Alliance News2021-05-05T14:08:38-04:00

Alliance for Connected Care Opposes Duplicate Coding for Telehealth Services

The Centers for Medicare and Medicaid Services (CMS) provided a response to our letter. See here for the response from CMS.

The Alliance for Connected Care sent a letter to the Centers for Medicare and Medicaid Services (CMS) regarding the consideration of new telehealth codes as proposed by the American Medical Association (AMA) in 2023.

The AMA Relative Value Scale Update (RUC) Committee in May proposed 17-20 new telehealth codes to be considered in the CMS Medicare Telehealth Services List. The Alliance and its members oppose the creation of new telehealth codes that duplicate services already covered by the Medicare program for the following reasons: 

  1. Telehealth is a modality of care, not a different service. It is therefore inappropriate for CMS to adopt multiple codes for the same service.
  2. Telehealth has expanded access to care for underserved and rural populations. The complexity and potential payment variation created by duplicate codes would hinder CMS’s health equity priorities.
  3. The 17 new codes would leave out 200 services and outpatient codes which telehealth is currently used as a modality for.
  4. There could be significant patient access and operational impacts as the new codes are adopted.

Read the full letter here, or below.

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January 31st, 2024|

JAMA Health Forum: Characteristics of Mental Health Specialists Who Shifted Their Practice Entirely to Telemedicine

JAMA Health Forum: Characteristics of Mental Health Specialists Who Shifted Their Practice Entirely to Telemedicine

While most mental health specialists have in-person and telemedicine visits, some have transitioned to fully virtual practice, perhaps for greater work-life flexibility (including avoiding commuting) and eliminating expenses of maintaining a physical clinic. This study found that, in 2022, 13.0 percent of mental health specialists serving commercially insured or Medicare Advantage enrollees had shifted to telemedicine only. A virtual-only practice allowing clinicians to work from home may be more attractive to female clinicians, who report spending more time on familial responsibilities, and those facing long commutes and higher office-space costs. The research suggests that introducing in-person requirements for visits and prescribing could cause care interruptions, particularly for conditions such as opioid use disorder.

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January 26th, 2024|

The New England Journal of Medicine: Wearable Digital Health Technologies for Monitoring in Cardiovascular Medicine

The New England Journal of Medicine: Wearable Digital Health Technologies for Monitoring in Cardiovascular Medicine

This review article presents a three-part true-life clinical vignette hat illustrates how digital health technology can aid providers caring for patients with cardiovascular disease. Although the uses of remote patient monitoring may be broad and could include management of diabetes and other cardiometabolic conditions, this review focuses on the three most common cardiovascular conditions for which remote patient monitoring is used: hypertension, heart failure, and atrial fibrillation. The foundational elements of remote patient monitoring and wearable technologies are present in cardiovascular practice today and are expected to mature. The overall goals are to shift from episodic care to asynchronous and continuous care, minimize burden on patients and caregivers, reduce structural inequities in access to care, and improve efficiency of evidence-based care delivery.

January 25th, 2024|

Alliance for Connected Care Urges AMA to Ensure Coding for RPM and RTM Accurately Represents Clinical Utilization

The Alliance for Connected Care sent a letter to the American Medical Association’s (AMA) CPT Editorial Panel in response to its February 2024 meeting agenda, which includes Tab 50 – Remote Monitoring. The public agenda seems to indicate major revisions to remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM).

The Alliance is concerned that the revisions to RPM and RTM codes because we do not believe these changes would improve a clinician’s ability to manage care and we are concerned with downstream implications of this change – such as the potential exacerbation of concerns with appropriate utilization and practice expense calculations for the relevant device codes.

The Alliance would like to emphasize four overarching themes around which our response is based:

  1. The Alliance appreciates the proposal to simplify RPM and RTM coding. However, given the significance of the change, we strongly believe the panel should not finalize this proposal without significant additional input and potential modifications from a wider range of stakeholders.
  2. The Alliance believes that RPM and RTM should remain separate for the time being due to different clinical use cases, the evolving nature of the technologies involved, and the relatively new nature of RTM coverage.
  3. The Alliance and its members are concerned with current and potential restrictions on overlapping RPM/RTM services across multiple clinicians and different monitoring services and the implications of this change on those concerns. We believe that simplifying coding like the application proposes would make it harder for payers to support multiple clinicians providing clinically distinct services, exacerbating this ongoing challenge.
  4. While the Alliance agrees that RPM and RTM coding could be simplified and improved, we believe there are other priorities to consider in this conversation, such as addressing uncompensated care for the 20-minute threshold for reimbursement, changes to the calculation of direct practice expense, and coding to support the reporting of multiple medical devices for different conditions.

