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MedPAC:What PHE Waivers Survive?, FCC's Telehealth Pilot & HHS on Rural Health-The HSB Blog 9/15/20

MedPAC Commissioners Hint at Telehealth Policies that May Stick Post-COVID-19

Event: (9/08) A recent article in Healthcare Dive discussed MedPAC’s 9/4/20 public meeting which reviewed the expansion of telehealth delivery in Medicare. The key point of discussion was which changes in Medicare telehealth payment policies, waived during the COVID-19 public health emergency (PHE) would lawmakers and regulators allow to become permanent after the COVID-19 PHE ends.

Description: During the pandemic Federal regulators relaxed many rules and payment policies surrounding telehealth to provide an alternative avenue of care, including the addition of 80 additional codes for Medicare covered telehealth services (from the then existing 100). When considering the issue some commissioners expressed concerns that expanding access could increase use of low-value services and also unwittingly widen the so-called digital divide with underserved populations (with two recent JAMA studies showing nearly 25% of older adults on Medicare lack access to computers with high-speed internet or a smartphone with a wireless data plan). In addition, commissioners appeared to dismiss the idea of continuing to allow the use of non-HIPAA compliant video platforms past the PHE but did appear inclined to continue coverage for audio-only services.

Implications: The easing of regulations during the pandemic dramatically increased the speed and breadth of telehealth usage, rapidly expanding penetration and acceptance. While growth has slowed recently, how and which PHE waivers will be made permanent will dictate the pace of growth going forward. Given some commissioners were more willing to allow broader telehealth flexibility if they were delivered under some type of alternative payment model, blanket changes to the rules are likely to take longer than market participants expect initially and could be more limited in scope than many have suggested. For example, final payment policies and reimbursement at facility vs. non-facility rates may depend on CBO scoring. [Please contact us for our article “Not So Fast on the Future of Telehealth” published in PE Hub for more details]

FCC Nears Launch of $100M Connected Care Telehealth Pilot Program: 5 Things to Know

Event: (9/08) A recent article in Becker’s Hospital Review noted that the FCC had recently published application details on its $100 million Connected Care Pilot Program, which aims to enhance telehealth access for low-income Americans and veterans (originally introduced in 2018).

Description: This three-year program provides $100M in grants to fund about 85 percent of telehealth programs’ connectivity costs, including patient broadband internet access services, provider broadband data connections and other network equipment. Under the program, users must have their own telehealth devices to participate and areas such as network deployment and construction of network and connectivity between healthcare providers will not be funded. Additionally, Connected Care is available in rural and non-rural areas, but is limited to nonprofit and public providers

Implications: The funding and access to telehealth resources is extremely important for rural and underserved communities such as low income Americans and veterans. Making these resources readily available helps address the health disparities that exist in these communities and gives them better access to address their needs. Additionally, making this program available to nonprofit and public providers can help broaden usage of these resources to other vulnerable populations.

HHS Issues Plan to Improve Rural Health, Leaning on Telehealth

Event: (9/04) On September 4th the U.S. Department of Health and Human Services (HHS) released an 84-page plan to address rural healthcare barriers, particularly due to the COVID-19 crisis. The plan details steps to expand telehealth services, emergency care consultations, and EMS training through a series of approximately $9M grants for up to 29 providers over the next four years.

Description: Rural areas are not only plagued by a shortage of providers, but also suffer from lower incomes and higher incidence of chronic health conditions compared to urban areas. The 57 million rural residents are significantly more likely to die of heart disease, cancer or stroke compared to urban dwellers. The plan would allow rural health clinics and federally qualified health centers to furnish Medicare telehealth services and be reimbursed for virtual care at similar rates as comparable telehealth services under Medicare. The rural health plan would also allow Indian Health Service and facilities to receive compensation even if telehealth services are provided over state lines. Additionally, $12.4 million has been pledged to expand a pilot project to improve care for rural maternity and obstetrics patients, with expanded telehealth services.

