Coronavirus Makes Strong Case for Telehealth
The Centers for Medicare & Medicaid Services (CMS) did not yet know the extent of the coronavirus pandemic when it released its Medicare Advantage proposed rule on February 5 of this year. None of us did. Tucked away in the rule’s 895 pages, however, was a provision that turned out to be quite prescient.
CMS proposed to embrace the uptake of technology-enabled care that is already happening across Medicare Advantage – the managed care option in Medicare where 24.4 million beneficiaries receive coverage – by allowing providers accessed via telehealth to count toward some of the network adequacy requirements delineated to Medicare Advantage plans.
CMS requires Medicare Advantage plans to offer access to primary care providers and specialists within a specified time and distance from a certain percentage of beneficiaries. In this rule, CMS proposed that, for some specialties like dermatology and psychiatry, this requirement could be eased. This acknowledges the new ways technology has made it easier for patients at home to connect virtually with their providers. It also ensures that more individuals, particularly those in rural communities, will have access to the benefits of coverage and care offered in Medicare Advantage.
This is still a proposed rule and not yet certain. CMS will finalize its plans by April 6 and is reviewing feedback from stakeholders now. Most are supportive of these changes, but some still want to protect the status quo and would stand in the way of new innovations in care delivery.
Between CMS’s issuance of the proposed rule and today, though, something else happened. Americans’ way of life has been brought to a standstill by a global pandemic. Simple tasks like going to see your doctor became impractical for many, especially for seniors, as public health officials urge people to stay at home.
In this difficult time, the health care community has looked to telehealth as a solution. Telehealth offers a way for clinicians to limit patients’ exposure to coronavirus and meet beneficiaries’ needs during this time of self-quarantine requirements, while also relieving strain on hospitals. Seniors, too, appreciate the ability to connect with their health practitioners without the worry of leaving home. In fact, health care providers in Medicare Advantage are using these technologies, already in place, in new ways to meet beneficiary needs in the midst of this health emergency.
ChenMed, an ally organization of the Better Medicare Alliance which operates a network of 59 primary care centers for seniors on Medicare Advantage across the country, is on track to treat 90 percent of patients via telehealth amid the coronavirus outbreak. ChenMed staff are even dropping off iPads at the homes of patients who lack the technology to make their virtual appointments.
They are not alone. Health care companies, insurers, and health systems across the nation are moving to telehealth to get patients the care they need amid this pandemic.
While this national emergency has awakened many to the possibilities of telehealth for the first time, it is nothing new for Medicare Advantage. As far back as 2017, CMS reported that 77 percent of Medicare Advantage plans covered remote access technologies that included two-way video and nurse call-in telephone lines.
An independent study released last year found that patient satisfaction with telehealth “ranks among the highest of any consumer category,” with 84 percent of patients able to completely resolve their medical concerns over the course of their virtual visit.
Today, Congress and the administration have made additional reforms to bring telehealth to bear in response to the coronavirus crisis, but some of these changes will only last as long as this national emergency. There is still a need for CMS to finalize provisions in its proposed rule that use telehealth to improve network adequacy requirements and meet beneficiaries where they are.
Thankfully, there are many health care leaders who recognize the value of these proposals for patients and have joined us in urging CMS to swiftly finalize this language. From the National Black Nurses Association, to Consumer Action, Population Health Alliance, American Telemedicine Association, and the Health Care Transformation Task Force, these champions for 21st century health care are speaking up to say that telehealth is health and Medicare policy should allow this innovation to do more good for more people.
Let’s learn from this national emergency and encourage the full potential of telehealth to deliver care for seniors. CMS is proposing rules that support telehealth and quality networks of providers that move health care forward into the future. We should stand with Medicare Advantage beneficiaries and support these proposed rules to ensure patients get the care they need, not only now in this national emergency, but also when we are back to our everyday lives.
Allyson Y. Schwartz is the President and CEO of the Better Medicare Alliance. She represented Pennsylvania in the U.S. House of Representatives from 2005 to 2015.
John Rother is President of the National Coalition on Health Care, which represents a broad range of health care stakeholders working toward a more affordable and effective health care system.