM. Health caregivers believe that there are a lot of benefits of using RPM instead of traditional treatment systems, but we have discussed a few of them, which are more common and basic.

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Following President Joe Biden’s State of the Union Address on Tuesday, Health and Human Services (HHS) Secretary Xavier Becerra kicked off the National Tour to Strengthen Mental Health in an effort to hear directly from Americans across the country about the behavioral health challenges they’re facing and engage with local elected officials and leaders to strengthen the mental health and crisis care system in our communities.

“The pandemic has not only taken a physical toll on all of us, but also brought on greater behavioral health challenges for everyone,” said Secretary Becerra. “From small towns to big cities, I’ll be traveling nationwide with members of my leadership team to meet with people who have been hit particularly hard, and partnering with local leaders to find ways to save lives in our communities. The Biden-Harris Administration will continue to deliver on our promise to build back better – and healthier.”

As President Biden launches a whole-of-government strategy to transform mental health services for all Americans, Secretary Becerra is leading HHS to address the mental health challenges that have been exacerbated by the COVID-19 pandemic, including substance use, youth mental health, and suicide. Building on work that agencies and offices across the Department have already been doing, Secretary Becerra and HHS leaders will hit the road in a concerted effort to deliver on the Biden-Harris Administration’s priorities to tackle these challenges.

Over the next few months, Secretary Becerra will make announcements on new initiatives and various resources provided by HHS, such as increasing the number of behavioral health professionals and community and behavioral health support workers in underserved and under-resourced communities, expanding pediatric mental health care access through telehealth services, and the transition to 988: America’s Suicide and Crisis Lifeline. Through meetings with partners, local leaders, and elected officials across the country, the Secretary will highlight the work HHS is doing and also take time to listen and gather ideas about ways to partner with states and communities to strengthen mental health services, and what more the Department can do.

The term “behavioral health” refers to the promotion of mental health, resilience and wellbeing; the treatment of mental and substance use disorders; and the support of those who experience and/or are in recovery from these conditions, along with their families and communities.

Provisional data from the Centers for Disease Control and Prevention (CDC)’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during the 12-month period ending in April 2021, an increase of 28.5 percent from the 78,056 deaths during the same period the year before. To combat this crisis, Secretary Becerra announced the release of the new HHS Overdose Prevention Strategy, designed to increase access to the full range of care and services for individuals who use substances that cause overdose, and their families.

Even before the COVID-19 pandemic, mental health challenges were common, with 1 in 5 adults experiencing a mental illness in any given year. Mental health challenges were the leading cause of disability and poor life outcomes in young people, with up to 1 in 5 children ages 3 to 17 in the United States having a mental, emotional, developmental, or behavioral disorder.

Additionally, from 2009 to 2019, the share of high school students who reported persistent feelings of sadness or hopelessness increased by 40 percent, to more than 1 in 3 students. The share of high school students who seriously considered attempting suicide also increased during this period, by 36 percent. The pandemic only exacerbated youth mental health challenges. In December 2021, the U.S. Surgeon General Dr. Vivek Murthy issued a new Surgeon General’s Advisory to highlight the urgent need to address the nation’s youth mental health crisis.

“Our country faced a mental health pandemic long before the COVID-19 pandemic began, and it was exacerbated by the traumatic effects of the past two years. That’s why, last December, I issued a Surgeon General’s Advisory on protecting youth mental health – because it will take policy, institutional, and individual changes alike to reframe and address this crisis with the urgency it deserves,” said Surgeon General Vivek Murthy. “I am grateful to Secretary Becerra and the Biden-Harris Administration for recognizing this, and for their commitment to work with communities across the country to strengthen and protect mental health.”

According to the CDC, in 2020, suicide was among the top 5 leading causes of death for people ages 10-64. Suicide was the second leading cause of death for people ages 10-14 and 25-34. Some groups have higher suicide rates than others. Among the highest rates are American Indian/Alaska Native and White populations, veterans, people who live in rural areas, and young adults who identify as lesbian, gay, or bisexual.

