Telehealth: The good that came out of COVID



[Editor's note: This story originally was published by Real Clear Health.]

By Marcelo Hochman
Real Clear Health

As the world returns to pre-pandemic status, the innovations we’ve gained in the past two years shouldn’t go with it. During the COVID-19 crisis, increased access to previously restricted telehealth was one silver lining. Medicare patients were able to receive care safely in the comfort of their homes once the Department of Health and Human Services and the Centers for Medicare and Medicaid Services lifted long-standing bureaucratic obstacles.

Patients made good use of their new health freedom. An HHS report found that more than 28 million Medicare beneficiaries used telehealth during the first year of the pandemic alone–using telemedicine 88 times more than the previous year. The average telehealth patient’s costs fell 61%, from $1,099 per month to $425 per month in just one year

Talking remotely to doctors was critical to providing care and saving lives during our lifetime's worst public health emergency. But by early next year, Congress' failure to act may take that critical remote care away for millions of patients.

Congress recently extended telehealth coverage for five months beyond the expiration of the federal public health emergency–which is expected in mid-October. While the five-month extension is a step in the right direction, Congress shouldn’t stop there. If Congress doesn’t act quickly to codify the temporary telehealth access allowed during the pandemic, only rural patients receiving certain services will be covered for telehealth.

By passing legislation like the Telehealth Modernization Act and the CONNECT for Health Care Act  Congress would keep the country from reverting to the past and allow patients from any geographic location to receive a wide range of health services. By permanently removing many obstacles to telemedicine, Congress would protect all Medicare beneficiaries' access to their doctors–not just a select few. 

In determining the future of telehealth in Medicare, Congress should consider the success of telehealth during the pandemic. 

According to the HHS report, “Beneficiaries' use of telehealth during the pandemic also demonstrates the long-term potential of telehealth to increase access to health care for beneficiaries. Further, it shows that beneficiaries particularly benefited from the ability to use telehealth for certain services, such as behavioral health services.” 

In addition to expanding remote access, telehealth services significantly reduce the no-show rate for patients. One study found that the no-show rate of telehealth visits during the pandemic was only 7.5%, compared to the in-office no-show rate of 36.1% during the pandemic and the pre-pandemic no-show rate of 29.8%. Allowing all Medicare patients the flexibility and comfort of talking to their doctors from any location incentivizes them to show up (remotely) and receive potentially life-saving care. 

It also helps prevent the spread of infectious diseases–a person with the flu, a cold, or COVID-19 can receive care in their house without going into the office and spreading germs. Allowing people with milder ailments to be treated at home keeps beds open and nurses available for people with more severe conditions. 

Remote check-ins can save lives for those whose symptoms require more constant care. For example, one study of pulse oximetry monitoring estimated that at-home monitoring had a 6 per 1,000 patient mortality rate compared to a 26 per 1,000 mortality rate for those without home monitoring. Researchers noted in the Journal of American Medical Association, "Based on a hypothetical cohort of 3,100 patients, the study projected that remote monitoring could potentially be associated with 87% fewer hospitalizations, 77% fewer deaths, reduced per-patient costs of $11 ,472 over standard care, and gains of 0.013 quality-adjusted life-years.”

Let's face it. If these restrictions weren't needed during a health emergency, they aren't required when it’s over. Through temporary telehealth authorizations, patients have had remote health care access for two years now, and far from the sky falling, it’s saved lives, cut costs, and reduced the unnecessary spread of germs. What could justify imposing restrictions again?

There’s a lot that won’t–and shouldn’t–be missed about the pandemic. But if Congress doesn’t act to codify the telehealth flexibilities from the past two years, we’ll lose one of our best tools to ensure all Medicare beneficiaries receive the health care they need.

Dr. Hochman is Double Board Certified, an extensive background of nearly 30 years in facial cosmetic and reconstructive surgery, and immediate past president of Charleston County Medical Society

[Editor's note: This story originally was published by Real Clear Health.]



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