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Telehealth: Where We Are Now

Telehealth: Where We Are Now

For months, we’ve been hearing about the surge of telehealth visits during the COVID-19 pandemic. Some sources estimated the increase was as much as 8,000 percent from the previous year, and a recent survey by Decision Resources Group showed that as of July 2020 80 percent of all U.S. physicians had had a virtual patient visit in the previous three months, up from 39 percent in April and just 9 percent in March.

But now that patients are able to return to doctors’ offices and clinics throughout the country, what is the current state of telehealth? And what about the future?

Pandemic Growth and Retraction of Telehealth Use

While telehealth visits comprised 69 percent of total encounters during the early COVID-19 peak in April, they accounted for just 21 percent of total encounters by mid-July, according to national data from EHR giant Epic. Still, more than half (52%) of the physicians who’d had a virtual patient visit in the last three months said they will likely continue to do so after COVID-19 mitigation measures have ended. And as of the end of July, Anthem CEO Gail Boudreaux reported to investors “that use of telemedicine for behavioral health among its members is at a rate 56 times that of pre-COVID-19 levels.”

Government Support of Telehealth

Also notable, an August executive order issued by President Donald Trump permanently expands some telehealth services beyond the COVID-19 pandemic, particularly for rural areas.

“Today I’m taking action to ensure telehealth is here to stay,” President Trump said during a press conference Monday evening. “I signed an executive order to make some of our regulatory reforms permanent.”

To implement that executive order, the Centers for Medicare and Medicaid Services (CMS) is recommending that some services temporarily approved for telehealth during the COVID-19 public health emergency (PHE) be permanently added to the approved Medicare telehealth services list. Other services on the temporary list also were extended through the calendar year in which the PHE ends. Those changes were included in the Proposed 2021 Medicare Physician Fee Schedule, for which CMS is currently receiving comments. 

But expanded telehealth use is not without its problems.

Telehealth on the OIG Work Plan

For one, the Office of Inspector General has added two reviews of telehealth to its work plan. The first review will examine the extent to which telehealth services are being used by Medicare beneficiaries, how the use of these services compares to the use of the same services delivered face-to-face, and the different types of providers and beneficiaries using telehealth services. The second review will identify program integrity risks with Medicare telehealth services to ensure their appropriate use and reimbursement during the COVID-19 pandemic.

Cyberattacks on Telehealth Are Up

As well, cyberattacks on telehealth platforms are on the rise. According to Healthcare Dive’s Rebecca Pifer, security alerts sent to IT staff at 148 of the most popular telehealth applications jumped 30% for the period March through April this year, compared to the pre-COVID period of September 2019 through February 2020.

“In the starkest difference, the healthcare industry overall saw a 77% decrease in IP reputation security alerts caused by malware infections, part of successful phishing attempts or other attacks. The same incidents in telehealth vendors jumped 117%, suggesting cybercriminals moved away from targeting healthcare organization networks in favor of third party supply chain vendors instead,” Pifer writes.

Majority of Physicians Still Wary

Perhaps most concerning for the future of telehealth is the way physicians think about it. According to that Decision Resources Group survey discussed above, close to 60 percent of physicians reported having lingering reservations about the quality of care they can provide remotely, and of the 20 percent of physicians who had not had a virtual patient visit in the previous three months, 49 percent said the reason was the possibility of diminished quality of care.

But even if quality of care issues are resolved, providers also want more assurance that if they invest further in telehealth that they will be compensated by government and private payers, and not just temporarily.

“Without permanent policy changes, it is unclear if telehealth services will represent a significant proportion of U.S. health care visits in the long run,” writes Lori Uscher-Pines, a senior policy researcher at the nonprofit, nonpartisan RAND Corporation, in a recent Health Affairs blog post.

Learn More

For more information about the evolution of telehealth during the COVID-19 pandemic and beyond, check out the following resources, including articles quoted above and some that were not:

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  • Telehealth Cheat Sheet

    Having trouble keeping track of all the details of telehealth?

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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