August 1 , 2018

As we pass the peak of summer, telehealth activity continues to heat up! You have likely already heard about the exciting Medicare  proposals made by CMS recently, including reimbursement for brief virtual check-ins, patient-initiated store and forward services, and eConsults (provider to provider consultations). Also proposed earlier in the month is an amendment to allow home health agencies to report remote patient monitoring in administrative costs.

Would you like to discuss these changes and more with regional colleagues? Register and join us on Wednesday, August 8 at 3:00pm ET for a meeting of the Northeast Telehealth Leadership Forum!  

We are also excited to announce that the National Consortium of Telehealth Resource Centers recently launched a new website. The NETRC team will be working with the Consortium to populate new resources and fact sheets on the website. Recent additions include several of NETRC's webliographies, such as our  Telehealth Resources for Safety-Net Organizations (see the  Evidence for Telehealth page for more). 

Other featured resources on the National Consortium website include  Telehealth Connect - a web-based registry of telehealth provider sites across the United States. Telehealth provider sites  can be searched based on medical specialty, location, type of practice, and other fields. If you are not already on the map, click here to add your organization.

In this month's newsletter, we cover:
As always, please let us know if there is anything the Northeast Telehealth Resource Center can do to assist with your telehealth initiatives.


The NETRC Team

On July 2, 2018, MVP Health Care, a regional non-profit health plan covering over 700,000 members across New York and Vermont,  announced that all Distant Site health care providers will be reimbursed for "TeleHealth" services at 50% of their contracted fee schedule.

According to the MVP policy:

TeleHealth is defined as the delivery of healthcare services such as diagnosis, consultation, or treatment through the use of live interactive audio and video over a secure connection that is HIPAA-compliant, regardless of whether the member is at a health care facility. TeleHealth does not include the use of audio-only telephone, email, or fax. 

T eleHealth care services provided in real time are covered to the same extent that the services would be covered if provided through in-person consultation in Vermont. In addition, Tele-ophthalmology or tele-dermatology services may be provided by Store and Forward Technology (asynchronous telemedicine). The Distant Site health care provider must document the reason the services are being provided by Store and Forward Technology.

MVP Health Care certainly is not the only payer to reimburse less for telehealth or telemedicine services. In 2016, New York's Excellus Blue Cross Blue Shield made headlines when they announced a similar rate reduction, although we have heard more recently that Excellus is reimbursing providers more than the 50% reduction they initially proposed.

To learn more about variation in private payer laws and implementation, check out the Milbank Memorial Fund/Center for Connected Health Policy Report: Telehealth Private Payer Laws: Impact and Issues.

What are your experiences with telehealth reimbursement? Should reimbursement rates be the same as in-person services? If you would like to receive invitations for monthly meetings of the  Northeast Telehealth Leadership Forum to discuss these kind of issues and more, let us know.

Fall Conference Schedule FallConferences
Austin, TX
September 26-28
New York Rural Health Conference
Cortland, NY
September 26-28, 
Telemedicine & Telehealth Service Provider Summit
Glendale, AZ
October 8-9
Value-Based Care Summit
Boston, MA
October 17-19
Connected Health Conference
Boston, MA
October 17-19
SEARCH Telehealth Research Symposium
La Jolla, CA
October 24-25
 Virtual Healthcare in the Mainstream
New York City
October 26-27
 New England Rural Health Conference
Newry, ME
November 7-8
 North Country Telehealth Conference
Glens Falls, NY
November 7-8

National Webinars Webinars
Mapping and Designing Telehealth Clinic Workflows
Thursday, August 16, 2018 at 2:00pm EDT

Hosted by the California Telehealth Resource Center
Presented by  Fay MacDonnell, Workflow Engineer

Workflow mapping can allow a team to visualize a process and identify gaps or areas for improvement. This presentation will provide an overview of how to develop workflow diagrams for your team and review the telehealth recommended workflows developed by OCHIN, in collaboration with CTRC, Chapa De Indian Health, and Riverside-San Bernardino County Indian Health.

Innovation and Impact with Speech Language
Pathology Telepractice

Hosted by the Northeast Telehealth Resource Center
Presented by  Michael Towey, MA, CCC-SLP, and  Nathan Curtis, MA, CCC-SLP, Waldo County General Hospital

In July, Michael Towey and Nathan Curtis, two of the nation's most experienced Speech Language Pathology (SLP) Telepractitioners, shared an overview of SLP Telepractice, highlighted web-based approaches and how various clinical disciplines can re-purpose "off the shelf " resources to extend treatment, and how these methods help improve engagement and outcomes. Their presentation included bedrock clinical principles applied to telepractice and techniques to engage a variety of age groups, with a focus on clinician and e-helper competencies, coaching within telepractice, key program results (NOMS), and patient, caregiver and e-helper feedback.

