Congress Facing Pressure to Pass Telehealth Bill for Senior Care

November 19, 2018 – Connected care advocates are lobbying Congress to pass the Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2018, which aims to reduce rehospitalizations at qualified skilled nursing facilities by giving them more incentives to use telemedicine and telehealth to improve patient care.

And they want it done soon.

Among those pushing for passage of the bill is Health IT Now. The broad-based coalition fired off a letter to lawmakers last week following the Centers for Medicare & Medicaid Services’ release of a report on the use of telehealth in Medicare.

“In this report, CMS makes the case for passage of the bipartisan, Health IT Now-endorsed RUSH Act better than we ever could ourselves,” Joel White, the group’s executive director, said in the letter. “Now, the agency should put its findings into action by joining us in calling for swift passage of this sorely needed legislation during the current ‘lame-duck’ session.”

“A growing chorus of lawmakers have already offered up the bill – which enjoys support from respected patient organizations such as the Alzheimer’s Association and the Michael J. Fox Foundation – for possible year-end consideration, and we intend to see it happen,” White added. “Presented with clear findings directly from CMS, lawmakers should have no reason to dither on advancing this worthy solution.”

Introduced in July by U.S. Reps. Adrian Smith (R-Neb.), Diane Black (R-Tenn.), Joe Crowley (D-N.Y.), Morgan Griffith (R-Va.) and Ben Ray Lujan (D-N.M.), the bill would, if made into law, create an “SNF-based Provision of Preventive Acute Care and Hospitalization Reduction Program,” which would be overseen by CMS and qualify SNFs to receive telemedicine and telehealth equipment described as “non-surgical items and services furnished at a hospital emergency department that may be safely furnished by a qualified group practice at a qualified skilled nursing facility.”

The bill would enable CMS to reimburse these SNFs for the technology, while also requiring the agency to evaluate each recipient six months after receiving the technology and at least once every two years after that.

“Skilled nursing facilities are often faced with few options to treat residents in need of emergency care, leading to excessive and costly hospital transfers,” the lawmakers said in a joint press release. “However, allowing medical professionals already working within these facilities to provide needed emergency care through telehealth, the RUSH Act will offer Medicare recipients with better access to care at a lower cost to taxpayers.”

According to the Centers for Medicare & Medicaid Services, almost 20 percent of all hospital transfers originate from SNFs, and 45 percent of them could have been avoided through access to virtual care. In addition, the Medicare Payment Advisory Commission (MedPAC) has noted that rehospitalizations expose seniors to increased risk of falls, delirium, infections and adverse medication interactions.

Black made another pitch for her bill in an Oct. 19 op-ed piece in The Hill, arguing that lawmakers have a chance to enact significant healthcare reform before the end of this year.

“This bill would use the technology of today to change this broken status quo, instantly bringing the capabilities of an emergency room right to the patient’s bedside,” she wrote. “The RUSH Act is our chance to move Medicare into the 21st century; stemming the nursing home to hospital pipeline and giving these facilities the technology-enabled tools needed to lower health care costs and, most importantly, save lives.”

In its report last week, CMS references a 2014 study published in Health Affairs which found that a long-term care facility which averages 180 hospitalizations a year could reduce that number by at least 15 through telehealth, saving more than $150,000 in Medicare costs.

“There is overwhelming agreement that telehealth can bring medical care into communities with limited access to health care providers, reduce wait times for patients, and be more convenient than travelling to a health care provider’s office,” the 47-page document noted. “Based on the experiences of multiple payers and health care providers, it appears that telehealth could play an important role in achieving the goals associated with value-based Information on Medicare Telehealth models by providing clinically indicated, high quality, ‘anytime, anywhere’ care to patients. In addition, many health disparities in rural communities are related to poor access to care, and most evidence supports telehealth use in these communities.”

“In conclusion, telehealth offers the promise of a technology and approach to care for a broad range of populations, including those enrolled in Medicare,” CMS concluded. “Emerging evidence indicates that telehealth can be a tool for empowering providers and patients to offer the best approaches to care, including consideration of the patient’s age, race/ethnicity, geographic location, and diagnoses, and provide high quality care without increasing costs.”