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While the American Telemedicine Association's ATA Action arm said its ultimate goal is to make Medicare telehealth flexibilities and the Acute Hospital Care at Home programs permanent, it supports and endorses a temporary extension through Nov. 21, currently before the U.S. House of Representatives.
Industry groups also continue to work on the digital divide – a major barrier to telehealth and remote patient monitoring programs – to help communities improve their readiness for virtual healthcare opportunities, with ATA launching a new tool to fuel grant applications and policy planning for digital health services.
WHY IT MATTERS
Not only do patients and providers who would face financial challenges if the waivers expire need assurance now, a temporary extension would also give Congress more time to negotiate a long-term plan, the telehealth organization said.
It's “apropos" that telehealth policy negotiations are ongoing this week, which is ATA’s annual Telehealth Awareness Week, according to Kyle Zebley, executive director of ATA Action and senior vice president of public policy at the ATA.
"We are mere days away from having telehealth services lapse, leaving literally millions of patients across the country with no access to necessary care and our healthcare providers helpless to deliver that care," he said in a statement.
"While we continue to push for permanency, we ask members of Congress on both sides of the aisle and in both chambers, as well as the Administration, to work together to put in place yet another temporary extension for telehealth," Zebley added.
President Donald Trump’s leadership during the pandemic opened up the flexibilities under Medicare and the move was thus "transformative" because it "proved indispensable to our healthcare system," he said. Then, he asked the President to "take another courageous step to stop this endless loop of uncertainty and secure permanent access to telehealth services."
In addition to the potential disruption for Medicare beneficiaries who have been receiving care via telehealth for years, providers are also threatened by a loss of reimbursements the end of extended Medicare telehealth flexibilities under the COVID-19 public health emergency could mean, according to Igor Gorlach, healthcare partner at law firm King & Spalding.
"As for healthcare providers, most now offer a variety of telehealth services, and will have to drastically scale back telehealth offerings to Medicare beneficiaries," he said.
Providers and others in the healthcare sector who have established telehealth practices would face vast financial challenges if the flexibilities and, therefore, reimbursements, expire, Gorlach added.
THE LARGER TREND
The “telehealth cliff” has loomed many times, and ATA and other industry groups have repeatedly called upon Congress to eliminate restrictions regarding where patients can use telehealth services, remove telemental health service limitations, and ensure federally qualified health centers, critical access hospitals, rural health centers and providers can provide telehealth and hospital-at-home services.
Waiver extensions for these virtual care programs have often had bipartisan support since the flexibilities were first granted in 2020. Carefully cultivated programs have been shown to benefit both patients and providers across the United States.
However, healthcare leaders are concerned these benefits will be lost if the programs are not codified under law, and ongoing uncertainty has limited the appetite for further investments, according to Jon Freedman, partner, digital and technology transformation, at Chartis.
"Progress made over the last few years will be significantly halted because of the requirements for initial in-person visits being reinstated, geographic implications and massive shortages in behavioral healthcare supply," he told Healthcare IT News in March.
"In addition to significant access issues, all parties have increasingly integrated telehealth economics into their operating models," he added.
ATA and other industry groups have also called for federal government agencies to address digital gaps, as broadband has long been regarded as the Achilles' heel of telehealth, impeding access in certain geographic regions.
In 2021, the Federal Communications Commission established the $14 billion Affordable Connectivity Program to do that. The ACP provided steep household discounts on broadband – up to $30 per month for eligible low-income households and up to $75 per month for qualifying tribal households, but effective June 1, 2024, Congress pulled the funding and ACP discounts are no longer available.
"No effort has ever done more, faster to close our digital divide than the Affordable Connectivity Program," Former FCC Chairwoman Jessica Rosenworcel said in an agency blog post at the time. "Initially established in December 2020 and later expanded and renamed by the Bipartisan Infrastructure Law, the ACP enrolled more than 23 million subscribers across rural, suburban and urban America. That’s one in six U.S. households."
ATA launched a Digital Infrastructure Score tool that analyzes communities' readiness for digital access and virtual healthcare for grant applications and policy planning. A heatmap interface displays scores by ZIP code or county and highlights broadband access, internet speeds, device availability and affordability, the organization said in an announcement on Tuesday.
"As the nation continues to grapple with an unrelenting pressure on key hospital infrastructure in rural and urban America alike, digital solutions will become increasingly critical in facilitating access to key services," David Smith, founder and CEO of Third Horizon Strategies and an ATA advisor on the tool's development, said in the statement.
ON THE RECORD
"On behalf of the patients who rely on our healthcare system, we implore policymakers to ensure that telehealth not get caught in dynamics around a government shutdown and we once again extend uninterrupted access to virtual care services," Zebley said in a policy statement.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
