Telehealth during the COVID-19 pandemic: What's different & what has stayed the same for clinicians

From relaxed federal regulations to expanded insurance coverage, the COVID-19 pandemic has driven several changes for clinicians providing telehealth services.

Here are five differences about telehealth visits for clinicians:

1. Licensing regulations. President Donald Trump on March 13 declared a national emergency over the COVID-19 pandemic, which allowed HHS to waive federal licensing regulations to permit out-of-state physicians to treat patients via telehealth.

2. Medicare reimbursement. CMS extended Medicare coverage for telehealth services during the coronavirus public health emergency, allowing physicians to be reimbursed at the same rate as in-person visits for more than 85 additional services delivered via telehealth. These services include common office visits, mental health counseling and preventive healthcare screenings.

3. Payer coverage. Insurance companies including Aetna, Cigna and UnitedHealthcare all expanded coverage for telehealth visits, allowing providers to be reimbursed for various services during the pandemic.

4. New telehealth platforms. President Trump relaxed HIPAA penalties in March, which allowed providers to start using platforms such as Apple FaceTime, Zoom and Skype to perform telehealth visits with patients.

5. More patients getting care virtually. Some hospitals and health systems have transitioned thousands of providers to its telehealth platforms to care for non-COVID-19 and COVID-19 patients. NYU Langone Health added 1,300 physicians and other care providers to its telemedicine platform in late March, and a recent Merritt Hawkins report found that 48 percent of physicians are treating patients through telehealth, up from 18 percent in 2018. 

Here are three things about telehealth visits that have stayed the same for clinicians:

1. Clinical documentation. For clinicians at Cleveland Clinic, schedules and clinical documentation for virtual visits can still be found in the health system's Epic EHR system.

2. Building relationships with patients. Even though clinicians are connecting more with patients via telehealth technology, they can still practice empathy through verbal and nonverbal actions. These can include maintaining direct eye contact with the patient and saying statements such as "I'm here for you."

3. Internet access, or lack thereof. Some clinicians are still struggling with virtually connecting with patients located in regions that lack broadband internet. Almost 35 million Americans do not have internet access, which restricts them from joining video chats with healthcare providers. Earlier this month, lawmakers proposed a bill that would allocate $2 billion to expand internet connectivity at public and nonprofit healthcare facilities.

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