Andrew Strohman June 19, 2020
Last month, the Weekly Checkup covered efforts from the
Trump Administration to remove regulatory barriers to telemedicine. In the wake
of these actions and data indicating increased use across the
country, there has been growing interest in making some of these changes
permanent. One of the more notable indications of such interest was a letter on Monday to the Senate leadership
in which 30 senators urged just such action, citing an 11,718 percent increase
in telehealth usage for Medicare beneficiaries in just 6 weeks. If lawmakers do
act to make telemedicine more broadly accessible permanently, the result could
be better health and reduced costs along with increased access in areas with
shortages.
Data indicate that telemedicine not only lowers
costs but also improves health outcomes. In a 2011 Health Affairs article, researchers decided to investigate
the potential impact of a telehealth program on Medicare beneficiaries. Elderly
patients constitute the majority of the chronically ill—who account for nearly
four-fifths of all health care spending—so the intervention study looked at
both changes in spending and health outcomes. The researchers found that
compared to a matched control group, the intervention group that used the
telehealth program saved between $312-$542 per person per quarter. In addition,
there was a statistically significant difference in overall mortality rates,
showing a 2.5 percent lower mortality rate in the intervention group in year
two of the study.
Research continues to show that the United States
faces substantial risk of physician shortages in the future with rural areas experiencing
them now, and continuing the expanded access to
telehealth could boost access in medically underserved areas. In their letter,
the senators pointed to the Creating Opportunities Now for Necessary and
Effective Care Technologies (CONNECT) for Health Act of 2019 that was the
basis for many of the temporary changes to telehealth access under recent
COVID-19 emergency legislation. Under the CONNECT for Health Act provisions
that the coronavirus packages adopted, the Health and Human Services secretary
can waive certain restrictions for telehealth use under the conditions that the
waiver would reduce spending without reducing quality and would apply to
services provided by health professionals of whom there is a shortage. The
restrictions that may be waived include geographic limitations on the location
of doctors and patients as well as restrictions on the types of technology used
to furnish telehealth services such as video conferencing applications.
Assuming privacy concerns are still able to be
met, expanding the ability of medical providers to give care to patients, even
if they are conceivably across the country, could go a long way in ameliorating
some of the provider shortage issues that disproportionately affect rural
areas.
Taken in combination, the potential for
permanent changes to telehealth utilization stands to improve the health and
health spending of some of our most vulnerable and costly citizens as well as
expanding access to care across the country.
https://www.americanactionforum.org/weekly-checkup/moving-the-needle-on-telehealth/#ixzz6Q6hd0MgW
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