Last Year in 2020, it was estimated that up to $250 Billion of U.S healthcare expenditure could be shifted to virtual care. New analysis conveys that telemedicine in healthcare has increased 38X times compared to pre-pandemic. Strong continued uptake, favorable consumer perception, and tangible investment into this space contribute to the continued growth of telemedicine in healthcare for the year 2021.
Telemedicine in healthcare became instrumental in rendering ultimate care throughout the COVID-19 pandemic as people avoided in-person interactions and were in a situation to maintain social distance. Though most of them prefer getting back to standard appointments, few Americans yet prefer telemedicine consultations and are expected to remain above the pre-pandemic levels. This article gives a clear picture of telemedicine in healthcare post-pandemic. Stay focused!
How did pandemic change Telemedicine Healthcare Policy?
- In 2020, former U.S President Donald Trump declared a national emergency, and former U.S Secretary of Health and Human Services declared a public health emergency in response to growing concerns over the spread of COVID-19.
- As a result of the authority granted under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Centers for Medicare and Medicaid (CMS) provided flexibility for Medicare telehealth services. It was done by broadening the waiver authority under section 1135 of the Social Security Act.
- Before the declarations, healthcare professionals were subject to CMS’ geographic and originating site requirements for telehealth reimbursement under Medicare.
- Proceeding with the requirements, the originating site is the patient’s location or places when telehealth services are received. Under Section 1834(m) of the Social Security Act, the originating site must be a physician’s office, skilled nursing facility, or hospital.
- “That meant an extremely small proportion of Medicare reimbursement was going toward telehealth, well under 1 percent,” says Kyle Zebley, vice president of public policy for the American Telemedicine Association (ATA).
- Healthcare professionals enrolled in Medicare program that’s licensed in any state can provide telehealth services to people anywhere in the U.S. if the state allows it. Each state has its telehealth policies.
- The waivers allowed healthcare practitioners and providers to practice from home since many offices were closed at the beginning of the pandemic.
- An interim final rule by CMS expanded coverage of audio-only health services that helped patients without access to two-way audiovisual technology and those who weren’t comfortable using video telehealth.
- “Laws hadn’t kept up with the way providers wanted to deliver care, so it was a game-changing moment,” says Zebley.
HIPAA – Compliant Telehealth Requirements to Return
- The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) enforces HIPAA requirements.
- It has announced on March 17, 2020, that “OCR will exercise its enforcement discretion and will not impose penalties for non-compliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”
- Telemedicine in healthcare creates a unique challenge for HIPAA compliance as a healthcare professional is not interfacing with a patient behind a closed clinic door.
- Instead, the patient’s data or information is digitally transformed, which requires various security precautions. When security requirements have been reduced, OCR loosely defined that providers could use communication technologies for telemedicine in healthcare.
- It has also encouraged healthcare organizations to inform patients about the privacy risks, which seems appropriate.
- “The reinstatement of HIPAA requirements is inevitable, and healthcare organizations need to prepare accordingly. They need to have their regulatory and legal offices getting ready to follow the spirit and letter of the law,” says Zebley.
- He also added, “It’s very clear what HIPAA requires. If an organization is operating a telehealth platform or technology that’s not HIPAA compliant, I expect that it would need to be compliant perhaps in a few months’ time.”
Is there a chance where Telemedicine restrictions would return Post Pandemic?
- The public health emergency and waivers are yet constant. But if the declaration ends before Congress or CMS acts, healthcare providers could hit a “telehealth cliff.”
- “If that happens, it’s going to be regressive, and however, I’m extremely optimistic that Congress will act before the emergency ends,” says Zebley.
- The public health emergency has been renewed approximately every 90 days since it was first declared, with the most recent renewal, by U.S. Secretary of Health and Human Services Xavier Becerra.
- CMS had released its 2020 Medicare Physician Fee Schedule on July 19, 2021, which would extend the waivers on some telemedicine in healthcare services, especially to those who address mental health, through the end of 2023.
- “As CMS continues to evaluate the temporary expansion of telehealth services that were added to the telehealth list during the COVID-19 PHE, CMS is proposing to allow certain services added to the Medicare telehealth list to remain on the list to the end of Dec. 31, 2023, so that there is a glide path to evaluate whether the services should be permanently added to the telehealth list following the COVID-19 PHE,” reads the CMS facts sheet.
- Almost 40% of telemedicine patients and users have stated that they will continue to use telemedicine in healthcare going forward, up from 11 percent of consumers using telehealth prior to COVID-19.
- From the healthcare provider’s side, 58% of them continue to view telehealth more favorably now than they did before COVID-19, though perceptions have come down slightly since September 2020.
- For April 2021, 84% of healthcare professionals offered virtual visits, and 57% preferred to continue offering virtual care.
- Few regulatory changes that enabled greater telehealth access during COVID-19 have been made permanent.
- CMS has allowed telehealth coverage for several current procedural terminology (CPT) codes permanently in the 2021 physician fee schedule final rule.
- Earlier there were several dozen additional CPT codes that CMS allowed telehealth coverage for temporarily in the 2021 physician fee schedule.
- Investment in telemedicine in healthcare continues to increase.
- The total venture capital investment into the digital health space in the first half of 2021 totaled $14.7 billion, which is more than all of the investment in 2020 ($14.6 billion) and nearly twice the investment in 2019 ($7.7 billion).
Telemedicine Use in 2021
- Telemedicine has undoubtedly shown tremendous potential since the early days of the pandemic. However, there have been some erratic trends in telehealth use in 2021.
- In the early part of 2021, researchers predicted that even though the elective care and in-patient visits have made a comeback, telehealth has found its way among the patients.
- However, research teams monitoring telehealth use throughout 2021 show confusing trends, thus making it difficult to predict how telehealth will function in a post-pandemic scenario.
- A report from Fair Health shows that there had been a significant dip in the telemedicine use in June and July. The pace however picked up in August and made its way to September.
- The patients have also shown different reactions to the use of telemedicine in 2021, as compared to the beginning of 2020.
- In 2020, 53% patients in a survey said that they were satisfied with the telemedicine service and would continue to use it. This number fell down to 43% in 2021.
- The fluctuating numbers indicate that telemedicine is yet to find a stable spot in the medical industry, especially after the in-person visits have started out in full swing. The fate of telemedicine in the post-pandemic era thus remains to be seen.
As the investment continues to grow, the companies continue to grow too. Telemedicine in healthcare has shown tremendous support in means of providing accessible and valuable healthcare to its patients. Even though the pandemic ends, telemedicine in healthcare will rise forever.
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