What does the future hold for telehealth reimbursement?

Oct 12, 2021 | Dialer Enterprise

What is the future for telehealth reimbursements?

The question at the forefront of healthcare providers’ minds… will telehealth visit reimbursements remain in parity with in-person visits? The COVID-19 public health emergency is due to end in December 2021 and while Congress is unlikely to rule on reimbursements until that time, there is reason to be cautiously optimistic about reimbursement parity. Since the beginning of the pandemic, attitudes have changed about the value of telehealth, and recently two developments in the evolving story emerged. For now, fortunately, reimbursements for telehealth visits will remain the same as in-person visits at least until the end of the year.


Development #1: The AMA’s point of view

The American Medical Association (AMA) announced support for what it considers to be the two most important healthcare policies Congress should include in the budget-reconciliation package it’s working on this September. They are 1) Medicare pay and 2) continued access to telehealth for Medicare patients after the COVID-19 public health emergency ends, which includes support of H.R. 2903/S. 1512, the “CONNECT for Health Act.” In April, 50 senators reintroduced CONNECT, which “would expand coverage of Medicare telehealth services and make some COVID-19 telehealth flexibilities permanent, among other provisions.”


Development #2: The ATA’s point of view

The American Telemedicine Association (ATA) announced support of the Centers for Medicare & Medicaid Services’ efforts to make access to some telehealth services permanent and for Congress to repeal a rule in the 2022 Physician Fee Schedule that would require Medicare beneficiaries to have an in-person medical appointment every six months in order to receive telehealth services. “As important as the Physician Fee Schedule is, we urge Congress to act before the majority of Medicare beneficiaries go off the telehealth cliff at the end of the public health emergency,” ATA CEO Ann Mond Johnson said in a statement.


Where we stand now on the public health emergency

The public health emergency, first declared by the Secretary of Health and Human Services on January 31, 2020, remains in effect and while it is currently set to end at the end of 2021, the ATA expects Congress will extend it into 2022. While all of us would like to see an end to this global health emergency, the rapid acceleration of the adoption of telehealth during the crisis has been a big positive for patients.

“Telehealth visits provide an opportunity for physicians to have a meaningful interaction while the patient is in their own environment,” said Amit Phull, MD, Senior Vice President of Strategy at Doximity and practicing emergency medicine at Northwestern Memorial Hospital. “Many patients, especially the elderly and those living in remote areas, are stressed by making arrangements to keep appointments, travel logistics, expenses, etc. Telehealth visits ensure these important patient-clinician connections are being made, ultimately providing better outcomes, reducing no-shows and saving money.”


Reimbursements in the future? Difficult to predict

Telehealth visits are popular with the public and disproportionately accessed by the most consistent voting demographic, those 50 and older. Typically, once services are provided it becomes politically more difficult to cut them (especially as we move closer to midterm elections). Many of the most significant changes to our healthcare and social systems—Social Security, Medicare, the Affordable Care Act, etc.—have initially been met with considerable political resistance. Once such programs become more familiar, and the benefits more apparent, they’re quickly woven into the fabric of our society. 

“The rapid adoption of telehealth indicates it’s likely here to stay and may evolve to benefit an even larger swath of society,” said Amit Phull, MD. “While there are still many things to fix in the US healthcare system, telehealth visits are a new and welcome addition to the way we practice medicine.”