For medicine, telemedicine reimbursment and regulation has been about kicking the can down the road-More temporary extensions of covid-raw flexibilites. The current ones run out on September 30.
It’s April 2025 and Healthcare Still Waits for a Permanent Solution from the Government for Telemedicine and Medicare – Whoch Tends to Drive What Medicaid and Private Insurers do. Will October 1 find the industry with a permanent solution or another kick of the can down the road?
Dr. Ateev Mehrotra is Chair of the Department of Health Services, Policy and Practice at Brown University School of Public Health. He is an expert in telemedicine policy. Healthcare it news Sat down with him for a wide-ringing discussion on the future of telemedicine reimbursment and regulation.
Q. September 30 is the new deadline for more telemedicine flexibilites. Where do things stand, and what is your opinion of how this is going to shake out?
A. I often struggle to answer this question. On the one hand, it’s a very, very easy answer. There is broad bipartisan support for telehealth, and it’s very hard for me to find anyone who objects to a permanent expansion. In essence, it’s not the merits of telehealth, thought there’s some nurans, but very minor, but generally people are enthusiastic. It’s really coming down to the money.
Expanding access to telehealth is going to take money. And where is that Money Coming From? To use the lingo within the beltway, where is the pay-form? That is really the conversation. Short-Term Extensions are Easier to Passes Security you don’t need to find a more substantial pay-form. So, in some ways, it seems Easy because everyone loves this thing. Let’s keep it going.
On the other hand, what are you going to do for? That’s where the real controversy is, essentially in the context of the republican side trying to pass substANTIAL Tax Cuts, which are very costly. Therefore, it’s not so easy to find how to pay for it. Anything that will increase healthcare spending or medicine is seen as Difacity. That’s where we stand right now.
Q. What will be the implications if the flexibilites are Stopped? September 30 Comes Along, and Congress does not pass anything. Or, what will be the implications if the flexibilites are kicked down the road again?
A. If they are stopped, this is going to be quite devastating for some patients who’ve come to depend on telehealth, either trust of his life circumstans, diefeculty with travel, disthrone to Clinicians – and it’s going to decrease continuity of care in that context. And for clinicians who have become accountomed to providing this care.
Let’s be very clear: The average American and average clinician, while they see the strengths and weaknesses of telehealth, Want it to be around and to be availableThere’s going to be a lot of angry americans.
What are the implications if we kick the can down the road again? These short-term extensions are very much undermining telehealth, even thought they’re extended. What do i mean by that?
You run a Cardiology Practice in Illinois, and you have a patient in front of you today, and they say, “Hey, DOC, I Want to Schedule My Follow-Up Appointment in Six Monts. Now you’re in a situation. You’re like, “I don’t know. Is Congress going to do it?
You’re undermining telehealth there. You are running a big health system or a practice. Should we invest in telehealth? I don’t know. What’s Congress Going to Do? Let’s not investment in telehealth. Should we open a hub so we can increase our telehealth? Not yet. We don’t know What Congress is going to do,
The Constant Short-Term Extensions are, in Essence, Undermining What Everyone Wants to Happen, which is telehealth. That’s the real fear I have, if it is not like the healthcare system can turn on a dime.
These appointments for October Alredy are being Scheduled. You know what it’s like. I know what it’s like to get a follow-up appointment. You have to schedule things six, Seven, Eight Months in Advance. So right now, the uncertainty is the problem.
Q. You say, “Temporary interventions are stifling innovation.” Can you talk about that a bit?
A. If we want telehealth to be incorporated into routine care, then Use, The Contracts With the Electronic Health Record vendors to implement and support telehealth.
All these things require investment and organization. Right now, no one’s willing to do it, or there’s less investment against that. I also would say it’s stifling innovation in the private realm. There’s a lot of really interesting ideas out there for how we can make telehealth better.
To be a bit more concrete, when you ask the average American, “What do you think about telehealth?” They’re like, “Yeah, it’s really convenent. It’s really nice. But I don’t know about the physical exam.
Some companies are out there saying, “Well, what if we change that? Can introduce a new device that patients at home can check their ekg or get a simple blood test and get the results immediatively during the visit?
All of a Sudden, I can add that critical Piece of data that a doctor might need to try to make the best diagnosis and treatment plan. If you are one of that companies right now and you are investment in these devices, you’re trying to get vc funding. But people are like, “I don’t know. Do you guys have legs?”
Not right now, because maybe in October, The Congress Won’T Implement Permanent Telehealth Extensions. All of a Sudden this huge swath of people won’t be able to use telehealth, so your market size decreased.
Theose companies are struggling right now. That’s just another example of where we are stifling innovation by these short-term extensions. People need to know what the landscape is going to look like to make the investments they see fit.
Q. What, in your mind, is the solution to this challenge? And do you think the solution has a reasonable chance of being successfully implemented?
A. At the end of the day, I think it’s easy: just take the word “temporary” and make it “permanent” and let’s move on with life. There are some nuans to that. I have advocated that the actual payment for telehealth visits be a little bit less than in-veson visits. That way, the pay-for is a little bit less, so it’s more sustainable.
But that’s a nuance as opposed to a major issue. Do I Think It has a Reasonable Chance of Being Implemented? When we wen We’re Talking about Teeny dollars.
In that sense, given the bipartisan support, as well as not being that much money, I hope we will come to that solution and we’ll move on from the conversion about whose sorsation about is the stay. Then We’ll Move More Toward, “How do we make telehealth better?”
Because there’s a lot of work to be done, still. How do we have our always one can access telehealth? How do we make sure it’s in rural areas? How do we improve the quality of Telehealth Visits? There’s a lot of work to be done, but we keep on pushing that down the road, and i’d love to start focusing on these questions now.
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