HJAR May/Jun 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2020 41 LaShannon Spencer Chief Executive Officer Community Health Centers of Arkansas executive officer and chief medical officer, respectively, of Blue Cross Blue Shield of Ar- kansas heeded a call-to-action by at sharp- ening and adjusting how insurer’s payment methods adequately encompass telehealth services. They have made changes to help ensure that providers are properly compen- sated, reducing roadblocks to telehealth. I applaud them for getting ahead and creat- ing solutions for what could have been a serious problem. Prior to the COVID-19 pandemic, numer- ous reasons, including cumbersome govern- ment rules and regulations of the Centers for Medicare and Medicaid Services, left many health care systems and organizations ham- strung. Those rules and regulations made utilizing telehealth services highly ineffi- cient and ineffective. But recently, CMS said it would temporarily pay for telemedicine in-patient visits for Medicare and Medicaid patients, no matter where the patient lives. Also, on an emergency and temporary basis, the federal government has relaxed prior telehealth restrictions. For example, patients can now visit with doctors by phone or vid- eoconferencing. These changes occurred within the Coronavirus Preparedness and Response Supplemental AppropriationsAct and the 1135Waiver. Now, Medicare will pay for office, hospital, and other visits furnished via telehealth, not just those in a rural area, which previously was the case. Given this health crisis, we are seeing a surge is tele- health usage, especially, but not exclusively, in rural areas. Additionally, telehealth will allow phy- sicians who must be quarantined because they’ve tested positive for the coronavirus, to continue certain aspects of their work via video conferencing. Telehealth also al- lows the continuation of care for high-risk patients who, regardless of the pandemic, still need access to health care. As this pandemic becomes a catalyst of sorts for a significant ongoing increase in the use of telehealth services, we must also recognize the kinks in this emerging sys- tem. For starters, far too many communi- ties do not have reliable internet services. And we still have to answer the question of who—community health centers, hospi- tals, solo practitioners, etc.—gets to bill for telehealth services. What if a provider and a community health worker, who assists with patient relations, transportation, and education, could each bill for telemedicine services?We’re talking healthcare delivery, billing, and payment systems that we’ve never seen before. There is a perception among some that telehealth is truly a way forward. A 2017 national survey by the Employee Benefit Research Institute found that 40 percent of 21 to 37 year old millennials regard tele- medicine as an extremely or very important option in their health benefits program. By comparison, this sentiment existed among 27 percent of GenXers, those aged 40 to 54, and 19 percent of Baby Boomers, the young- est of whom is 55. We have some persuading to do. We need far more data to prove the assorted values of telehealth. We need to show how a solid telehealth model can create an additional level of financial support for healthcare pro- viders; how the right models would reduce both costly hospital stays and readmissions; how the right models really would provide some needed conveniences for patients. COVID-19 will continue to impact our culture in many ways for years to come. Small business, including health care pro- viders, will be forever changed. How we interact with each other will be different. Physical workplaces will look different. Will the custom of shaking hands, kisses on the cheek, or even a hug, disappear from our culture? I wish I could predict how this is going to shake out, and I wish there weren’t so many unknowns. I wish you all health, safety, and peace. Be kind to each other, and try to look to a positive future healthcare delivery system in Arkansas, where we all partner together, focusing on achieving the best possible out- comes for all people—whether that medicine is delivered in person or remotely. n “Amid the current lack of appropriate medical supplies, the demands placed on an often already over-burdened health workforce, the shortages of critical care and hospital beds, and the insufficient mechanisms for paying for care, we are indeed looking ever more toward telehealth.”