In response to COVID-19, Medicare significantly increased remote health care benefits. Here are the facts.
Although advocates have been calling for greater adoption of virtual doctor visits for years, it was only after the outbreak of the coronavirus that telehealth became mainstream. Federal data shows that more than 12.1 million Medicare beneficiaries received remote care between mid-March and mid-August. This was because both patients and health care professionals wanted to avoid infection.
This was made possible by the Centers for Medicare & Medicaid Services (CMS), which took drastic steps to relax rules and increase reimbursements for telehealth services.
Telehealth has been promoted by employers and insurers for many years as a low-cost option for non-emergency care. Patients were reluctant to sign up, and Medicare was slow in embracing it. Telehealth is therefore limited to rural patients who live in rural areas.
COVID-19 changed that. In response to the pandemic, CMS removed barriers to telehealth coverage, allowing patients throughout the country to access care from their homes.
New services added
This year, the agency added 135 services on its list of telehealth services it will pay during the public health crisis. These include non-COVID-19 doctor appointments, initial inpatient visits with new practitioners, discharge services, and cardiac and lung rehabilitation treatments. CMS increased the number of providers that can use telehealth and waived patient copays. It also raised reimbursement rates to levels comparable to in-person visits.
Telehealth options have increased for Original Medicare and Medicare Advantage. This is a multi-insured alternative.
“We saw growth of telehealth go form 0.1% of patients, to 40% of our Medicare beneficiaries,” Dr. Saurabha Bhagnagar, chief physician and head of technology performance at UnitedHealthcare Medicare & Retirement says. “I was stunned.”
It remains to be determined if any of these changes will be permanent. CMS is currently evaluating telehealth usage in the context of the pandemic, while also keeping an eye on fraud and inappropriate use. The agency published a proposal in August to allow home visit evaluations permanently and to extend payment for telehealth services outside of the current coronavirus crisis.
“It’s hard to imagine merely reverting to the way things were before,” CMS Administrator Seema Verma wrote in an article for Health Affairs published in July.
Advocates fear that some patients may not have access to health care due to permanent changes. Seniors living in areas with poor broadband or low-income Medicare beneficiaries may be particularly vulnerable.
The Center for Medicare Advocacy stated in a press release that “Before making permanent changes, careful study is required to examine whether telehealth is exacerbating disparities in order to determine how to rectify identified problems.”
COVID-19, however, has made it possible for telehealth in some way to continue. Here are some ways you can make the most of it.
Telehealth is a good option.
Telehealth has been used by Medicare beneficiaries to avoid infection. It’s important to keep in mind that not all types of care are suitable for virtual visits. Follow-up visits for existing conditions or diseases work well. However, it’s better to see a doctor in person if you have a new concern.
Christopher Ciano, president and CEO of Aetna Medicare, said that mental health services work especially well online. He believes that remote care may encourage people who might not otherwise be able to access the services they need.
Make the most of the technology that you love
Telehealth providers are limited by laws regarding privacy and government regulations. The pandemic opened up all manners of virtual communication, even everyday tools like Skype and FaceTime.
Bhatnagar states, “We want to make it as simple as a FaceTime call with a loved one to a doctor.”
CMS is also reimbursing providers of telephone services at the same rates as in-person visits. This is a significant change. When you schedule a telehealth appointment, let your provider know which technology you are most comfortable using.
Your copay should be checked
During the pandemic, many Medicare Advantage and Medicare provider insurers waived copays for patients who accessed telehealth services. Going forward, it’s likely Medicare patients will pay the same copay as for in-person doctor visits. It’s a smart idea to inquire about your cost-sharing before you make your appointment due to all the changes in billing that have been triggered by the pandemic.
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