Federal policymakers, home health providers, insurers and other health care stakeholders continue to call attention to the benefits of telehealth amid the worsening coronavirus outbreak.
But actions speak louder than words.
Last week, the U.S. Senate approved an $8.3 billion bill targeting the COVID-19 virus. In addition to emergency funding, the bill stripped away certain restrictions on how, when and where health care providers can use telehealth technology.
The U.S. Centers for Medicare & Medicaid Services (CMS) followed that up with a telehealth announcement of its own on Monday night. As part of the announcement, CMS explained how “easy-to-use, accessible benefits” like video chats serve as a “lifeline” for Medicare beneficiaries, often people who are older, sicker and at higher risk of developing serious complications linked to COVID-19.
“As we continue to learn about the COVID-19 virus, it’s important for all Americans, and particularly vulnerable populations who are at heightened risk, to be able to access their providers when they feel sick or have questions,” CMS Administrator Seema Verma said.
Since 2018, fee-for-service Medicare has provided reimbursement for “virtual check-ins” for patients to connect with their doctors without going to their brick-and-mortar offices.
Traditional Medicare also covers some telehealth services when furnished by physicians and practitioners within accountable care organizations (ACOs). Additionally, in some cases, Medicare pays for in-home telehealth services when technology is deployed to care for individuals with certain mental health conditions.
Yet home health providers interested in complementing their in-person services with telehealth tools often have to eat that cost themselves.
In fact, CMS didn’t allow home health agencies to include the cost of remote patient monitoring as an allowable cost on their cost reports until the 2019 fiscal year.
“When you’re looking at the cost of care, we were never able to calculate our investment in [remote patient monitoring] into that,” Donna DeBlois, president and CEO of MaineHealth Care at Home, previously told Home Health Care News. “And Medicare uses that cost report for a lot of different things, including decision making and benchmarking.”
Broadly, remote patient monitoring is a form of telehealth.
Humana pushes telehealth
The telehealth reimbursement landscape outside of FSS Medicare is more favorable.
Medicare Advantage (MA) plans, for instance, may provide their enrollees with a variety of Medicare Part B services via telehealth in any geographic area and from a variety of places, including beneficiaries’ homes.
And multiple insurers are taking advantage of that during the coronavirus outbreak.
One is Louisville, Kentucky-based Humana Inc. (NYSE: HUM), which highlighted numerous steps it’s taking to prevent the spread of COVID-19 on Monday. Among its actions, Humana is waiving out-of-pocket costs associated with COVID-19 testing, allowing early refills on prescription medicines and encouraging members to use telemedicine as a first line of defense for all urgent care needs.
Humana — whose in-home care provider operations include Humana At Home and Kindred at Home — is also waiving costs for telemedicine urgent care needs for the next 90 days.
“Effective immediately, we are waiving the out-of-pocket costs associated with COVID-19 testing and increasing the availability of telemedicine options to reduce additional exposure,” Humana Chief Medical Officer Dr. William Shrank said in a statement.
CFO Brian Kane shed further light on Humana’s COVID-19 efforts during a Tuesday morning presentation at the Barclays Global Healthcare Conference.
“We’re encouraging our members to use telehealth and waiving any co-pays on the urgent care side,” Kane said. “On the provider side, [in] our provider clinicians, our primary care clinics, we’re ensuring that our health care workers have the protections they need … to provide care for our members as they come into those settings.”
The Blue Cross and Blue Shield Association (BCBSA) and its network of 36 independent and locally operated BCBS companies also recently announced increased access to telehealth services.
“Given the nature of the COVID-19 outbreak, seeking in-person medical care may lead to further spreading of the virus,” BCBSA said in a statement. “BCBS companies will encourage the use of virtual care and will also facilitate member access and use of nurse [or] provider hotlines.”
Moving forward, CMS may have to consider further opening the door for home-focused telehealth services, as a large portion of impacted Americans are Medicare beneficiaries.
As of Tuesday afternoon, COVID-19 had hit at least five long-term care facilities, including a facility in Kirkland, Washington, where 18 residents have died.
Generally speaking, many of the preventative measures CMS has taken thus far have been focused on nursing homes — and not on expanding telehealth rules nor alleviating non-coronavirus pressures for home health agencies.
For example, last week, CMS announced it was immediately refocusing inspections of skilled nursing facilities on compliance with the agency’s infection control policies — and suspending all non-emergency survey work.
At the same time, CMS moved forward with its launch of the Review Choice Demonstration (RCD) in Texas on March 2. So far, it hasn’t indicated whether it’s open to delaying the launch of RCD in North Carolina and Florida, scheduled for May 4.
There are now more than 800 reported cases of coronavirus in the United States overall.