Keep telehealth alive and well, experts tell Senate subcommittee

For many Americans, telehealth options to connect with their health care providers seem to spring to life suddenly in 2020, even though some virtual care options started years earlier.

Now, experts warn, telehealth could face a slow or even quick death if politicians do not take specific actions soon.

That’s because the temporary Medicare rules created at the start of the COVID-19 pandemic will expire on December 31, 2024.

Four of those experts, including Michigan Medicine’s Chad Ellimoottil, MD, MS, testified about the urgent need for action before the Senate Finance Committee’s Health Subcommittee on November 14.

The hearing, held by Senators who play a key role in formulating Medicare policy for the nation, is available to watch.

“The slow death of telehealth can occur when patients and providers become increasingly frustrated by regulations and unexpected bills and ultimately stop using telehealth,” Ellimoottil warned in his prepared testimony.

“Making the expansion of telehealth permanent is about ensuring that Medicare beneficiaries have choices in their care, whether in person, via video or over a phone call.”

Ellimoottil cited research from his Telehealth Research Incubator team and others at the University of Michigan and beyond on the use of telehealth before and since March 2020.

He is the past director of the telehealth research effort at the UM Institute for Health Care Policy and Innovation and medical director of virtual care for the UM Medical Group, the faculty group practice of Michigan Medicine. .

He also spoke from his experience as a urologist connecting with patients considering surgery or symptom management, including those in rural areas with poor connectivity through video-based appointments.

For them, he told senators, the ability to hold audio-only appointments over a phone line and have Medicare pay for the session would be vital.

Also crucial, he said, is to make permanent Medicare rules that allow telehealth appointments from a patient’s home or other location, not just an approved clinical location as was the case before the pandemic.

Allowing flexibility for geographic location is also vital.

Ellimoottil also requested that telehealth-based care be reimbursed at the same rate as in-person care because of the ongoing cost of maintaining clinics and staff. He also warned that regulators should avoid putting in place “guardrails” on telehealth that are not based on clinical evidence as a way to prevent fraud and abuse.

What happens in the coming months with Medicare policy, he and other witnesses told senators, will have ripple effects for people who also have other forms of health insurance. In fact, the uncertainty about Medicare payment for telehealth past the end of 2024 has already started to create problems.

“If Medicare continues to view expanded telehealth coverage as ‘temporary,’ commercial payers will reduce or eliminate their coverage for telehealth services,” he said.

“This is already underway, and we are witnessing the development of a fragmented telehealth payment system that is creating confusion for patients and providers.”