Implications of the Telehealth Modernization Act
The Telehealth Modernization Act was passed in 2022, modifying requirements for the coverage of telehealth services under Medicare. It effectively extends certain flexibilities initially authorized during the COVID-19 public health emergency. Endorsed by a number of professional organizations, from the American Association of Orthopedic Surgeons (AAOS) (1) to the American Hospital Association (AHA) (2), the legislation has a number of critical implications.
In April 2020, at the beginning of the pandemic, over 40% of Medicare fee-for-service primary care visits were carried out through telehealth, and over 10 million beneficiaries accessed telehealth services from mid-March through early July of 2020 (3). While regulatory coverage restrictions have long prevented telehealth services for many of the nation’s roughly 61 million Medicare beneficiaries, the COVID-19 pandemic acutely highlighted the importance of access to telehealth care.
Among other elements, the bill allows (1) federally qualified health centers and rural health clinics to act as the location of the health care practitioner; (2) the home of a beneficiary to act as the location of the health care beneficiary for all services; and (3) all types of practitioners to provide telehealth services, as assessed by the Centers for Medicare and Medicaid Services (4).
The Telehealth Modernization Act applies to a full spectrum of health care. In addition to providing Medicare recipients many additional telehealth services, the act will 1) help patients continue to access telehealth from varied health care workers, from speech language pathologists to physical therapists, and 2) help Medicare patients receiving services ranging from home dialysis to hospice care keep receiving this care through telehealth.
The most important implication of the Telehealth Modernization Act is the increased flexibility of – and therefore access to – health care. Permanently eradicating geographic and originating site restrictions, the Telehealth Modernization Act will reduce access barriers that have continuously increased in recent times. Relatedly, it will enable greater access to high-quality health care services for vulnerable populations, in particular among seniors.
In addition to ensuring access to essential care for patients, the increased use of telehealth helps address certain workforce pressures, including those that arose as a result of an overwhelmed healthcare system during the COVID-19 pandemic.
Many opportunities and challenges remain to be addressed in view of a telehealth-centric future, however (5). First, patient trust and security are top priorities (6). One study found that ensuring that health services provision meets patients’ needs at all times depends not only on a certain degree of flexibility in care delivery modalities and interprofessional collaboration, but also healthy, sustained relationships with patients. Second, and relatedly, it will be important to ensure that patients receive the right amount of empathic, personalized care, crucial to a good patient experience and patient well-being. As many have experienced, virtual interactions so far have major differences compared to in-person ones. To this end, guidelines and training are needed, as well as careful attention to technological challenges and interpersonal relationship needs (7).
Overall, telehealth has been beneficial for millions of Americans, especially during the pandemic (3). While continued research is required to ensure that its key provisions are implemented in the most smooth and efficient way possible, the Telehealth Modernization Act will surely continue to positively reshape healthcare delivery.
References
1. AAOS’ Advocacy Efforts Focus on Access to Quality Care [Internet]. [cited 2022 Jul 25]. Available from: https://www.aaos.org/aaosnow/2022/may/advocacy/advocacy01/
2. AHA Comments to Modernization Subcommittee of the Healthy Future Task Force Re: Telehealth | AHA [Internet]. [cited 2022 Jul 25]. Available from: https://www.aha.org/lettercomment/2022-03-04-aha-comments-modernization-subcommittee-healthy-future-task-force-3-4-22
3. Scott, Schatz, Shaheen Introduce Bipartisan Legislation to Increase Access to Telehealth in the Midst of the Pandemic | U.S. Senator Tim Scott of South Carolina [Internet]. [cited 2022 Jul 25]. Available from: https://www.scott.senate.gov/media-center/press-releases/scott-schatz-shaheen-introduce-bipartisan-legislation-to-increase-access-to-telehealth-in-the-midst-of-the-pandemic
4. H.R.1332 – 117th Congress (2021-2022): Telehealth Modernization Act | Congress.gov | Library of Congress [Internet]. [cited 2022 Jul 25]. Available from: https://www.congress.gov/bill/117th-congress/house-bill/1332
5. Blandford A, Wesson J, Amalberti R, AlHazme R, Allwihan R. Opportunities and challenges for telehealth within, and beyond, a pandemic. The Lancet Global Health. 2020. doi: 10.1016/S2214-109X(20)30362-4.
6. Hale TM, Kvedar JC. Privacy and security concerns in telehealth. Virtual Mentor. 2014. doi: 10.1001/virtualmentor.2014.16.12.jdsc1-1412.
7. Breton M, Sullivan EE, Deville-Stoetzel N, McKinstry D, DePuccio M, Sriharan A, et al. Telehealth challenges during COVID-19 as reported by primary healthcare physicians in Quebec and Massachusetts. BMC Fam Pract. 2021; doi: 10.1186/s12875-021-01543-4.