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Within one year, the U.S. Department of Health and Human Services must propose regulations that adjust the network adequacy requirements for Medicare Advantage plans to factor in access to telehealth services per a Trump Executive Order.

By Dr. Amit Phull 1 Comment / Oct 14, 2019 at 9:00 AM

On Oct. 3, President Trump signed an Executive Order outlining measures for Medicare reform— specifically telehealth for seniors — through network adequacy in Medicare Advantage (MA) plans. Within one year, the U.S. Department of Health and Human Services (HHS) must propose regulations that adjust the network adequacy requirements for MA plans to factor in access to telehealth services.

Today, most American voters support Medicare expansion, and the government has made gradual moves to expand coverage for telehealth services, but this new order will accelerate those efforts. Under the “Protecting and Improving Medicare for our Nation’s Seniors” order, MA plans will be able to provide telehealth as a supplemental benefit starting in 2020. The goal is to encourage the adoption of telehealth technologies by streamlining approval of new advances in telehealth services and breakthrough medical devices. Additionally, seniors will have the ability to more directly benefit from any cost savings that MA plans generate (i.e. monetary rebates).

Politics aside, this is good news for physicians and patients.

Telehealth is particularly beneficial for aging Americans. Most Medicare-age patients have chronic clinical needs that require frequent visits with their physicians — primary care physician, geriatrician, endocrinologist, etc. However, many Medicare patients face mobility issues which can often lead to missed appointments or patients simply not seeking care they need. Telehealth addresses these challenges head on by meeting patients where they are, in real-time. By providing care in a virtual setting, physicians also consider telehealth as a way to democratize access to quality care, removing geographical boundaries.

Research has shown that patient demand for telehealth services continues to rise, alongside physicians’ increasing interest in telehealth practices. JAMA recently published a report on the rising number of telemedicine visits, stating that patient visits grew 261 percent between 2015 and 2017. This growth in patient demand correlates with physicians’ interest in practicing telemedicine, with the number of physicians who have self-reported telemedicine as a skill doubling — increasing 20 percent per year in just three years (2015–2018). Lastly, hospitals are also adopting the technology to offer telemedicine services. The American Medical Association reports that over 15 percent of physicians work in practices that use telemedicine.

New research analyzed specialties most engaged with telemedicine job postings and found geriatrics was in the top 10, along with several other specialties that largely serve the senior population, like urology and endocrinology. In fact, the state of Florida – where the President announced the Executive Order – has the highest number of physicians who have expressed interest in telemedicine.

In my personal experience, I’ve been able to see the benefits of telemedicine first-hand. I am able to reach patients who may not have had access to care otherwise, since many of them live in very rural parts of the country. A visit to the nearest hospital for example may very well be 50 or more miles away. By removing the physical barriers, physicians can expand their patient-base to those who are underserved. Telehealth services have made this possible and will play a key role in addressing the looming physician shortage. With more telehealth offerings in place, soon, it won’t matter where the physician, particularly a specialist, is located.

Medicare is the country’s single largest health insurance provider, and as such, will continue to be the central focus for healthcare debate in the 2020 presidential campaign. A recent poll shows that Americans consider healthcare to be the top concern for them in the upcoming presidential election, followed by immigration and the economy. But access to quality care transcends partisan politics. It is my sincere hope that, regardless of who sits in the White House beyond 2020, that they will uphold the tenets of this Executive Order and continue expanding patient access to telehealth resources.

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