Alliance Submits Comments in Response to White House OSTP on Clinical Research Infrastructure and Emergency Clinical Trials
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The Alliance for Connected Care submitted comments in response to the request for information from the White House Office of Science and Technology Policy (OSTP) on clinical research infrastructure and emergency clinical trials .
The Alliance specifically outlined licensure restrictions that present a barrier to clinical trial recruitment and diversity and
present a recommendation for OSTP’s consideration.
As one goal of this emergency clinical trials initiative is to support the expansion of clinical research into underserved communities, and increase diversity among both trial participants and clinical trial investigators, the Alliance believes that continuing to modernize and decentralize clinical trials is critical for creating opportunities for more diversity and patient engagement.
To read the full letter, click here or see below:
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Open in new tab Differences in Telehealth During COVID-19 Between Commercial and Medicaid Enrollee
American Journal of Managed Care: Differences in Telehealth During COVID-19 Between Commercial and Medicaid Enrollees
This study found that during the first year of the COVID-19 pandemic, California managed care enrollees had higher rates of telehealth use compared with Medicare fee-for-service (FFS) enrollees, regardless of insurer. Among FFS enrollees, those enrolled in Medicaid had higher rates of telehealth use compared with those insured by CalPERS. Telehealth policies should be aware of this heterogeneity, as well as its implications for equity of telehealth access.
Alliance Urges CMS to Preserve Beneficiary Access to Telehealth Services
Action Needed to Align Payment with Congressional Authority
On January 13, 2023, the Alliance for Connected Care sent a letter to the Centers for Medicare & Medicaid Services (CMS) regarding the implementation of the telehealth provisions in the Consolidated Appropriations Act, 2023.
Some Medicare telehealth codes are currently scheduled to expire 151 days after the expiration of the COVID-19 public health emergency (PHE). While most telehealth codes can simply be extended in the annual calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS) rulemaking, the timeline is too rapid to address the issue.
The Alliance requests that CMS issue an interim final rule to implement the date changes as per the Consolidated Appropriations Act, 2023.
To read the letter, see below or click here.
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The Alliance for Connected Care also joined a larger stakeholder letter to CMS to extend the availability of the codes that are temporarily on the Medicare Telehealth Services List to align with the Consolidated Appropriations Act of 2023.
Health Systems and Telemedicine Adoption for Diabetes and Hypertension Care
American Journal of Managed Care: Health Systems and Telemedicine Adoption for Diabetes and Hypertension Care
This study examines whether practice size and ownership were associated with more extensive adoption and maintenance of telemedicine for adults with diabetes and/or hypertension during the early stages of the COVID-19 pandemic. The study found that solo physician and advanced practice clinician-only practices had significantly lower telemedicine use among adults with diabetes with or without hypertension, highlighting the need for technical support for small practices. However, practices with higher proportions of Black patients continued to expand telemedicine use through the end of 2020, while practices with lower proportions of Black patients were de-adopting or maintaining telemedicine use levels. Practices with high shares of Black patients may have redesigned care more extensively to accommodate patients during the pandemic.
Maternal Outreach Through Telehealth for Rural Sites: The MOTHeRS Project
North Carolina Medical Journal: Maternal Outreach Through Telehealth for Rural Sites: The MOTHeRS Project
The pandemic brought challenges to rural maternal health. The North Carolina Statewide Telepsychiatry Program (NC-STeP), a statewide telepsychiatry program, used telehealth and health technologies to bring multidisciplinary care to three community-based primary care obstetric clinics. The MOTHeRS (Maternal Outreach through Telehealth for Rural Sites) Project brings the primary obstetrician together with multiple aspects of patient care. Telepsychiatry offers a potential approach for enhancing maternal health care by linking the maternal health practice with an offsite psychiatrist in an integrated care model. Preliminary results show improvement in care access and reduced health disparities.
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Telehealth Delivery of Behavioral Health Care in Medicaid: Findings from a Survey of State Medicaid Programs
Kaiser Family Foundation: Telehealth Delivery of Behavioral Health Care in Medicaid: Findings from a Survey of State Medicaid Programs
Kaiser Family Foundation (KFF) surveyed state Medicaid officials about policies and trends related to telehealth delivery of behavioral health services. The survey found that states most commonly reported adding audio-only telehealth coverage of behavioral health services, which can help facilitate access to care, especially in rural areas with broadband access challenges and for older populations who may struggle to use audiovisual technology. Nearly all states reported expanding behavioral health services that are allowed to be delivered via telehealth, such as to newly allow telehealth delivery of group therapy or medication-assisted treatment (MAT). Finally, most states reported expanding the provider types that may be reimbursed for telehealth delivery of behavioral health services, such as to allow specialists with different licensure requirements (e.g. marriage and family therapists, addiction specialists, and peer specialists). See KFF’s press release for more information.
Estimated Indirect Cost Savings of Using Telehealth Among Nonelderly Patients With Cancer
JAMA Network Open: Estimated Indirect Cost Savings of Using Telehealth Among Nonelderly Patients With Cancer
This economic evaluation of cost savings from completed telehealth visits in a single-institution National Cancer Institute-Designated Comprehensive Cancer Center found that telehealth saves time, travel, and money for patients. The main outcome was estimated patient cost savings from telehealth, which included two components: costs of travel and potential loss of productivity due to the medical visit. Telehealth was associated with savings in patient time and travel costs, which may reduce the financial toxicity of cancer care. Expansion of telehealth oncology services may be an effective strategy to reduce the financial burden among patients with cancer.
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Telehealth Treatment of Behavior Problems in Young Children With Developmental Delay
JAMA Pediatrics: Telehealth Treatment of Behavior Problems in Young Children With Developmental Delay
In this study, young children with developmental delay (DD) saw improvements in behavior after receiving treatment through telehealth. In this randomized clinical trial, behaviors and caregiving stress between child and caregiver were analyzed at preintervention, midtreatment, postintervention, and during 6-month and 12-month follow-ups. A clinically significant change was seen in 74 percent of the internet-delivered parent-child interaction therapy (iPCIT) group analyzed postintervention, compared to 42 percent of the control group. These results indicated positive outcomes from telehealth treatment in maintaining improvements for young children with DD and their caregivers. Investigators hypothesized telehealth could expand the scope and reach of care for low-income families.
Mental Health Service Utilization Rates Among Commercially Insured Adults in the US During the First Year of the COVID-19 Pandemic
JAMA Health Forum: Mental Health Service Utilization Rates Among Commercially Insured Adults in the US During the First Year of the COVID-19 Pandemic
This study found that the weekly rate of in-person mental health service utilization decreased by more than 50 percent after the start of the COVID-19 pandemic but concurrent increases in telehealth led to a slight increase in total utilization for anxiety disorders and stability in total volume of service for other disorders. For the three highest-prevalence diagnostic categories, researchers also found that service utilization continued to increase throughout 2020, primarily in the telehealth context. The findings suggest that the pandemic disrupted in-person mental health care but expansion of telehealth enabled care for an increasing number of patients.
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Alliance for Connected Care Executive Director Featured in The Hill
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Krista Drobac, executive director of the Alliance for Connected Care, was featured in The Hill.
See below for an excerpt:
Clock is still ticking on virtual mental health prescribing
Congress acted last month to extend important telehealth flexibilities that will ensure millions of Americans and their providers will continue to have access to telehealth when the COVID-19 public health emergency is officially over. The importance of these policy extensions can’t be overstated. However, there is one remaining critical action item: prescribing for mental health and substance abuse treatment.
Read the full article here.
For more information about the Alliance’s advocacy in this area, see here.