Welcome to Telehealth Roundup, highlighting news and features about emerging trends in telemedicine and telehealth.
Insurers Pull Back Telehealth Despite COVID-19 Spike
As COVID-19 cases soar, some insurers are starting to scale back telehealth benefits, .
This includes resuming out-of-pocket payments and requiring prior authorizations.
Early in May, Blue Cross Blue Shield of Texas set the expiration date for its telehealth expansion at May 31. That date's been moved three times since then, with the expansion program now set to expire Aug. 31.
Other insurers have announced deadlines when they will stop covering remote visits and start charging co-pays again. Nearly all insurers say they are continually reevaluating their coverage, USA Today noted.
Paul Berggreen, MD, a gastroenterologist in Phoenix, said his office staff must check insurers' websites frequently because telehealth payment rates and co-payment waivers seem to change every week.
"A lot of my patients still don't want to come in to my office," he said.
"Now is probably not the time to walk back any telehealth provisions. We don't know when this thing is going to end. It seems like you would want to keep the telehealth channel open, particularly for the vulnerable populations."
Colorado, Idaho Lock in Telehealth Expansion
Many state and federal telehealth coverage changes are set to expire when the COVID-19 public health emergency ends, but expanded telehealth access is becoming permanent in some states, according to .
Colorado Gov. Jared Polis signed a bill preventing insurers from requiring patients to have a pre-established relationship with a virtual care provider or from imposing additional location, certification, or license requirements on providers as a condition for telehealth reimbursement.
The new law applies to state-regulated health plans and Medicaid and adds remote patient monitoring as a covered service. It also removes restrictions on whether audio or video technology is used: as long as it's HIPAA-compliant, it's covered.
In Idaho, Gov. Brad Little issued an executive order asking state agencies to take steps to make waivers of telehealth rules that were issued during the pandemic permanent. Those waivers broadened telehealth technology, allowed telehealth providers to prescribe more drugs, and allowed out-of-state providers to treat Idaho patients.
"We are thrilled to see Colorado and Idaho embracing telehealth by permanently breaking down state regulatory barriers," said Krista Drobac, executive director of the Alliance for Connected Care, a telehealth advocacy group based in Washington, D.C.
"The reality is that many of the barriers in place needlessly restrict patient access to healthcare providers through technology," she added. "The flexibilities allowed during this pandemic have clearly illustrated the necessity of re-examining the rules that were so quickly changed for an emergency."
While some telehealth advocates have insisted the surge in telehealth will be part of the "new normal" after the COVID crisis subsides, others are skeptical, Modern Healthcare said. One analysis suggested telemedicine use may be tapering: at mid-June, telehealth visits were up 8% compared with pre-pandemic levels, down from 14% in early April.
Telehealth Claim Lines Climb
Claim lines -- an individual service or procedure listed on an insurance claim -- for telehealth rose more than 80-fold across the country in April 2020 compared with April 2019,.
The findings came from the nonprofit group's , which showed telehealth increased from 0.15% of medical claim lines in April 2019 to 13% in April 2020. The data represent privately insured patients, excluding Medicare and Medicaid.
"Month by month, FAIR Health's Monthly Telehealth Regional Tracker is showing the impact of COVID-19 on telehealth," FAIR Health president Robin Gelburd said in a statement. "Our data indicate that this venue of care is being transformed at a rapid pace."
The FAIR Health report showed the largest hikes were in the Northeast, where claim lines increased more than 260-fold in April 2020 compared with April 2019.
In both April 2019 and April 2020, telehealth had a greater share of medical claim lines in urban than rural areas.
Most Docs Forecast Fewer Than 10% of Visits will be Virtual in a Year
What role will virtual visits play 1 year from now?
Most physicians in primary care, behavioral health, and medical and surgical specialties think their practices will include only a slight shift to telemedicine in the next 12 months, according to a recent poll featured in .
The , from Baltimore-based consulting firm Sage Growth Partners, asked 4,380 physicians between May 28 and June 3 about current practices and post-pandemic predictions.
The majority of respondents -- 79% of primary care physicians, 73% in behavioral health specialties, 88% in medical specialties, and 97% in surgical specialties -- thought fewer than 10% of their visits will be virtual in the next year.
About 20% of primary care physicians, 20% in behavioral health specialties, 10% in medical specialties, and 3% in surgical specialties predicted that virtual visits would constitute 11% to 30% of their practice, Becker's said.
Nearly two-thirds of respondents in primary care (64%), behavioral health (64%), and medical specialties (62%) said they currently provided telehealth services, but only 24% of respondents in surgical specialties did.