The COVID-19 pandemic significantly changed how healthcare is delivered, bringing telehealth into focus. Recent permanent changes to Medicare highlight the growing accessibility and convenience for patients and healthcare providers in the United States. This article will examine the evolution of telehealth, recent Medicare provisions, and their implications for those managing medical practices.
Prior to the COVID-19 public health emergency (PHE), telehealth faced many challenges. Each week, only 15,000 Medicare beneficiaries used telemedicine services before 2020. When the pandemic began, this number rose sharply. By April 2020, about 46.7% of beneficiaries were utilizing telehealth services, emphasizing the urgent need for accessible care options. The Centers for Medicare & Medicaid Services (CMS) quickly acted to allow more telehealth access. From March to October 2020, 144 new telehealth services were added, enabling over 24.5 million Medicare beneficiaries to receive care via telehealth.
In the time since, policymakers and healthcare stakeholders have examined the lasting effects of telehealth on healthcare delivery. Permanent changes to Medicare are forming, defining a future where telehealth is an essential aspect of care.
The U.S. Department of Health and Human Services (HHS) made key policy changes that formalized telehealth’s role in Medicare. Some important provisions include:
Medicare telehealth services now include a wider range of eligible providers, such as non-physician practitioners. This broadens the pool of professionals who can deliver remote care.
CMS has also raised payment rates for office and outpatient evaluation and management (E/M) visits, recognizing the complexities involved in caring for individuals with chronic conditions. The updates to E/M coding are the most substantial in 30 years, aimed at improving reimbursement according to the quality of care provided. This is especially important as over two-thirds of Medicare beneficiaries manage multiple chronic conditions.
The changes to telehealth policies have various implications for medical practice administrators and IT managers.
The growth of telehealth services has not been uniform. There are significant differences in access and use among various demographics. In 2023, telehealth utilization in urban areas was about 27%, while only 19% in rural areas. This gap highlights ongoing issues for rural patients, including lack of technology and reliable internet access.
Despite differing trends, behavioral health services saw a notable increase in use across various groups. Access through audio-only mediums has been particularly important for seniors and those with long-term disabilities. Beneficiaries eligible for both Medicaid and Medicare showed a telehealth usage rate around 34%, indicating its role in meeting complex healthcare needs.
As temporary telehealth flexibilities are set to expire in December 2024, there is bipartisan support for extending these provisions. Legislative efforts, such as the Telehealth Modernization Act of 2024, are being considered to preserve telehealth access for all Medicare beneficiaries.
While extending telehealth flexibilities is estimated to cost $2.4 billion through 2024, the Congressional Budget Office suggests that the benefits—such as reduced emergency room visits and improved medication adherence—could provide returns that make the investment worthwhile.
Healthcare providers and administrators need to stay informed about ongoing discussions regarding telehealth and its future within Medicare policies. Adjusting operations while preparing for changes in reimbursement structures will be crucial for practices aiming for success in this evolving environment.
The ongoing development of telehealth services requires an understanding of billing practices, compliance with new rules, and adapting to new technologies in order to maximize the benefits of telehealth within healthcare systems.
As telehealth expands, innovations in artificial intelligence (AI) have the potential to improve workflows and patient engagement. AI technology can assist with various administrative functions.
Telehealth signifies more than a change in care delivery. It represents an opportunity for healthcare providers to rethink their operational models, utilizing technology while maintaining quality patient care.
In summary, the evolution of telehealth has transformed Medicare services. It has broadened access to important healthcare resources for many Americans. Medical practice administrators, owners, and IT managers must navigate this evolving landscape effectively, preparing for both the current environment and future developments in telehealth policy and technology.
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