Unsurprisingly, investors took note. Venture capital funding for telehealth reached $ 15 billion in the first half of 2021, up from $ 6.3 billion in the first half of 2020.
The rapid increase in telehealth adoption would not have been possible without streamlining regulations in response to the public health emergency.
“Before the pandemic, telehealth covered only about 100 service areas, mainly those serving beneficiaries in rural areas,” Fleming said. But in early 2020, the Centers for Medicare and Medicaid Services (CMS) expanded Medicare coverage by adding 140 more services regardless of location. This includes emergency room visits, occupational therapy / physiotherapy, issues related to hospital discharge days, and other non-critical care services. In addition, a much wider range of providers can now provide these services through telehealth.
“This extension of Medicare and Medicaid coverage has helped spawn payment for telehealth from private insurers,” Fleming said. “By authorizing this expansion, the government has recognized the essential role of telehealth in expanding access to health care. “
What’s the next step in telehealth?
But while telehealth has played a pivotal role in expanding access to healthcare during the pandemic, the scope of the relaxed regulations was not intended to be permanent. So when do the waivers expire and will they be maintained?
Fleming explained that currently, the waivers will remain in effect until the end of the public health emergency or the end of the year. “With Delta’s surge and the additional challenges that have arisen this summer and fall, there hasn’t been an additional schedule extension, but that doesn’t mean there won’t be,” she declared.
Such an extension can have a broad base of support, but this will not necessarily happen automatically or without further change.
In recent years, federal regulators have scrutinized telehealth agreements, with particular concern about fraud and abuse. Pandemic waivers have cut red tape, but federal regulators remain concerned about potential issues of fraud and abuse.
“It’s not as easy as we might hope to permanently remove some of the relaxed regulatory requirements during the pandemic,” Fleming said. “Depending on regulatory concerns, we may not see it expand to as broad a base as we see during the public health emergency. “
Peck also noted that some waiver extensions will require congressional action, not just administrative changes.
States will also play a role in the continued and ongoing expansion of health care. Typically, state regulatory regimes are concerned with licensing and scope of practice issues, while federal regulations primarily deal with reimbursement and prevention of fraud, abuse and abuse. health care. Thus, reforming telehealth regulations will require both federal and state action.
“Some states have already made changes to their licensing rules,” Fleming said. For example, Florida created a specific telehealth license that allows out of state providers to be licensed to provide telehealth services in the state.
“I hope other states will follow. This could create a solution to the shortage of certain specialists in particular fields, ”she said.
The Biden administration has been busy solving telehealth issues. In August 2021, the Authority announced a $ 19 million investment in telehealth, targeting 36 beneficiaries serving rural areas and underserved communities. This grant will finance:
- Learning programs based on telehealth technology., Mentoring capacity building in underserved areas.
- Twelve regional and two national telehealth resource centers. These centers will provide telehealth resources, information and education to health care providers.
- Evidence-based direct-to-consumer telehealth networks. Bypasses some of the service restrictions.
- The creation of telehealth centers of excellence programs. These centers will assess and improve services in rural and underserved areas where disease and poverty rates are high. This work will include piloting new services and publishing research.
“This amount of money is exciting because it provides funding for the growth of the current telehealth structure,” Fleming said.
Looking to the future: the near future of telehealth
Of course, expanding access to telehealth services requires patients to have broadband broadband Internet connections.
“We assume that if telehealth exists, anyone can use it, and that’s just not the case,” Fleming said. Many remote rural areas, in particular, struggle to access broadband. The federal Infrastructure and Jobs Investment Act aims to close this disparity by providing $ 65 billion to expand broadband infrastructure.
“We assume that if telehealth exists, anyone can use it, and that just isn’t the case.”