Implications: The health and geographic disparities in rural areas has been an existing, but heavily neglected issue for many years. HHS’s plans rely on telehealth and while telehealth has potential to help reduce geographic disparities in access to care, this may not be as helpful for addressing these issues in rural health. Telehealth relies on digital infrastructure that's largely not in place in non-metro regions and one-third of rural households say they don't have a broadband connection at home.

Seattle Health Tech Startup Raises $15.6M for Remote Patient Monitoring Service

Event: (9/09) A recent article from Geekwire noted that the Seattle health tech startup had raised $15.6M for remote patient monitoring service. The article noted that has raised more than $21 million in total funding to date.

Description: Founded in 2015, Optimize sells a remote end-to-end patient monitoring service used by independent practices, hospital systems, and more. When health providers see that a patient at home needs support because a device such as a blood pressure cuff or a pulse oximeter indicates a potential health issue, the Optimize software provides a variety of communication methods for contacting the patients, including text messages and video calls. The company’s dashboard also provides a way to trigger a bill to the insurer for the clinician monitoring. The system integrates with Electronic Health Record (EHR) software.

Implications: As COVID-19 outbreak continues, consumers are managing their health remotely. is allowing patients to receive regular care and updates through text message and voice calls in the comfort of their own home. This enables more accessible, convenient, and cost-effective healthcare.

5 CTA Members Leading the Digital Therapeutics Frontier

Event: (8/25) In late August the Consumer Technology Association (CTA) launched a new initiative with 25 health technology companies to develop standards for the use of digital therapeutics. The goal of the initiative is to recommend best practices for the definition, application, use and performance requirements for the field to help educate the industry and, eventually, consumers to advance the adoption of the technology. As part of the launch, CTA profiled 5 of the companies in the initiative.

Description: AppliedVR reshapes pain management care with its virtual reality platform aimed at alleviating a number of ailments, from labor pains to discomfort during infusions for cancer treatment. Ginger offers on-demand mental health support with trained behavioral health coaches, therapists, and psychiatrics with personalized skills building activities. GlucoseZone provides workouts, education and coaching to help users of the app reach their fitness and diabetes control goals. Healium leverages virtual and augmented reality (AR/VR) travel to allow users to biometrically alter their virtual environment through emotions and decrease their own stress.

Implications: As the world continues to grapple with the effects of the COVID-19 outbreak, consumers have begun taking more control of their health care in the comfort and safety of their homes. Digital therapeutics, a relatively new branch of digital health, enables this socially distant health care delivery. The technology uses software applications to enhance clinician decision making, optimize the dose and delivery of other forms of medical treatment through patient monitoring, or even act as a stand-alone intervention. The standards from the CTA will help educate the industry and eventually consumers, to advance the adoption of the technology.

A Buyer’s Guide to AI in Health and Care

Event: (9/09) Last week, the NHSX, a unit of Britain’s National Health Service, published “A Buyer’s Guide to AI in Health and Care” proposing 10 questions on how to make the right decision purchasing products using Artificial intelligence (AI). AI has become desirable in advanced medical settings because it has the capability to interpret and classify test results more rapidly than physicians, allowing physicians to direct attention to more complicated issues facilitating improvements in the health of patients.

Description: When purchasing products that use AI, consideration should be given to the type of problem you want to solve, the appropriate scale for addressing the problem, ensuring regulatory standards are met, and what the intended uses are for the product(s). The Buyer’s guide, linked below, does not provide a comprehensive treatment of commercial contracting, but proposes questions that are classified under the following categories: problem identification, product assessment, implementation considerations, and procurement, and delivery.

Implications: Since there is a shortage of clinicians in health care, a range of AI-powered innovations will allow physician time to be freed up for analysis of more complex cases and grant more time for direct patient care. This will help decrease costs, improve outcomes and create more positive health experiences. “A Buyer’s Guide to AI in Health and Care” points out important questions to consider when purchasing products that use AI to assure they are safe and effective for the organization being served.


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