5 ways to fuse telehealth into primary care beyond the pandemic

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While the COVID-19 pandemic reduced structural and policy barriers for telehealth, certain aspects of virtual care, such as payment reimbursement, still need to be updated, according to a Sept. 9 Health Affairs viewpoint article.

For the article, a team of New York University and Rutgers University researchers worked with Health Affairs to conduct six repeated surveys of primary care providers working in mostly small independent practices to assess their experience with telehealth and what they need for permanent expansion.

Here are five recommendations, based on the survey findings, for policy makers and insurers to support telehealth use by primary care providers. 

1. Coordinate reimbursement criteria. While CMS and commercial insurers increased telehealth reimbursement rates, there has been confusion among providers and payers over variables such as HIPAA compliance of platforms and payment parity for phone versus video versus in-office visits. Policy makers and insurers must decrease the differences in payments to reduce confusion around billing for telehealth.

2. Establish billing codes or payment models for additional work needed for telehealth services. Providers reported new and additional activities associated with telehealth visits that are not reimbursable in the fee-for-service system. These include providing one-on-one sessions to help patients download video conferencing platforms and having staff members call prior to the visit to test their video and audio capabilities. Given these workflow changes, telehealth services should fall under value-based reimbursement models.

3. Insurers should cover at-home monitoring devices. Providers are using remote monitoring to keep track of their patients' health, but 77 percent of survey participants said their patients had to buy the devices on their own, which can impact the quality of telehealth being delivered.

4. Incentivize telehealth technologies to avoid flaws for patients of different backgrounds and different provider settings. Financial incentives for telehealth technology developers will improve the design and function of virtual care platforms to address issues with usability, such as language barriers and user-friendly image upload abilities.

5. Review and expand telehealth malpractice policies. Regional health departments must give providers more guidance on legal liabilities related to telehealth, as many liability insurers have not embraced coverage for it. There is limited information available about the standards of care or damage caps, and patients may be more likely to sue providers they have not met in person.

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