A report from the Department of Health and Human Services (HHS) found huge increases in the use of telehealth by Medicare beneficiaries during the COVID-19 pandemic, with specialists such as behavioral health providers seeing the highest telehealth utilization relative to other providers.
The number of telehealth visits grew from 910,490 before the pandemic (March 1, 2019 through February 29, 2020) to more than 28 million during the pandemic (March 1, 2020 through Feb 28, 2021). About 53% of Medicare users tried telehealth during that timeframe.
The types of patients who accessed care via telehealth and the types of providers they saw varied substantially. Patients in urban areas accessed telehealth services more than rural communities, and Black Medicare beneficiaries were less likely to use telehealth than White beneficiaries. Among providers, telehealth visits comprised a third of total visits to behavioral health specialists in 2020, compared to 8% of visits to primary care providers and 3% of visits to other specialists.
The Centers for Medicare and Medicaid Services (CMS) said it will use this data to design future telehealth policies. CMS significantly revised policies to pay for more telehealth during the pandemic public health emergency, and the new policies are slated to expire on December 31, 2023. Before the pandemic, CMS generally only paid for telehealth visits inside the patient’s home in rural areas. While overall use of telehealth services increased and improved access to services for many beneficiaries, more research is needed to understand how it affects the quality of care and why certain beneficiaries used it less than others, CMS said.
CMS Promotes Birthing-Friendly Hospital Designation
The Centers for Medicare and Medicaid Services (CMS) will propose a “Birthing-Friendly” designation for certain hospitals to drive improvements in perinatal health outcomes and maternal health equity. Under the plan, this designation initially would identify hospitals that provide perinatal care, are participating in a maternity care quality improvement collaborative, and have implemented recommended patient safety practices.
Beginning with discharges on October 1, 2021, CMS adopted a new quality measure for its Hospital Inpatient Quality Reporting Program that asks hospitals to attest to whether they participate in a statewide or national maternal safety quality collaborative. They also must have implemented recommended patient safety practices or bundles to improve maternal outcomes. CMS is proposing using these metrics to label a hospital “Birthing-Friendly”—with special designation on the agency’s Care Compare website.
According to the Centers for Disease Control and Prevention, data show that state and multistate maternal safety quality collaboratives have proven they can improve care: They’ve succeeded in reducing deliveries before 39 weeks of pregnancy without a medical reason, reducing healthcare-associated bloodstream infections in newborns, and reducing severe pregnancy complications.
Plan for Free SARS-CoV-2 Home Testing Coming Soon
In response to the threat of the omicron variant of the SARS-CoV-2 virus, President Biden announced a series of measures intended to boost vaccine uptake and access to testing. Key to this effort is the administration’s plan to require at-home test kits to be reimbursed by private insurance. For those not covered by private insurance, at-home tests will be distributed through community sites such as health centers and rural clinics. The U.S. is on track to quadruple the supply of rapid at-home tests compared to the summer of 2020, according to the administration.
Critics of the plan noted that paying up front and waiting for insurance reimbursement is still a barrier for some people, and it compares unfavorably to the process of some governments such as the U.K. that have offered home testing kits for free on demand. In a statement to Reuters, America’s Health Insurance Plans spokesperson Kristine Grow said the industry is still working with the administration to understand the plan. Insurers are concerned about price gouging, premiums, and the rules around implementation, she said.
Already two states, Washington and New Hampshire, have programs offering not only free SARS-CoV-2 tests, but also free home delivery.