Reviews of CMS UpdatesCMSupdates

Telehealth in Medicare Comprehensive End-Stage Renal Disease Care
Center for Connected Health Policy, July 24, 2018
Effective October 1, 2018, the Centers for Medicare and Medicaid Services (CMS) will implement a new telehealth waiver within the Comprehensive ESRD Care (CEC) Model...

Medicare's New Virtual Care Codes: A Monumental Change and Validation of Asynchronous Telemedicine
Health Care Law Today, July 18, 2018
The Centers for Medicare and Medicaid Services just issued a proposed rule introducing monumental changes to the physician fee schedule...

CMS Includes Telehealth Changes to Proposed Physician Fee Schedule for CY 2019
Center for Connected Health Policy, July 17, 2018
CMS released its proposed Calendar Year (CY) 2019 Physician Fee Schedule (PFS) containing its proposal for momentous changes for Medicare, aiming to modernize the healthcare system and help "restore the doctor-patient relationship" by reducing administrative burden...

Hooper, Lundy, Bookman, July 14, 2018
CMS proposes a number of changes of note, including permitting Medicare reimbursement for certain communication technology-based and remote evaluation services...

Center for Connected Health Policy, July 10, 2018
CMS proposes amending billing regulations to Medicare remote patient monitoring, OIG decision, and more...

Medicare Expands Remote Patient Monitoring for Home Health Agencies
mHealth Intelligence, July 9, 2018
CMS has proposed changes so that home health agencies can include the cost of remote patient monitoring on the Medicare cost report form...

Additional Telehealth NewsNNews
Patient EngagementHIT, July 30, 2018
The National Organization of Nurse Practitioner Faculty (NONPF) recently called on medical schools  and nurse practitioner graduate programs to create telehealth curricula for their students...

Why Physicians Resist Telemedicine's Growth
HealthLeaders, July 24, 2017
A Deloitte Survey documents sources of reluctance and offers tips to make virtual technologies a reality...

Observer-Dispatch, July 23, 2018
The Bassett Healthcare Network launched a telepsychiatry program in May...

NHPR, July 17, 2018
The telemedicine landscape in N.H. is discussed with several stakeholders...
Health Data Management, July 12, 2018
The Federal Communications Commission intends to create a new $100 million Connected Care Pilot Program supporting the use of telemedicine solutions for low-income and rural Americans...

mobihealthnews, July 6, 2018
In the second quarter of 2018, hospitals and other healthcare providers continued to advance technology in a number of ways...

mHealth Intelligence, June 29, 2018
The Physical Therapy Licensure Compact went live in three states on July 9....

Industry UpdatesIndustry

Providers are increasingly adopting cloud-based telehealth systems
MedCity News, July 30, 2018
Cloud-based platforms for telehealth eliminate the heavy burden of maintaining a locally installed native system while delivering all the benefits and security of cloud computing...

AMD Global Telemedicine and NuPhysicia Health of Texas Partner to Offer On-Site Healthcare Options for Self-Insured Employers
Press Release, July 17, 2018
AMD Global Telemedicine Inc.  announces their partnership with NuPhysicia Health to deliver scalable on-site healthcare options  for self-insured employers...

Recommended Telehealth Research & ResourcesRResources

Providing comprehensive medication management in telehealth
Badowski ME, Walker S, Bacchus S, et al. Pharmacotherapy 38(2):e7-e16, 2018

Center for Connected Health Policy. CCHP/Public Health Institute, June 2018

Centers for Medicare & Medicaid Services. Medicare Learning Network Fact Sheet, January 2018

Freed J, Lowe C, Flodgren G, Binks R, Doughty K, Kolsi J.  J. Innov. Health Inform. 25(1):14-18, 2018

Greenhalgh T, Shaw S, Wherton J, et al. J. Med. Internet Res. 20(4): e150, 2018

Hernandez C, Mallow J, Narsavage GL. Breathe 10(3): 198-212, 2014

Lee PA, Greenfield G, Pappas Y. BMC Health Serv. Res. 18(1):495, 2018

Martinez-Martin N, Kreitmair K. JMIR Ment. Health 5(2):e32, 2018

Marzorati C, Renzi C, Russell-Edu SW, Pravettoni G. J. Med. Internet Res. 20(6):e223, 2018

Chronic Care Management: Information Resource
National Council on Aging. March 2018

Rat C, Hild S, Rault Sérandour J, et al. J. Med. Internet Res. 20(4):e135, 2018

Tse G, Chan C, Gong M, et al. J. Geriatr. Cardiol. 15(4):298-309, 2018

Udeh C, Udeh B, Rahman N, Canfield C, Campbell J, Hata JS. Methodist Debakey Cardiovasc J. 14(2):126-133, 2018

The role of telemedicine in postoperative care
Williams AM, Bhatti UF, Alam HB, Nikolian VC. mHealth 4:11, 2018