Telehealth

NQF Telehealth Draft Report Provides Opportunity For Stakeholders

Posted by Rene Quashie on June 15, 2017
HHS, Telehealth / No Comments

Close up of male doctor with laptop computerThe National Quality Forum (“NQF”) has published a draft report (“Report”) recommending various methods to measure the use of telehealth.  By way of quick background, NQF is a non-profit, nonpartisan organization that seeks national collaboration to improve health and healthcare quality through measurement.  The Department of Health and Human Services (“HHS”) requested NQF to convene a multi-stakeholder committee to recommend various methods to measure the use of telehealth as a means of providing care. Among other things, the Report analyzes the best way to ensure clinical measures are appropriately applied to telehealth, proposes a measure framework, sets some guidelines for future telehealth measurement, and identifies measurement gaps.

To help develop a telehealth measurement framework, NQF began by conducting a comprehensive scan identifying existing measures and potential measure concepts related to telehealth. As explained in the Report, the “framework is a conceptual model for organizing ideas that provides high-level guidance and direction on priorities for what is important to measure in telehealth and how measurement should take place in order to assess its impact on healthcare delivery and outcomes.” The Report analyzed reports and white papers from organizations such as the American Telemedicine Association, the Health Information Management and Systems Society, and the Office of the National Coordinator for Health Information Technology. Continue reading…

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The Telehealth Cost Wars

Posted by Rene Quashie on March 22, 2017
Telehealth / No Comments

How to properly evaluate and weigh cost savings in health care has long been a controversial subject—perhaps nowhere more so than when technology-enabled health care is evaluated. A recent study is a case in point. The journal Health Affairs recently published a study that has caused quite a stir in the telehealth community. Without getting into details regarding methodology and results—best left for a more in-depth article—the study acknowledges that reimbursement for direct-to-consumer (“DTC”) telehealth visits are lower than would be the case for in-person physician or ED visits. However, the study raised two concerns. First, the researchers posited that there could be increased spending for DTC visits “if the direct-to-consumer telehealth visit is more likely to result in follow-up appointments, testing, or prescriptions, compared to similar visits to other settings.” Second, the researchers believe that DTC physicians “may be more likely to recommend that patients have a subsequent in-person visit with a provider.”  The basis for these concerns is not made entirely clear, and quite frankly doesn’t square with my discussions with DTC telehealth stakeholders.

The study also broadly concludes that DTC telehealth may lead to increased utilization as patients will seek care for illnesses for which they would not have sought care had telehealth not been available. More to the point, the researchers calculated that about 88 percent of telehealth usage represents new utilization. In other words, only 12 percent of DTC telehealth usage replaced or substituted visits to other providers. Ultimately, the study argues that DTC telehealth may increase access by making care more convenient for some individuals, and, thereby, may also increase utilization and health care spending. Continue reading…

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Will Congress Come Together for Telemedicine?

Posted by Marc Goldsand on February 05, 2016
Healthcare, Medicare, Telehealth, Telemedicine / No Comments

Consistent with what we have been seeing in our own practice, and consumers’ growing demand for better access to telemedicine services, a bi-partisan movement is growing in both houses of Congress to expand telehealth services, improve health outcomes, and reduce healthcare costs. On Wednesday February 5, 2016, U.S. Senators Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.), Thad Cochran (R-Miss.), Ben Cardin (D-Md.), John Thune (R-S.D.), and Mark Warner (D-Va.) introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (s. 2484), which seeks to overhaul Medicare’s treatment of the practice of telemedicine and its related technologies. Companion legislation was introduced in the House of Representatives by U.S. Reps. Diane Black (R-TN), Peter Welch (D-VT), and Gregg Harper (R-MS). According to the Senate bill’s sponsors, the CONNECT for Health Act would:

  1. Create a bridge program to help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and RPM without most of the 1834(m) restrictions contained in the aforementioned Senate bill;
  2. Allow telehealth and Remote Patient Monitoring to be used by qualifying participants in alternative payment models, without most of the aforementioned 1834(m) restrictions;
  3. Permit the use of remote patient monitoring for certain patients with chronic conditions;
  4. Allow, as originating sites, telestroke evaluation and management sites; Native American health service facilities; and dialysis facilities for home dialysis patients in certain cases;
  5. Permit further telehealth and RPM in community health centers and rural health clinics;
  6. Allow telehealth and RPM to be basic benefits in Medicare Advantage, without most of the aforementioned 1834(m) restrictions; and
  7. Clarify that the provision of telehealth or RPM technologies made under Medicare by a health care provider for the purpose of furnishing these services shall not be considered “remuneration.”

So far, the following organizations have publically endorsed the bill:

  • AARP
  • ACT | The App Association
  • Airstrip
  • Alliance for Aging Research
  • Alliance for Connected Care
  • Alliance of Community Health Plans (ACHP)
  • Alzheimer’s Foundation of America
  • America’s Essential Hospitals (AEH)
  • America’s Health Insurance Plans (AHIP)
  • American Academy of Neurology (AAN)
  • American Academy of Physician Assistants (AAPA)
  • American Association of Diabetes Educators (AADE)
  • American Heart Association/American Stroke Association (AHA)
  • American Medical Association (AMA)
  • American Medical Group Association (AMGA)
  • American Nurses Association (ANA)
  • American Occupational Therapy Association (AOTA)
  • American Osteopathic Association (AOA)
  • American Psychological Association (APA)
  • American Society of Nephrology (ASN)
  • American Telemedicine Association (ATA)
  • American Well
  • Anthem
  • Association for Ambulatory Behavioral Healthcare
  • Association for Behavioral Health and Wellness (ABHW)
  • CAPG
  • Cerner
  • DaVita
  • Federation of State Medical Boards (FSMB)
  • Hawaii Medical Service Association (HMSA)
  • Health Care Chaplaincy Network
  • Healthcare Leadership Council (HLC)
  • Healthcare Information and Management Systems Society (HIMSS)
  • Intel
  • Kaiser Permanente
  • LifeWIRE
  • NAADAC
  • National Association for Home Care & Hospice
  • National Association for the Support of Long Term Care (NASL)
  • National Association of ACOs (NAACOS)
  • National Association of Community Health Centers (NACHC)
  • National Council for Behavioral Health
  • National Council of State Boards of Nursing (NCSBN)
  • National Health IT Collaborative for the Underserved
  • Personal Connected Health Alliance (PCHA)
  • Population Health Alliance
  • Qualcomm Incorporated (and Qualcomm Life)
  • Telecommunications Industry Association (TIA)
  • The ERISA Industry Committee (ERIC)
  • The Evangelical Lutheran Good Samaritan Society
  • The Jewish Federations of North America
  • Third Way
  • University of Mississippi Medical Center (UMMC) Center for Telehealth
  • University of Pittsburgh Medical Center (UPMC)
  • University of Virginia (UVA) Center for Telehealth

The full text of the bill can be found here.

Marc Goldsand

Marc Goldsand joined Cozen O’Connor’s Miami office as an associate in the Health Care Practice Group in 2015. Marc focuses his practice on the corporate representation of physicians and healthcare businesses, bringing value and experience in an array of corporate and regulatory areas, including but not limited to, capital raising, enterprise sales, and mergers and acquisitions, while counseling clients regarding federal and state rules and regulations, including Anti-Kickback, Stark, Affordable Care Act, and HIPAA compliance and data privacy.

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