Fed or future? Expansion of telehealth by advancing the epidemic


WAS SHINGTON (AP) – TeleHealth There is a bit of American ingenuity that seems to have paid off in the coronavirus epidemic. Medicare Smartphones have temporarily waived restrictions predicting the era and are now under pressure to make telemedicine widely available in the future.

When society closes in early spring, Tuna consults patients and doctors connected to tablets, laptops and phones. Telehealth visits dropped with the reopening, but they are still much more common than before.

Increasing access permanently involves maintaining a balance between cost and quality, tackling privacy concerns and potential fraud, and exploring how telehealth can reach marginalized patients, including those with mental health problems.

“I don’t think it would take the place of a personal face-to-face visit, because sometimes a doctor needs to have a hand on a patient,” said Seema Verma, head of Medicare and Medicaid Centers, and the Trump administration’s leading advocate for telehealth.

On one side of the caves, “it’s almost a modern-day domestic call,” he added.

“It is fair to say that telemedicine was in its infancy before the epidemic, but it has come of age this year,” said Murray Itke, a data payer at IQVI, which tracks the impact.

In the ths depth of coronavirus shutdown, before the public health crisis, as low as 0.1%, telehealth accounts for more than 40% of first aid for patients with conventional Medicare. As the government’s main health care program, Medicare covers more than 60 million people, including people aged 65 and over and those with minor disabilities.

A recent poll of older adults by the University of Michigan Institute for Healthcare Policy and Innovation found that more than 7 out of 10 people are interested in using telehealth to follow-up with their doctor, and about 2 out of 3 feel comfortable with video conferences. .

But privacy was an issue, especially for those who did not try telehealth. The poll found that 27% of older adults who did not have a telemedicine visit had privacy concerns, compared to 17% of those who tried.

Those who tried telehealth did not sell out completely. About 4 out of 5 were concerned that the doctor could not examine them physically, and 64% worried that the quality was not so good.

Dr. of Dayton. “After initial stimulation, patients realize that ‘I can’t get my vaccine’, or ‘you can’t see this thing behind my throat on the computer,'” said Gary Leroy. , Ohio, primary care physician and president of the American Academy of Family Physicians.

For Jean Grady, a Medicare beneficiary from Westford, Vermont, telemedicine was a relief. She needed a checkup from Medicare to receive supplies for her wearable insulin pump. Being in the high-risk group for COVID-19, Grady worried about a possible contagion in the doctor’s waiting room, and even more worried about losing her diabetes supply if she missed a Medicare check deadline.

“I would have had to go back to take the insulin through the syringe,” he said.

Grady prepared for a virtual visit by calling her technician’s tech department and downloading teleconference software. She says she will make some future visits via video, but not all. For example, people with diabetes need periodic blood tests, and their legs are checked for signs of circulatory problems.

Grady said, however, that a few follow-ups can “be done very efficiently and be as useful to the therapist and to me as going to and seeing them in person.”

Many private insurance plans, including Medicare Advantage, offer telemedicine coverage at some level.

But traditional medicine has limited it to rural residents, who usually had to travel to specially designated sites to connect.

Under the Coronavirus Public Health Emergency, the administration has temporarily waived Medicare restrictions so that registration can use telemedicine anywhere. Patients could connect from home. Legislation from Congress will be needed to make such changes permanent, but it is in the mutual interest.

Senate Lamar Alexander, chairman of the Senate Committee on Health, Education, Labor and Pensions, says he would like to see an expanded view without breaking the bank.

“Our job is to ensure that change is achieved with the goals of low outcomes, good outcomes and good patient experiences.” Said Alexander, R-Ten.

It is a .com order.

Payment will be a sticky barrier. For now, Medicare pays the clinician to visit virtually and in person.

“Policymakers seem to be in a hurry to pass legislation, but I think it’s worth taking a little longer,” said Juliet Kubansky, a Medicare expert at the non-partisan Kaiser Family Foundation. “Fraud is a big area that policymakers need to be aware of.”

The cheaters agree.

“Telehealth is so new that at the moment we have no real understanding of where the huge risks are,” said Van Andrew Vanlandingham, senior attorney for the Inspector General of Health and Human Services. “We are in an experimental phase.”

Despite the risks, advocates see opportunities.

Extended Medicare Telehealth can:

– Move the nation closer to the long-desired goal of treating mental health in the same way as physical conditions. Sen. Ron Wyden, D-Or. Wants to use telemedicine as a springboard to improve mental health care. IQVIA data show that 60% of psychiatric counseling was taken by telehealth during closure.

Remote For those living in remote communities, access to low-income urban areas and even nursing homes. Medicare research shows that low-income beneficiaries have a similar way of using telehealth for primary care, as the overall program is enrolled.

Improving the coordination of care for people with chronic chronic health conditions, a goal that requires patient and constant monitoring. Chronic care is at the expense of most programs.

University of Michigan health policy expert Mark Fendrick says Medicare should find out what services are valued for patients ‘health and taxpayers’ wages, and pay for them.

Telehealth was “an overnight sensation,” Fendrick said. “Hopefully it’s not a hit wonder.”

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