Federal lawmakers face a year-end deadline to stabilize or repeal a series of Covid-era payment changes for telehealth services that include allowing people to stay in their homes to see a doctor or therapist.
During the hearing in early March, Wenstrup and other members of the House offered personal anecdotes about how telehealth, home visits and remote monitoring have helped patients, their relatives and their constituents. Wenstrup, an Ohio Republican who is also a podiatrist and retired Army reservist, told the audience, “Patients are less anxious and heal better when they can be at home.”
Most of the proposals focus on how Medicare covers telehealth services. But the rules affect patients in all kinds of insurance plans because typically private insurance companies and some government plans follow Medicare’s lead. Without congressional action, virtual health care services such as audio-only calls or online meetings with medical specialists — such as an occupational therapist — could end. The bills would also continue to allow rural health clinics and other health centers to offer telehealth services, while waiving the requirement for in-person mental health visits.
The use of telehealth increased during the early months of the Covid-19 pandemic and became a household term. The practice has become a hot topic for lawmakers on both sides of the aisle.
In a US Census Bureau survey conducted from April 2021 to August 2022, Medicare and Medicaid enrollees reported making the most telehealth visits — 26.8 percent and 28.3 percent, respectively. The survey of nearly 1.2 million adults also found that black patients and those earning less than $25,000 reported high rates of telehealth use. Specifically, people of color were more likely to use audio-only visits.
Ensuring access to telehealth services “is the best public policy,” said Debbie Curtis, vice president of McDermott+Consulting, a Washington, D.C.-based health care lobbying firm. “It’s the best business outcome. It’s the best patient care outcome.”
But it’s a presidential election year, and Congress is a “deadline-driven organization,” Curtis said. He expects Congress to “kick the can” after the November election.
Kyle Zebley, senior vice president of public policy at the American Telemedicine Association, who also lobbies on Capitol Hill, said Congress “could very well be in that ducking season.” issue,” he said.
In January, lawmakers — including senators from Mississippi and South Dakota — sent a letter to the Biden administration urging the White House to quickly work with Congress to ensure continued payments for Medicare patients who use telehealth, “especially for rural and underserved communities.”
Maya Sandalow, senior policy analyst for the Bipartisan Policy Center, a Washington, D.C.-based think tank, said lawmakers and policymakers are likely to consider a temporary extension of the payments rather than permanent changes.
“Research is still coming out covering more recent years of the acute effects of the pandemic,” Sandalow said. The center expects to issue policy recommendations in the coming months.
Questions addressed include what type of health care services are best for audio and video-only visits; Sandalow said researchers are also weighing how telehealth can “expand access to affordable, high-quality care while ensuring patient choices remain personal.”
In North Dakota, David Newman of Sanford Health said virtual care is often the only way some of his patients in the western part of the state can get subspecialty care, such as behavioral health.
Newman, a Sanford endocrinologist and virtual care physician, said 10% to 20% of his patients are seen almost exclusively during the summer, compared to about 40% in the winter months, because “the weather can be so bad » where the roads are impassable.
In past winters, Newman would sit “doing nothing for a day” because patients couldn’t visit him. Now, he has a full clinic that uses telehealth technology.
“I tell my patients that if you can make a reservation at a restaurant or if you can order a pizza online, you can have a virtual visit,” Newman said.
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