Amazon, Walmart join providers in pushing Senate to extend telehealth policies

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Major healthcare disruptors Amazon and Walmart have joined a chorus of hospitals, provider groups and telehealth organizations in pressing the U.S. Senate to extend telehealth flexibilities, such as removing in-person requirements for virtual behavioral health and increasing access to virtual health in the commercial market.

As it stands, those policies – which were enacted in response to the COVID-19 pandemic – are set to expire 151 days after the end of the public health emergency. The PHE is currently set to end in October, though health officials are expecting the Biden administration to extend the PHE at that time, according to Politico.

Other current telehealth flexibilities include provisions to waive provider and patient location limitations, and to facilitate access to clinically appropriate controlled substances without in-person requirements.

In the joint letter to Senate leadership, more than 370 organizations said the short-term nature of the temporary policies add uncertainty into the healthcare system.

"Providers must weigh the costs of investing in the technological and clinical infrastructure required to maintain telehealth programs at scale against the uncertainty of when these telehealth policies may end," the groups wrote. "Further, patients who utilize telehealth as part of their care plan face the possibility of a forced return to in-person care."

They said this is particularly concerning for anyone utilizing virtual care to reach experts at longer distances, as well as those receiving ongoing remote care for chronic conditions.

Other signers of the letter include the American Telemedicine Association, the Consumer Technology Association, the Connected Health Initiative, the Alliance for Connected Care and HIMSS. HIMSS is the parent company of Healthcare Finance News.

WHAT'S THE IMPACT

In calling for a two-year extension of the telehealth flexibilities, the organizations behind the letter have argued that virtual care is now a fundamental part of the U.S. healthcare system – one that has been shown to improve both access and care continuity.

"While many of the most compelling clinical use cases for virtual care are only now emerging, more communities than ever have experienced the powerful impact telehealth has had in bridging gaps in care," the letter read. "Telehealth is helping to address the crisis-level mental health, primary care, and other workforce shortages."

Historically underserved communities now have additional support, the organizations added. But without "statutory certainty," they said, the work of building infrastructure, trust and relationships with communities is beginning to stall.

The letter advocates for passage of the Advancing Telehealth Beyond COVID-19 Act, which the House passed by a vote of 416-12, and said Congress should continue to push for a permanent extension.

THE LARGER TREND

The current PHE, signed on July 15, will end in mid-October. Health and Human Services Secretary Xavier Becerra has promised to give providers 60 days' notice before announcing the end of the public health emergency.

The notice gives hospitals and other providers time to prepare for the end of waivers and other flexibilities put in place during COVID-19.

The Consolidated Appropriations Act of 2021 expanded access to telehealth services for the diagnosis, evaluation or treatment of mental health disorders after the end of the PHE.

The Advancing Telehealth Beyond COVID-19 Act, which passed the House in July, would allow federally qualified health centers and rural health clinics to serve as the distant site, or the location of the healthcare practitioner; it would allow beneficiaries to receive telehealth services at any site, regardless of type or location; it would allow any type of practitioner to furnish telehealth services, subject to approval by the Centers for Medicare and Medicaid Services; and it would continue coverage for audio-only evaluation and management and behavioral health services.

Despite the advantages of telehealth, there are also frustrations, according to recently released UnitedHealth Group research. The survey of 240 healthcare providers showed a majority (69%) consider telehealth to be convenient, but another 28% described virtual care as frustrating.

While those might seem like contradictory descriptors, providers shed some clarity on their thinking, with 58% saying they were frustrated with the quality of care they can provide through virtual platforms, and 55% saying they have to manage patient expectations for virtual visits. Half the respondents were vexed with the technical details that come with navigating telehealth.

Telehealth still enjoys widespread popularity among patients, even though its appeal has dimmed somewhat. A December 2021 Rock Health survey found that in 2020, 53% of respondents were more satisfied with live video virtual care than in-person interactions. This satisfaction decreased somewhat in 2021, however, with just 43% of respondents reporting the same.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com