Reimbursement, health management, technological advancements



There are many forces that have driven the growth of telehealth over the past decade, including value-based reimbursement models, trends in population health management, and technological advancements. As we have discussed in previous blog posts, the COVID-19 pandemic was the jet fuel that propelled the use of telemedicine into the stratosphere. This growth was, in large part, due to the need to limit in-person contact to avoid widespread transmission of COVID-19. In fact, as COVID-19 began to spread in the United States, the Centers for Disease Control and Prevention (“CDC”) advised health care providers to offer care through telemedicine technologies, as the case may be. appropriate. However, all of this growth in the telehealth space cannot be attributed to the need for social distancing during the pandemic; Although the transmission of COVID-19 has slowed in many areas, providers continue to offer telehealth for patient care, and patients continue to use it.

Notably, the use of telehealth has not maintained the record levels we saw at the start of the pandemic. At the height of the pandemic, more than 32% of total outpatient visits took place via telehealth. As of February 2021, telehealth use began to decline, with usage levels now appearing to have stabilized at 13-17% of total outpatient visits. A monthly telehealth tracker tracks the month-to-month evolution of telehealth claim lines, which represent the individual telehealth-related services that appear on insurance claims and are a useful guide for the evolution. telehealth use over time. Data from the tracker confirms that telehealth use declined in the first few months of 2021. However, while these declines in telehealth use may appear large at first glance, increases in telehealth use. telehealth in 2020 have been staggering. So even some decrease in telehealth use in 2021 from 2020 levels probably does not represent a downward trend from the levels of telehealth use we saw in 2019. In fact, a estimate suggests that telehealth use is still 38 times higher than pre-pandemic levels. . Additionally, it appears that providers generally expect telehealth to be here to stay; a recent survey asking health officials what they expected to see in terms of trends in telehealth use showed that 65% of health officials expect use of telehealth telehealth remains at pandemic levels, if not increasing, in 2021.

Ultimately, however, the ability of providers to continue providing telehealth services at cost-effective levels depends on whether the laws and regulations allow it. During the pandemic, the Centers for Medicare and Medicaid Services (“CMS”), along with state governors and lawmakers, relaxed laws and regulations, allowing greater flexibility in providing patient care through telemedicine . Some of these changes are here to stay. For example, earlier this month, in its proposal to update the physician fee schedule, CMS proposed allowing certain telehealth services added during the pandemic to remain on the list until at least the last month. end of 2023. In addition, CMS has proposed removing some restrictions on access to mental health. health services through telehealth, allowing greater flexibility for beneficiaries seeking to access mental health services using telemedicine technologies. However, as we reported in a previous blog post, some states, including New York, began reducing regulatory flexibilities at the state level in 2021. Further regulatory changes in telehealth are expected. still be made urgently and temporary exemptions are withdrawn.

Now that telehealth has become ubiquitous across the country, it stands to reason that it will continue to play an important role in the delivery of health care for the foreseeable future. Telehealth remains an important tool to help providers engage patients, increase access, provide patient-centered care, and succeed in value-based reimbursement models.

© 2021 Proskauer Rose srl. Revue nationale de droit, volume XI, number 209


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