COVID-19 is changing the landscape for health care delivery

With the materialization of the virus causing the disease COVID-19, there is a need to expand the use of technology to help people who need routine care, and keep vulnerable beneficiaries and beneficiaries with any symptoms in their homes while still providing access to the care they need.

The Centers for Medicare & Medicaid Services (CMS) has expanded access to Medicare telehealth services so that Medicare patients can receive a wider range of services from their doctors without having to travel to a healthcare facility.

Medicare patients will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling, and preventive health screenings. I have not seen how this will be done with Medicare Advantage plans. The reason for this welcoming change in the law is to safeguard Medicare beneficiaries who are at a higher risk for COVID-19. This way they are able to visit with their doctor from their home, without having to go to a doctor’s office or hospital (which puts themselves and others at risk). 

One of the challenges that quickly comes into my mind is the concern of how many seniors have access to a smartphone. Additionally, how many will know how to download apps (if the physician’s office uses an app to conduct the visits) and how can home health agencies use this technology to conduct face to face visits as well? 

TYPES OF VIRTUAL SERVICES:

There are three main types of virtual services physicians and other professionals can provide to Medicare beneficiaries:  Medicare telehealth visits, virtual check-ins, and e-visits.

MEDICARE TELEHEALTH VISITS:  Currently, Medicare patients may use telecommunication technology for office, hospital visits and other services that generally occur in-person. 

  • The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home. Distant site practitioners who can furnish and get payment for covered telehealth services (subject to state law) can include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians, and nutrition professionals. 
  • It is imperative during this public health emergency that patients avoid travel, when possible, to physicians’ offices, clinics, hospitals, or other health care facilities where they could risk their own or others’ exposure to further illness. Accordingly, the Department of Health and Human Services (HHS) is announcing a policy of enforcement discretion for Medicare telehealth services furnished pursuant to the waiver under section 1135(b)(8) of the Act. To the extent the waiver (section 1135(g)(3)) requires that the patient have a prior established relationship with a particular practitioner, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.

KEY TAKEAWAYS:

  • Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances.
  • These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.
  • Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.
  • While they must generally travel to or be located in certain types of originating sites such as a physician’s office, skilled nursing facility or hospital for the visit, effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home.
  • The Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
  • To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.

Information for this blog, provided by:  https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

What does all of this mean for home care, home health, and hospice organizations? I have had conversations over the last 24 hours and so many new ideas and thoughts are being discussed.

  • Hospice agency/home health providers now using their nurse practitioner to perform home visits, and billing part B for the services.
  • This allows every home health agency to visit a patient and assist in helping in the use of an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home. 
  • Use RPM equipment. Private duty companies, that are short on staff, have increased their charges by $2 a day and placed these devices in every patient’s house. With devices like Electronic Caregiver, the patient has an emergency button that they can press, plus a fall detection device that will alert anyone who is listed on the notification that the patient fell or activated the emergency response system. When home care is involved with those notifications it allows us an opportunity to immediately reach out and identify that more hours may be needed for a patient plan of care.

It has become apparent that new strategies are needed to continue providing care the those who have the highest risk of contracting the COVID-19 Virus. Telehealth is an obvious solution that needs truly evaluated to reduce the spread of this disease.

If you would more information about digital health or to become a master care partner with Electronic Caregiver at no cost to you, go to www.homecaresales/caregiver and you can help your patients be monitored by your agency.