The Centers for Medicare and Medicaid Services (CMS) made another big step to expand telehealth services to Medicare members, announcing it will now cover over 80 new services. The government health plan will pay for some remote monitoring services for conditions related to the coronavirus — like initial hospital care — as well as many unrelated to the virus — like neurological and psychological testing, per Politico.
It’s also allowing docs to collect payments for conducting consultations over the phone, versus requiring video to collect payment. And the host of new services and looser restrictions should catapult virtual care uptake among the 40 million US seniors covered under traditional Medicare.
The US government is cutting red tape that’s impeded Medicare and Medicaid members from accessing care amid the coronavirus — and covering payment for a longer list of telehealth services could ensure the CMS’ senior members receive care for costly chronic conditions, too. For example, in its initial spending package passed at the beginning of March, Congress pumped $500 million into an emergency telehealth program to eliminate barriers, like geographic location, that were inhibiting Medicare beneficiaries from accessing virtual care.
And the CMS has been approving Medicaid waivers, allowing states to suspend lengthy processes like prior authorization requirements, which can prolong the amount of time it takes overburdened docs to provide care, Modern Healthcare notes. Further, it makes sense for the CMS to add telehealth services for non-coronavirus medical conditions, considering seniors are costlier to take care of given the prevalence of high-cost chronic conditions among this cohort is double that of the general population. And adverse health events associated with these ailments could be exacerbated if seniors are unable to leave home to seek care as they normally do.
Private insurers have also been paving the way for members to more easily access telehealth amid the pandemic — and we’re seeing massive upticks in adoption among patients. The largest health insurers are also eliminating copays for virtual doc visits and building out offerings for their beneficiaries. And once-hesitant patients are turning to virtual options at astounding rates: In Washington state, telehealth vendor Amwell has seen a 700% uptick in patient volume since the start of the pandemic, for example.
Industry pros expect telehealth usage to keep climbing post-coronavirus, but sustained uptake would require all insurers to continue paying for these services — and the fragmented insurance landscape in the US makes us unsure if a unified response to coverage is in the cards. The coronavirus is forcing patients to shake off any concerns about using telehealth. But US consumers are tethered to their insurers in terms of what types of care they can access — and how they receive it.
It’s unclear if payers will continue to offer and encourage the use of telehealth post-coronavirus or if they’ll reapply restrictions after outbreaks subside. However, patients will likely get comfortable with the convenience telehealth affords — and traditional providers are going to want to make sure telehealth investments they’re making now have long-term viability. So, it’s likely we’ll hear louder calls for private and public payers to keep telehealth options across the board accessible. And I (Zoë) think demand for unified virtual and traditional offerings from payers could translate into stronger support among US docs and patients for a single-payer system as the election season nears.