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Policy
HHS studies how to keep telehealth
waivers, but can’t do it alone
By Jessica Kim Cohen
medicine has been shown to save
some costs, like in travel time and
HHS IS STUDYING WAYS to extend
expenses, Parker said. But travel
telemedicine flexibilities pushed
through during the COVID-19 pan- increase healthcare costs. Tele-
time and expenses aren’t covered
demic, but eliminating regulatory by Medicare.
barriers will require support from “We may discover that the di-
other federal agencies, Congress rect benefits to patients of tele-care
and state governments. at home has increased the cost of
“Looking forward, we do face care as a replacement for in-person
the challenge of where we go from GETTY IMAGES/MODERN HEALTHCARE ILLUSTRATION care,” he said. “The technology of
here,” Jim Parker, senior adviser “We may discover that the telehealth has some costs, and we
for health reform to the HHS secre- direct benefits to patients must determine if convenience for pa-
tary, said during an online panel on of tele-care at home has tients justifies that cost.”
telemedicine and COVID-19 hosted increased the cost of care Parker also stressed the need for
by Washington think tank Bipartisan stronger broadband infrastructure to
Policy Center. “Consumer expectations as a replacement for support increased telemedicine use.
are likely changed moving forward.” in-person care.” “We could develop a magnificent reim-
Telemedicine has grown substan- Jim Parker, senior adviser for health bursement policy for telehealth—and
tially in response to the coronavirus reform to the HHS secretary have it stalled if the technology’s not
outbreak, helped by a host of regula- there to support it.”
tory flexibilities. That includes CMS HHS has been working with the
expanding Medicare reimbursement, ing telemedicine flexibilities past the Federal Communications Commis-
Congress giving HHS authority to COVID-19 pandemic, Parker said HHS sion and Department of Agriculture to
waive originating site requirements will review data about telemedicine, build up broadband infrastructure for
for Medicare beneficiaries, and states including its use during the pandemic, telemedicine, Parker said.
waiving licensing restrictions. to “ensure a soft landing for telehealth, Kripa Sreepada, health policy adviser
Many providers want to see that instead of a hard stop.” to Sen. Tina Smith (D-Minn.), said she’s
flexibility continue after the pandemic seen bipartisan interest in “pursuing
subsides. Recent reimbursement ex- Next steps for telemedicine “may in- permanent telehealth changes.”
pansion allowed Avera Health to “turn clude looking at what administrative Sreepada said the pandemic pro-
up the volume” on its telemedicine net- levers we have at HHS,” Parker said, but vides an opportunity to gather data
work, including creating a call center there are also statutory barriers that re- on which of the temporary flexibilities
in anticipation of a patient surge, said quire intervention by Congress. put in place are proving successful and
Dr. Jennifer McKay, Avera’s medical One of the main avenues HHS has to should be made permanent or built
information officer. That encourage continued tele- upon, as well as whether patients and
helped the Sioux Falls, medicine adoption is mak- clinicians who are using telemedicine
S.D.-based system avoid THE TAKEAWAY ing recent reimbursement now find it preferable to in-person care.
around 50 emergency de- HHS is working expansions under Medi- A particular point she said needs in-
partment visits per day. to “ensure a care permanent. CMS Ad- vestigation is which medical specialties
Reducing barriers for soft landing for ministrator Seema Verma and services can be provided via phone
telemedicine required co- telehealth, instead has suggested some of the call alone, rather than needing a video
ordination and support of a hard stop,” a telemedicine waivers from component.
from Congress, multiple senior HHS adviser the pandemic will stay Expanded telemedicine use during
federal agencies, state gov- said. But that will in place. the pandemic offers “a unique oppor-
ernments and private pay- require work from There are still issues to tunity to study what’s working and
ers, Parker noted. the agency, states assess, such as whether what we should make permanent,”
In terms of extend- and Congress. telemedicine use could Sreepada said. l

6 Modern Healthcare | June 8, 2020