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Another thread on telehealth. Important to realize that CMS has been clear that without a public health emergency they cannot waive the rural restriction only Congress can. 1/
CMS is pushing to the absolute limit with implementation of category 3 and extending all the way through 2021. With the amazing vaccine news the COVID-19 PHE will be over before Jan 1, 2022. Telehealth has been amazing tool for the pandemic. https://www.aledade.com/covid-19/telehealth 2/
Because the pandemic ends does not mean the end of telehealth. Policy should support a strong primary care relationship and a strong relationship today and in the future will be both in person and face to face. https://www.aledade.com/making-telehealth-and-person-care-work-primary-care-long-term Sorry for the registration in advance 3/
Policy supporting a PCP relationship needs to determine the right pricing for telehealth administered by physicians who also see patients in person, the right patient incentives to support a strong PCP relationship and evaluation of the services best aligned with tele 4/
The right pricing. CMS has never priced telehealth before. It adopted prices made for outpatient hospital departments pre-PHE and prices for in person during the PHE. Neither is correct. 5/
We need to price it accounting for the service itself as well as switching time from in person and back. Any policy that does not account for switching incentivizes siloed physicians who either exclusively do telehealth or in person. The opposite of a strong PCP relationship. 6/
Patient incentives should also align with a strong PCP relationship. Patients should have less or no copay/coinsurance for telehealth for practices they have also seen in person compared to telehealth only situations. 7/
Alternative payment models provide a great testing bed for this combination. With practices financially incentivized to both keep people healthy and to not duplicate services it is the best proving ground. 8/
Next Steps: CMS has carried us through 2021, but should begin work on pricing Telehealth correctly. Congress should remove the remote limitation right away for all alternative payment models and explore with CMS possible removal altogether. 9/
Bonus 10/ Day to day I live in primary care and accountable care. There are so many amazing applications for telehealth in other specialties especially mental health that I hope someone more qualified will take up that thread.