Read the full letter here, or below.

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January 18th, 2024|

JAMA Network: Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease

JAMA Network: Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease 

A study found receiving care from a palliative telecare team resulted in more improvements in quality of life than usual care among patients with COPD, interstitial lung disease or heart failure. In a single-blind, randomized trial of two Veterans Administration health care systems, researchers split the groups into patients that received palliative telecare from a nurse and social worker team (ADAPT intervention) and usual care (educational handout). Researchers found more improvement in COPD health status and heart failure health status at 6 months among those in the ADAPT group vs. the usual care group.

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January 16th, 2024|

Nature Mental Health: The Digital Divide in Access to Broadband Internet and Mental Health

Nature Mental Health: The Digital Divide in Access to Broadband Internet and Mental Health

A study published in Nature Mental Health found that that US counties with low densities of mental health care resources also have a higher percentage of homes without broadband access. There was an average of 7.03 mental healthcare physicians, 10.86 non-physician mental health practitioners, 1.48 psychiatric and substance abuse hospitals, 1.18 inpatient psychiatric and substance abuse treatment facilities, and 12.33 outpatient facilities available per 100,000 members of the population across US counties. However, US counties with low broadband access had reduced densities of mental health services, with an average of 3.63 mental healthcare physicians, 2.86 non-physician mental health practitioners, 1.33 psychiatric and substance abuse hospitals, 0.94 inpatient psychiatric and substance abuse treatment facilities, and 11.28 outpatient facilities available per 100,000 members of the population. The findings suggest that, while telemedicine may mitigate many key barriers to in-person mental healthcare, lack of broadband access may present an additional barrier to care for individuals already living in medically under-resourced communities.

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January 4th, 2024|

JAMA Network: Increasing Telehealth Access Through Licensure Exceptions

JAMA Network: Increasing Telehealth Access Through Licensure Exceptions

Several researchers from Harvard released a viewpoint article on interstate telehealth. The authors explain how exceptions can be used to connect patients via telehealth with a physician in another state, why this is a more practical and effective strategy, and finally what needs to happen for this to be a feasible solution. Many exceptions are limited in scope and use vague language. A set of well-crafted exceptions to physician licensure requirements designed to support interstate telehealth, adopted consistently across the states or at the federal level, would address the current problems.

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December 14th, 2023|

Alliance for Safe Online Pharmacies: National Consumer Survey Finds Americans Are More Likely To Turn to Scam Online Pharmacies if DEA Curbs Telehealth Rx

Alliance for Safe Online Pharmacies: National Consumer Survey Finds Americans Are More Likely To Turn to Scam Online Pharmacies if DEA Curbs Telehealth Rx

The American for Safe Online Pharmacies released survey data which found that without comprehensive legislative and regulatory policy solutions, Americans will use be unaware of the prescription medicine sellers they encounter online. The survey found:

  • More people buy medications online now than ever before, and that number is rising quickly. 85 percent of Americans who have used an online pharmacy currently use an online pharmacy to fill one or more medications.
  • Demand for convenience and cost-savings is driving consumers to purchase medication online, with recent drug shortages and changes in access likely to fuel a continued rise.
  • 60 percent of Americans who have used online pharmacies would be open to purchasing prescription medicines from an online source not approved by a U.S. regulator if it made ordering medicines more convenient.
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December 6th, 2023|

FAIR Health: Hypertension Became the Top-Ranked Asynchronous Telehealth Diagnosis Nationally

FAIR Health: Hypertension Became the Top-Ranked Asynchronous Telehealth Diagnosis Nationally

According to FAIR Health’s Monthly Telehealth Regional Tracker, hypertension ranked in first place among asynchronous telehealth diagnoses nationally. It had ranked in second place in the earlier months of the year. In September, hypertension increased in its share of asynchronous telehealth claim lines nationally and in every region. In September, diabetes mellitus entered the national top five rankings of asynchronous telehealth diagnoses (at number five) for the first time in 2023.

December 5th, 2023|

MD Revolution: Implementing Remote Patient Monitoring and Chronic Care Management improves Patient Outcomes and Practice Revenues

MD Revolution: Implementing Remote Patient Monitoring and Chronic Care Management improves Patient Outcomes and Practice Revenues

study, commissioned by MD Revolution, found that physician practices and hospitals who have implemented remote patient monitoring (RPM) and chronic care management (CCM) programs are measurably improving patient outcomes, increasing patient satisfaction and simultaneously building practice value.

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December 5th, 2023|
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