Apr 09 2020
Patient-Centered Care

Expanded Telehealth Coverage for Seniors: Why It Matters Now

Virtual care is key to social distancing, especially for older adults with chronic illness. A temporary shift in reimbursements could have positive long-term implications.

On March 17, the Trump administration announced the expansion of telehealth services for Medicare beneficiaries during the COVID-19 pandemic — a direct effort to keep older adults with health problems at home to avoid exposure to the coronavirus.

“Providers will be allowed to use everyday technologies to talk to telehealth patients, more telehealth services will be covered ... and providers will be allowed to offer these telehealth benefits to Medicare beneficiaries at a lower cost than traditional services,” Health and Human Services Secretary Alex Azar said in a prepared statement.

It’s a smart and welcome strategy that will allow millions of older adults to access virtual consultations from their homes or in assisted living communities. Some wider telehealth reimbursements already were enacted last year; this is poised to serve millions more.

And the effort is crucial, especially for high-risk individuals, as a growing number of shelter-in-place orders seek to limit unnecessary outings.

The benefits are part of a broader effort by the White House to ensure Americans of all ages are aware of telehealth and other accessible benefits to maintain good health while flattening the curve, according to the Centers for Medicare & Medicaid Services.

I’m hopeful that the expansion of telehealth during this global emergency will prompt wider and permanent coverage via Medicare to benefit a population that’s increasingly looking for better quality of life and more ways to age in place.

Telehealth’s Benefits and How Coverage Is Expanding

Telehealth enables caretakers to virtually screen patients, answer questions and make treatment recommendations without exposure to a hospital or clinic where a person could contract or spread the virus. Providers can also see patients in any geographical location, greatly easing the stress on busy organizations fighting the pandemic.

Consider how helpful this option could be for people who have mobility issues or lack transportation — not to mention those with diabetes, heart or lung problems, or other conditions that could hinder their prognosis if they contracted the novel coronavirus.

Still, there are divides that must be addressed. Despite telehealth’s steady growth and acceptance — benefits consultant Mercer found that nearly 9 out of 10 companies with 500 or more employees offered virtual care as part of their health benefits last year — telehealth coverage under traditional Medicare has been relatively limited until now.

Prior to March 17, Medicare’s telehealth reimbursements were mainly restricted to rural areas where patients were required to use kiosks in specially designated facilities. That’s of little comfort to people who want to avoid public spaces. Medicare last year also had begun paying for 5- to 10-minute virtual check-ins, but with many restrictions.

Under emergency declarations from the Trump administration, Medicare coverage now includes three types of virtual services that could have long-lasting impacts on how physicians and other professionals provide care to older adults:

  • Telehealth visits: Expanded coverage will enable Medicare beneficiaries to seek real-time consultations, whether it be from a smartphone or computer, and the exchange needn’t be with their primary care provider. It’s not possible to diagnose coronavirus via telehealth, but patients can be virtually evaluated based on symptoms and be directed to in-person testing and treatment.
  • Virtual check-ins: Medicare patients can initiate brief communications with their care provider to avoid unnecessary trips to the doctor’s office. These are intended for patients with existing ties to a care provider. This could include people with chronic illness who need routine check-ins that don’t necessarily require an office visit.
  • E-visits: This service, also initiated by the patient, enables communication with providers that are typically done through the patient portal, rather than face to face. Mainly, this service allows for nonurgent communication at the patient’s leisure, where providers can follow up with care or advice for patients on how to best seek treatment.

Expansion of these services for older adults is intended to last only for the duration of the COVID-19 public health emergency. But as more lawmakers and clinicians discover the health benefits, convenience and cost savings of virtual care, there’s a strong argument to be made that the arrangement — properly scaled and managed — could become a way of life.

This article is part of HealthTech’s MonITor blog series. Please join the discussion on Twitter by using #WellnessIT.


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