Hospitals get omnibus wins in extension of telehealth and hospital at home programs
The legislation extends waivers for both programs that were put in place under the public health emergency.
Photo: Luis Alvarez/Getty Images
The extension of telehealth and hospital-at-home programs beyond the end of the public health emergency are two big wins out of the $1.7 trillion omnibus spending bill that President Biden signed into law Friday.
The legislation extends waivers for both programs that were put in place under the public health emergency.
Telehealth flexibilities are now in effect through the end of 2024. Prior to passage, providers and Congress – which needed to act to block the telehealth cliff – were looking at getting an additional 151 days after the end of the PHE.
According to the American Hospital Association, the omnibus legislation keeps in place PHE waivers, including expanding the originating site to include any site at which the patient is located, including the patient's home; expanding eligible practitioners to furnish telehealth services to include occupational therapist, physical therapist, speech-language pathologist and audiologist; extending the ability for federally qualified health centers and rural health clinics to furnish telehealth services; delaying the six-month in-person requirement for mental health services furnished through telehealth; extending coverage and payment for audio-only telehealth services; and extending the ability to use telehealth services to meet the face-to-face recertification requirement for hospice care.
Additionally, the omnibus bill extends safe harbor exceptions for telehealth services in high-deductible health plans.
The Health and Human Services Secretary will be required to submit a report to Congress on utilization of services. The interim report is due in October 2024 and the final report in April 2026, according to the AHA.
The bill also extends Acute Hospital Care at Home until December 31, 2024.
It requires the HHS Secretary to analyze and compare care delivery under Acute Hospital Care at Home programs with traditional inpatient care delivery and publish a report demonstrating these findings.
WHY THIS MATTERS
Both programs have been essential for hospitals and physicians during the height of the COVID-19 pandemic and the ensuing financial challenges caused by labor shortages, discharge delays and inflation.
Without the bill, Congress would likely have acted on telehealth provisions within the 151 deadline at the end of the PHE. Without action, telehealth would revert in large part to rural care done out of physicians' offices.
Hospital at Home, which was pioneered and trademarked by Johns Hopkins Medicine an estimated 20 years ago, has allowed at-capacity hospitals to move acute care patients home using skilled nursing, digital and telehealth services.
Hospitals that are able to scale these services and have value-based contracts can realize a financial advantage, Sg2 principal consultant Mark Larson said last year. Sg2 is a consulting and analytics firm and Vizient subsidiary.
ROI is realized when contracts are extended to the 30-day episode in Medicare Advantage agreements, he said. Even more money is saved on avoiding readmissions.
THE LARGER TREND
Hospitals were pleased that the omnibus bill prevented the statutory Pay-As-You-Go Medicare 4% sequester for two years. The legislation prevents the $38 billion in Medicare cuts that otherwise would have taken effect in January.
Physicians voiced displeasure that they received only partial relief from a 4.5% reduction in reimbursement rates starting on January 1, 2023. The
legislation reduced the cut to 2% for 2023 and around 3% for 2024.
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
