It was all the rage during the pandemic years. Now, not so much, but experts say it remains popular for certain things
By Stefan Yablonski
There are several factors driving the decline in telehealth utilization in healthcare settings, according to experts.
One reason is cost — many insurance companies are not covering telehealth visits at the same rate as in-person visits, which can make them less attractive to patients.
However, telemedicine is not dead — it still utilized frequently today, according to local healthcare providers.
“Other than the obvious virtual visits for patients with COVID-19 that we are trying to avoid having in waiting rooms, when possible, we use telemedicine when patients are unable to get to the office due to transportation or distance,” said Jessica Digby, physician assistant at Oswego Family Physicians, affiliated with Oswego Health.
“Inpatient consultation by specialists who are not on staff in local hospitals is utilized regularly in many hospitals, including our own.”
Hybrid care that incorporates both virtual and in-person options has become a new standard of care.
“We prefer to see patients in person whenever possible. However, having a virtual option helps us continue to give care to patients where it otherwise may not be accessible,” Digby said.
Prior to COVID, ConnextCare, a health provider with clinics all over Oswego County, didn’t offer any telehealth services — “not because we did not have the equipment to do so, it was mostly driven by the payors and not covering this type of service,” said Tricia Peter-Clark, president and CEO of ConnextCare.
“Once this changed at the start of the pandemic, our telehealth visits soared, especially within our behavioral health program. In the early parts of 2021, each month, telehealth contributed to between 70% – 80% of all of our visits,” she said. “Now, four years later, we still average about 50% of all visits for counseling and psychiatry being done through the virtual platform.”
It truly is a great way to keep the patients connected to essential services without encountering any other barriers, such as transportation, child care, time away from work to come in to the actual office, she added.
The challenge currently is the reimbursement for telehealth visits, according to Peter-Clark.
ConnextCare only receives 1/3 of its total reimbursement when the provider and patient are both offsite.
“This was a practice we did for more than three years during the pandemic as it worked for patients and our provider staff. Now, in order to receive our full reimbursement the provider or the patient have to be in the office,” she said. “ConnextCare moved all of our psychiatry team and social workers back in house, so we would continue to receive our full reimbursement, only to still see 50% of their schedule virtually.”
Designated physical space for the behavioral health team to work within the office limits their ability to expand these services by adding more staff, “as we do not have the office space within any of our locations to accommodate it,” she said.
The fix for this was included in last year’s as well as this year’s state budget.
However, despite support by the Senate and Assembly, it was not supported by the Executive and therefore was omitted in the budget.
“A separate bill was sponsored (Community Health Center Telehealth Payment Parity A.7316 (Paulin)/S.6733 (Rivera),” she said. “This not only impacts us, but all other Article 28’s across New York state.
“Unfortunately despite a tremendous amount of advocacy and support within the Senate and Assembly, this was not addressed before the legislative break. So we are right back to where we started.
“This change would expand access to mental health support at a time when our community really needs it. Without the reimbursement to support the services, we are limited in what more we can do.”
Medicare Telehealth Extended
Recent legislation authorized an extension of many of the Medicare telehealth flexibilities that were in place during the COVID-19 public health emergency through Dec. 31.
Through Dec. 31, 2024, all patients can get telehealth wherever they’re located. They don’t need to be at an originating site and there aren’t any geographic restrictions. A distant site is the location where a physician or practitioner provides telehealth.
Pending acts
The CONNECT for Health Act would permanently remove telehealth geographic restrictions and expand originating site locations to include the patient’s home and remove requirements for in-person visits for behavioral health treatment. It would also allow rural health clinics and federally qualified health centers to serve as distant sites.
The Telehealth Modernization Act would permanently remove geographic originating site restrictions, expand the types of providers eligible to provide telehealth services and extend coverage for audio-only telehealth, among other telehealth flexibilities.
Excellus BlueCross BlueShield: “Telehealth is Here to Stay”
“Telehealth has been an important tool that has expanded options for care for busy patients and providers with packed schedules. It has made it much easier for people to access health care, especially behavioral health support, regardless of where they live or if they have the transportation to access those services,” said physician Lisa Y. Harris, senior vice president, chief medical officer at Excellus BlueCross BlueShield. The company is the largest insurer in Central New York.
“Even after the pandemic, the number of telehealth visits have stayed very high showing that telehealth is a convenient way for our members to receive health care.
“Telehealth is an important tool to make sure our members have access to affordable, high-quality health care. Telehealth is here to stay and it’s a great option for care.”
