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ACP Working to Expand Telehealth, Calls for Lifting of Restrictions

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Member survey conducted prior to coronavirus pandemic shows only a third of respondents implemented video visits

April 17, 2020 (ACP) – With some of the regulations surrounding telehealth relaxed during the coronavirus pandemic, it's easier than ever for medical professionals to treat patients via online tools, but there's more work to be done. The American College of Physicians is using new survey results to advocate for further expansion of telehealth and improvements to reimbursement.

“We are realizing how effective remote modalities can be,” said Dr. Robert M. McLean, president of ACP. “This process is being put on hyper drive due to the pandemic, and we anticipate it will change the paradigms of how we deliver care. If the previous restrictions stay loosened, we may see this new system remain in place going forward.”

The newly released results of an ACP member survey offer an update on the adoption of telehealth – and its limitations to date.

A third of survey respondents said they had implemented video visits, while 27 percent said they were considering them. Forty-two percent reported implementing e-consults, while 20 percent were considering them. Thirty-nine percent of respondents said they'd implemented asynchronous evaluation – the evaluation of data submitted through a patient portal or other secure system – while 14 percent were considering it.

The use of remote monitoring, remote management and wearables was less common with 24 percent, 28 percent, and 6 percent, respectively, reporting that they'd implemented these strategies. The survey also revealed that the use of online video visits, remote monitoring and remote management have all grown significantly during the past year.

The survey was distributed randomly to 1,972 U.S. members of ACP aged 65 years and younger between December 2019 and January 2020. Responses were received from 231 members providing patient care (49 percent general internal medicine, 24 percent hospital medicine and 26 percent subspecialists).

Prior to the pandemic, obstacles from insurers and the federal government prevented physicians from fully embracing the potential of telehealth. “We've seen a major shift in payer policies over the past month, both Medicare and private payers,” said Shari Erickson, ACP vice president of governmental affairs and medical practice. “They've loosened site restrictions and some of the supervision requirements, are allowing billing for new patients for some services that were previously limited to established patients, and are suspending some cost sharing requirements. These changes are a major step in allowing for more patients to get access to care through telehealth.”

Now, she said, it's clear that telehealth delivered remotely is essential to patient care during this public health crisis.

In addition to the lifting of obstacles to telehealth, which traditionally requires both an audio and video component, many insurers are expanding the types of connections physicians can have with their patients. “At the time of this survey, telephone call visits were not covered by any insurance payers,” McLean said. “No physicians were formally calling them ‘visits,’ so we did not even ask the question.” However, due to the advocacy of ACP and others in order to address concerns about access to care in safe and efficient ways, CMS and many other payers are now paying for audio-only telephone visits—and CMS is making those payments retroactive to March 1.

What now? “We are continuing to advocate for changes to help physicians and patients be better able to take advantage of telehealth technologies. One point of progress has been that CMS and many commercial payers are establishing policies to pay for video visits in parity with in-office visits,” McLean said. “We are in the midst of strong advocacy efforts to make the same happen with phone visits, which are currently being covered at significantly lower pay rates. That's very problematic for practices that are trying to sustain themselves and keep their doors – and phone lines! – open to care for their patients.”

McLean urged fellow members to keep an eye on the ACP News section of the ACP website for statements about telehealth and communications that are being sent to Congress, the White House and the Coronavirus Task Force, CMS, and insurers.

As a resource for members, ACP recently launched “Telemedicine: A Practical Guide for Incorporation Into Your Practice,” an online CME program to help physicians implement telemedicine. ACP also released “Telehealth Coding and Billing During COVID-19” to make it easier for physicians to continue care for their patients during the pandemic. It provides telehealth coding and billing information.

More Information

The 2020 ACP Member Survey About Telehealth Implementation is available on the ACP website.

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Back to the April 17, 2020 issue of ACP Advocate