CMS telehealth policies are expiring—an enormous problem for some Medicare patients

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The news: Pandemic-era Medicare telehealth policies helped boost telehealth adoption amongst socioeconomically disadvantaged patients within the US, in response to recent Health Affairs data.

  • In 2019, lower than 1% (0.42%) of patients had a minimum of one outpatient telehealth visit.
  • But throughout the pandemic, recent telehealth regulations made it easier for doctors to treat patients via telehealth and more cost effective for patients to access virtual care.
  • In consequence, about 10% of patients had a minimum of one outpatient telehealth visit in 2021. Health Affairs noted high telehealth use in “disadvantaged neighborhoods.”
  • For context, researchers analyzed 30 million Medicare fee-for-service claims from 2019 to 2021.

How we came: When the pandemic hit, the CMS relaxed telehealth policies to assist expand access to healthcare for Medicare patients in rural areas.

These policies were all the time touted as temporary, and are set to run out on July 15, 2022.

  • Temporary telehealth waivers include the flexibility for rural patients to conduct their telehealth visit from their homes, fairly than the closest healthcare facility.
  • The CMS can be temporarily allowing physicians to conduct telehealth visits across state lines.

But the general public health emergency period is sort of up: That would eliminate telehealth access for some Medicare patients altogether.

The federal gov’t introduced some telehealth bills requesting everlasting telehealth regulations, but no major bills have passed in Congress.

  • If the US gov’t decides to finish its public health emergency period come July, a ton of Medicare patients won’t find a way to access care as frequently as they’ve over the past two years.
  • That’s bad news for health outcomes. About 60% of physicians agree telehealth has enabled them to offer higher quality care, per the 2021 American Medical Association survey.

The issue: Most telehealth consumers are still younger individuals with high incomes. Less telehealth coverage could widen socioeconomic barriers to virtual care.

In 2021, the groups least prone to use telehealth were adults 55+, those with incomes lower than $35,000 annually, rural respondents, and the uninsured, in response to Rock Health’s 2021 Consumer Adoption Report.

  • Then again, consumers making $75,000 to $150,000 annually used telehealth at the identical rate (80%) as those making 150,000+ annually, per Rock Health.
  • Similarly, 77% of adults aged 18 to 55 used telehealth, while only 64% of users aged 55+ used telehealth.

The socioeconomic gap between telehealth users could develop into narrower if the CMS decides to keep up its relaxed telehealth policies. That might give Medicare beneficiaries more time to develop into adjusted to regular telehealth use.

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