The National Tour to Strengthen Mental Health will also promote health equity and prioritize hearing from diverse voices. The Secretary will travel to traditionally underserved communities and hold conversations in spaces and places that are under-resourced. As the Secretary leads the Administration’s efforts to ensure equitable access to health care, HHS will continue working across the Department and in partnership with other agencies to close behavioral health disparities and invest in comprehensive treatment, early intervention, prevention, and recovery support services for all Americans.

The Secretary also intends to bring with him a message of hope – because in the face of startling statistics, there are prevention strategies that work and stories of resilience that should be shared. For example, providing 24/7, free and confidential support to people in crisis works – numerous studies have shown that the existing SAMHSA-funded National Suicide Prevention Lifeline helps thousands of people overcome crisis situations every day. The transition to 988 in July will make it more accessible.

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Telehealth plays an increasingly critical part in treating patients, improving health outcomes and lowering costs.

The U.S. Department of Health and Human Services has signed a Memorandum of Understanding with the Federal Communications Commission and the U.S. Department of Agriculture to work together on the Rural Telehealth Initiative, a joint effort to collaborate and share information to address health disparities, resolve service-provider challenges, and promote broadband services and technology to rural areas in America.

The ongoing coronavirus pandemic has highlighted the critical importance of telehealth in delivering quality healthcare to rural Americans. The action delivers on President Trump’s recently signed executive order on improving rural health and telehealth access.

Rural Americans are acutely affected by gaps in the healthcare system, from hospital closures to a lack of specialty care. According to the Centers for Disease Control and Prevention, rural Americans, who make up more than 15% of the U.S. population, face numerous health disparities compared with their urban counterparts. Rural Americans are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease and strokes than their urban counterparts. 

WHAT’S THE IMPACT?

Telehealth plays an increasingly critical part in treating patients, improving health outcomes, lowering costs and helping healthcare providers maximize their impact on their communities, especially in rural areas of the U.S.

The challenge to rural healthcare has only been exacerbated by the COVID-19 pandemic, with certain areas of the country in need of enhanced connectivity to provide health services to residents. 

Upon adoption of the COVID-19 Telehealth Program, the FCC has approved 539 funding applications for a broad swath of providers ranging from mental health clinics to community health centers and nonprofit hospital systems in both urban and rural areas. That, said HHS, allowed for more patients to be treated at home, thus freeing up hospital beds and mitigating potential exposure to the coronavirus. The partnership with HHS and the USDA is meant to extend these efforts.

U.S. Secretary of Agriculture Sonny Perdue said the USDA is committed to increasing access to quality telehealth services and working to expand broadband availability in rural areas. USDA’s Rural Broadband ReConnect program is doling out up to $650 million in loans, grants and loan-grant combinations to facilitate high-speed Internet to rural communities that lack access.

As part of this Memorandum of Understanding, the agencies intend to establish an interagency Rural Telehealth Initiative Task Force comprised of representatives from each agency. This task force will meet regularly to consider future recommendations or guidelines for this effort and exchange agency expertise, scientific and technical information, data, and publications.

THE LARGER TREND

The COVID-19 pandemic has accelerated the use of telehealth in U.S. healthcare, and according to Fitch Ratings, providers and distributors are poised to benefit from this trend, as remote care services are helping to effectively provide a revenue stop-gap during this time of social distancing and patient apprehension over entering the healthcare system.

Telehealth is largely providing revenue continuity, and the ripple effects are being felt in the supply chain as well, with doctors continuing to prescribe medications. 

All of this is good news for hospitals and health systems, but it comes with one caveat: The demand for telehealth after the pandemic ends will depend on whether payers – including Medicare and private insurers – continue to reimburse telehealth at current levels. At the moment, its reimbursement is higher than in the past due to temporary waivers that are slated to evaporate once the public health crisis comes to a close.

ON THE RECORD

“This Trump Administration-wide partnership will help more Americans in rural areas get access to the care they need,” said HHS Secretary Alex Azar. “Better access to telehealth in rural America means better health for some of our most vulnerable and greater resilience at times of crisis like the COVID-19 pandemic. President Trump has made rural health a priority throughout his time in office, making payment reforms to help rural hospitals and establishing a Rural Health Task Force at HHS. We look forward to working with our colleagues at the FCC and USDA to expand access through telehealth to quality, affordable care for the 57 million Americans living in rural areas.”

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