CMS Administrator’s Telehealth Recap

An important conversation took place on telehealth policy as it relates to healthcare at the “Deep Dive for Health Systems: Telehealth Policy Developments” event held November 15, 2018 in Washington D.C. The Conference was presented by the Alliance for Connected Care http://www.connectwithcare.org and sponsored by Intel, American Well, and MDLIVE.

As noted by Krista Drobac, Executive Director for the Alliance, “There have been a number of policy changes in the last 18 months.” One of the leaders in this effort, Seema Verma Administrator for the Centers for Medicare and Medicaid Services (CMS), https://www.cms.gov  presented a recap on the recent new changes occurring at Medicare related to telehealth.

According to Administrator Verma, starting in January Medicare will pay for virtual check-ins, which will enable patients to connect with their doctors by phone or video chat, for the first time, CMS will be paying for virtual consultations between physicians and the evaluation of remote pre-recorded images and video. Also, Medicare’s recently released home health rule will enable home health agencies to use remote patient monitoring for Medicare patients.

New for 2019, Medicare patients receiving home dialysis, will be able to receive their monthly clinical assessments via telehealth from their homes, patients with symptoms of an acute stroke will be able to receive telehealth services from mobile stroke units.

CMS recently has proposed options for modernizing and expanding telehealth through their Center for Medicare and Medicaid Innovation (CMMI) models and demonstrations. As announced a few weeks ago, Medicare Advantage enrollees in 2020 will have more options for receiving telehealth services beyond what is otherwise available in the traditional program.

Administrator Verma talked about her recent visit to the Cleveland Clinic. She saw firsthand innovative ways to use remote patient monitoring from a central hospital command center. This model uses a mission control operation where off-site personnel use sensors and high definition cameras to monitor patients and assimilate the data to trigger on-site intervention. In addition, the Cleveland Clinic is sending paramedics to seniors’ homes and connecting them virtually to their doctors.

Right now, CMS is overhauling the Meaningful Use Program to focus on promoting interoperability. As CMS has announced, hospitals that don’t give patients their data in the next two years will be penalized, and doctors’ incentive programs will be tied to interoperability.

Innovations related to telehealth are key to delivering the best treatments possible for patients. The Administrator pointed out how important technology can be in an emergency. For example, her husband experienced a near death experience last year. Thanks to bystanders, the defibrillator at the airport, and the medical team that treated him at the hospital, he was able to survive a very serious cardiac episode.

Taking it a step further, maybe his cardiac episode could have been predicted before it happened if his electronic watch or some other novel device had been compiling information such as his heart rate, breathing, other data, and then forwarding the information on to his doctor.

The Administrator summed up, “The reality is that once information is freely flowing from the patient to the provider, it will help spur innovation in the entire digital health information ecosystem. Then the advances in coordinated value-based and patient-centric care will be even greater than anything we can imagine today.”

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