The Changing World of Telemedicine
Updated: Apr 4
Telemedicine needs and usefulness has shattered most predictions during the COVID outbreak. A 50% increase in use was documented and published early in the pandemic.
Virtual encounters have proven extremely useful in initial and continuing medical care by minimizing potential provider and patient virus exposure and increasing access to care. Public acceptance of remote telehealth has been significant. For example, the CDC cites increases in telemedicine usage from 50% to 130% for years 2020 and 2021 to date.
Federally Qualified Health Centers (FQHCs) have been awarded funding options during the COVID outbreak to assist in meeting increased care needs. As an example, CMS initiated reimbursement increases for FQHCs and Rural Health Centers (RHCs) for the expansion of virtual services via revised reimbursement policies. These policies have seen intermittent revisions with no firm date for retraction noted. https://www.cms.gov/files/document/se20016.pdf
FQHC patients have been positive about increased offerings of virtual care during the pandemic. The National Association of Community Health Centers (NACHC) cites that 75% of FQHC patient visits nationally in late 2020 were virtual verses the traditional in person sessions.
As we see the COVID epidemic continue, what additional changes may be pending for FQHCs?
Increased EMR Adoption of Telemedicine Software
COVID has increased the need for telemedicine and virtual care offerings. Policy variances from state and federal oversight entities made the need for this transition much easier in 2020 and 2021. Many of the variances remain in place at this time.
Early in the COVID outbreak, many providers and entities experienced challenges with their EMR telemedicine modules and video connections. Initial concerns included dropped connections, inability to link systems, and connection with non-patients. Many of these concerns have been corrected by vendors with their dedication and understanding of the increased demand.
While increased virtual healthcare during COVID is beyond many projections, this demand made some hospital services, practice resources, and
patient records hard to access and manage. This brought faxing and alternative communication and sharing options back into this intermittent mainstay.
Many virtual communication concerns have been corrected for FQHCs and RHCs, with many looking at the pending COVID Delta outbreak as a true test of telemedicine changes to date.
Changes in Insurance Carrier Revenues
In addition to FQHC and RHC entities, medical practices and hospital systems have increased their patient access during COVID with remote and/or virtual service offerings. These entities have seen increased revenues from virtual services due to commercial insurance carrier policy variances.
We are seeing commercial carriers start to rescind these payment variances with some requesting refunds and initiating takebacks causing concern and confusion with entities and patients. Medicare and many state Medicaid reimbursement variances for FQHCs remain, with additional or final COVID revenue and policy changes to be determined.
Supplementary Grant Funding for FQHC Entities
Industry insiders predict additional federal revenues for FQHC entities. Based on recent allocations, these funding opportunities could be significant.
Reporting requirements for FQHCs through the Uniform Data System (UDS) have been increased during the outbreak. Results may have influence on additional funding programs for FQHCs.
Carrier Telemedicine Policies
Commercial carriers have expressed reluctance to continue telemedicine as a primary source of care (verses in-person visits) during recent months. Entities have seen reduced revenues and requests for refunds for recent virtual visit.
Patient satisfaction with telemedicine services during COVID is significant with 80% to 88% of respondents having a “satisfied” or “very satisfied” impression of their encounter through telemedicine care.
Healthcare entities are lobbying state and federal representatives to implement policy that require carriers to maintain telemedicine reimbursements as a permanent part of their programs moving forward.
Many hospitals and health systems have increased interest in collaboration with FQHCs during the COVID outbreak. Access to additional providers and resources during the outbreak along with positive outcomes are trending drivers of the interest. We are encouraged with this trend and are assisting in answering some of the “how do we….” questions with entities.
What additional challenges may be coming?
Persistence of the COVID virus with variants appears to be on the horizon. Our attention to virus changes, treatments, and recommendations in coming weeks will assist in addressing the need to minimize additional exposures and health concerns to our patient populations and families.
In addition to direct medical needs, social services and additional support services will be needed to assist, counsel, and move our patients and clients toward a traditional lifestyle we are all used to and now appreciate more.