Mercy Home Health — a Medicare-certified home health agency under the Trinity Health Mid-Atlantic health system — is no stranger to telehealth.
Remote monitoring has been part of the Philadelphia-area provider’s game plan for more than a decade — and a key value-add that has helped the agency nearly double its patient volumes in recent years and cut readmission rates for congestive heart failure (CHF) patients to just 5.26%.
Amid the coronavirus, Mercy has ramped up its telehealth services even further and largely refocused its efforts on the coronavirus. Rather than start from scratch like many agencies have had to do, Mercy’s existing telehealth infrastructure has made the process relatively seamless.
“Our telehealth primarily has been used for the management of CHF patients,” Ruth Martynowicz, vice president of operations at Mercy, told Home Health Care News. “Daily weights and vital signs give us a window into seeing how the patient is doing. … Now, we’re [also] using it in a different fashion.”
Mercy has been drop shipping items such as pulse oximeters to COVID-19 patients in order to remotely monitor their oxygen levels. Decreasing oxygen levels could indicate that a patient is deconditioning. The information allows Mercy to intervene sooner rather than later, before the patient becomes sick enough to notice the problem without technology.
Currently, Mercy is seeing between 140 and 150 COVID-19 patients per day, and telehealth is just a small part of what the agency is doing for them.
“A lot of patients that are recovering from COVID actually benefit from increased rehab services. They’re gotten deconditioned while they were hospitalized,” Martynowicz said. “It really knocks the wind out of them, so part of the recovery is looking at doing rehab, both physical and occupational therapy.”
Still, the value of telehealth alone is undeniable. By being able to remotely check patients’ oxygen levels, Mercy is cutting down on unnecessary virus transmission risk while still monitoring their conditions.
However, the capabilities come at cost, according to Mark McPherson, interim president and CEO of both Mercy Home Health and Trinity Health at Home, a home health and hospice provider network that’s also housed under Trinity Health.
It’s the same price that home health providers nationwide are paying: the cost of providing telehealth without Medicare reimbursement.
“There’s a lot that we can do for patients without actually having to physically go out to the home,” McPherson told HHCN. “So it needs to be treated as a reimbursable visit, and right now it’s not.”
While the Centers for Medicare & Medicaid Services (CMS) has granted home health providers a bevy of regulatory flexibilities amid the COVID-19 emergency, it has yet to announce reimbursement for telehealth. In fact, CMS has said it doesn’t have the power to do so and that Congress must act to make it possible.
Meanwhile, Sen. Susan Collins has said she’s working on it and plans to introduce a home health telehealth reimbursement bill “soon.”
For Mercy, the added cost of deploying telehealth for COVID-19 patients hasn’t been large because the agency already had an existing framework in place. Still, it’s a matter of principal, McPherson said.
“If [telemedicine] can be reimbursed for physicians, why wouldn’t you start reimbursing for home health?” he said. “In my mind, that’s really the main issue.”
Until that issue is resolved, Mercy will continue to view telehealth as it always has: as a cost reduction tool designed to add value and reduce hospitalizations. While it doesn’t yield direct payment, the strategy has always paid off.
“We probably get more business than we otherwise would because it’s viewed as a value-added service,” Martynowicz said. “An insurance company …will say, ‘Let’s use Mercy Home Health because they have a telehealth program that will help us with our cost reduction.’ … And as we move forward, I do think there’s opportunities to use just telehealth to help manage some chronically ill patients, and I think people will come to that realization.”